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Udi Y, Gilad-Bachrach R, Cohen H, Sagi-Dain L. Impact of body mass index and examination type on utilization of screening programs: A big data study. Prev Med 2024; 185:108045. [PMID: 38901741 DOI: 10.1016/j.ypmed.2024.108045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE To investigate the relationship between Body Mass Index (BMI) and adherence to recommended screening tests, addressing gaps in previous literature by utilizing a large cohort, while considering longitudinal changes in weight and the type of screening. METHODS Data from Clalit Health Services in Israel were retrospectively analyzed, including participants aged 50 and above from 2002 to 2021. BMI measurements and various screening test records were examined. Generalized Estimating Equations were employed for analysis, adjusting for potential confounding variables, including age, gender, geographic location, and socioeconomic status. RESULTS The study included 634,879 participants with 4,630,030 BMI measurements and 56,453,659 test records. Participants were categorized into BMI cohorts at the time of the test, with overweight and obese individuals showing lower odds of undergoing intimate examination-based screening tests (mammography, PAPS, and skin examination), as opposed to higher odds of several non-intimate tests (e.g., diabetes and eye disorder screenings). DISCUSSION Our findings suggest that individuals with overweight and obesity are less likely to undergo screenings involving intimate physical examinations, potentially due to weight stigma and discomfort. This avoidance behavior may contribute to increased morbidity rates in these populations. Interventions addressing weight stigma, improving access to care, and enhancing patient engagement are warranted.
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Affiliation(s)
- Yarin Udi
- Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - Ran Gilad-Bachrach
- Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv, Israel; Edmond J. Safra Center for Bioinformatics, Tel-Aviv University, Tel-Aviv, Israel
| | - Hilla Cohen
- Research Authority, Clalit Health Care Organization, Carmel Medical Center, Haifa, Israel
| | - Lena Sagi-Dain
- Genetics Institute, Obstetrics and Gynecology department, Carmel Medical Center, affiliated to the Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
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2
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Intimayta-Escalante C. Ethnic inequalities in coverage and use of women's cancer screening in Peru. BMC Womens Health 2024; 24:418. [PMID: 39048988 PMCID: PMC11267911 DOI: 10.1186/s12905-024-03225-6] [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: 03/12/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVE This study aimed to assess ethnic inequalities in the coverage and utilization of cancer screening services among women in Peru. METHODS Data from the 2017-2023 Demographic and Family Health Survey in Peru were analyzed to evaluate ethnic disparities in screening coverage for breast and cervical cancer, including clinical breast examination (CBE), Pap smear test (PST), and mammography. Measures such as the GINI coefficient and Slope Index of Inequality (SII) were used to quantify coverage and utilization disparities among ethnic groups. RESULTS The study included 70,454 women aged 30-69. Among women aged 40-69, 48.31% underwent CBE, 84.06% received PST, and 41.69% underwent mammography. It was found inequalities in coverage for any cancer screening (GINI: 0.10), mammography (GINI: 0.21), CBE (GINI: 0.19), and PST (GINI: 0.06), in 25 Peruvian regions. These inequalities were more pronounced in regions with larger populations of Quechua, Aymara, and Afro-Peruvian women. In rural areas, Quechua or Aymara women (SII: -0.83, -0.95, and - 0.69, respectively) and Afro-Peruvian women (SII: -0.80, -0.92, and - 0.58, respectively) experienced heightened inequalities in the uptake of CBE, mammography, and PST, respectively. Like Quechua or Aymara women (SII: -0.50, SII: -0.52, and SII: -0.50, respectively) and Afro-Peruvian women (SII: -0.50, SII: -0.58, and SII: -0.44, respectively) with only a primary education. CONCLUSION Ethnic inequalities affect breast and cervical cancer screening coverage across regions in Peru. In Quechua, Aymara, and Afro-Peruvian women the uptake of mammography, CBE, and PST was less frequently than their white or mestizo counterparts. These inequalities are attributed to sociodemographic conditions such as lower education levels and residence in rural or non-capital areas.
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Affiliation(s)
- Claudio Intimayta-Escalante
- Facultad de Medicina de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru.
- Departamento de Promoción de la Salud, Prevención y Control Nacional del Cáncer, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
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Verhoeven D, Siesling S, Allemani C, Roy PG, Travado L, Bhoo-Pathy N, Rhayns C, Junkermann H, Nakamura S, Lasebikan N, Tucker FL. High-value breast cancer care within resource limitations. Oncologist 2024; 29:e899-e909. [PMID: 38780115 PMCID: PMC11224985 DOI: 10.1093/oncolo/oyae080] [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: 07/06/2022] [Accepted: 03/19/2024] [Indexed: 05/25/2024] Open
Abstract
Breast cancer care is a costly global health issue where effective management depends on early detection and treatment. A breast cancer diagnosis can result in financial catastrophe especially in low- and middle-income countries (LMIC). Large inequities in breast cancer care are observed and represent a global challenge to caregivers and patients. Strategies to improve early diagnosis include awareness and clinical breast examination in LMIC, and screening in high-income countries (HIC). The use of clinical guidelines for the management of breast cancer is needed. Adapted guidelines from HIC can address disparities in populations with limited resources. Locally developed strategies still provide effective guidance in improving survival. Integrated practice units (IPU) with timely multidisciplinary breast care conferences and patient navigators are required to achieve high-value, personalized breast cancer management in HIC as well as LMIC. Breast cancer patient care should include a quality of life evaluation using ideally patient-reported outcomes (PROM) and experience measurements (PREM). Evaluation of breast cancer outcomes must include the financial cost of delivered care. The resulting value perspective should guide resource allocation and program priorities. The value of care must be improved by translating the findings of social and economic research into practice and resolving systemic inequity in clinical breast cancer research. Cancer survivorship programs must be put in place everywhere. The treatment of patients with metastatic breast cancer must require more attention in the future, especially in LMIC.
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Affiliation(s)
- Didier Verhoeven
- Department of Medical Oncology, University of Antwerp, AZ KLINA, Brasschaat, Belgium
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Pankaj Gupta Roy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Luzia Travado
- Champalimaud Clinical and Research Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Nirmala Bhoo-Pathy
- Department of Epidemiology, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Seigo Nakamura
- Division of Breast Surgical Oncology, Department of Surgery, Showa University, Tokyo, Japan
| | - Nwamaka Lasebikan
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
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4
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Li S, Lin Y, Liu G, Shao Z, Yang Y. Unveiling the potential of breast MRI: a game changer for BI-RADS 4A microcalcifications. Breast Cancer Res Treat 2024; 206:425-435. [PMID: 38664289 DOI: 10.1007/s10549-024-07320-y] [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: 02/06/2024] [Accepted: 03/28/2024] [Indexed: 06/19/2024]
Abstract
PURPOSE To assess the diagnostic performance of breast MRI for BI-RADS 4A microcalcifications on mammography and propose a potential clinical pathway to avoid unnecessary biopsies. METHODS Bibliometrics analysis of breast MRI and BI-RADS 4 was provided. A retrospective analysis was conducted on 139 women and 142 cases of BI-RADS 4A microcalcifications on mammography from Fudan University Shanghai Cancer Center. The mammographic BI-RADS level and the MRI reports were compared with the final pathological diagnosis. RESULTS Much attention has been given to breast MRI and BI-RADS 4 in the literature. However, studies on BI-RADS 4A are limited. Pathological results showed 117 cases (82.4%) were benign lesions, malignant cases of 25 (17.6%) in our study. The positive predictive values (PPV), specificity, sensitivity and negative predictive values (NPV) of MRI were 44.2% (23/52), 75.2% (88/117), 92.0% (23/25), and 97.8% (88/90), respectively. Therefore, 75.2% (88/117) of biopsies for benign lesions could potentially be avoided. There were 2.2% (2/90) malignant lesions missed. Logistic regression indicated that patients who are postmenopausal (HR = 2.655, p = 0.012), have a history of breast cancer (family history) (HR = 2.833, p = 0.029), and exhibit clustered microcalcifications (HR = 2.179, p = 0.046) are more likely to have a higher MRI BI-RADS level. CONCLUSIONS Breast MRI has the potential to improve the diagnosis of BI-RADS 4A microcalcifications on mammography. We propose a potential clinical pathway that patients with BI-RADS 4A on mammography who are premenopausal, have no personal history of breast cancer (family history) or have non-clustered distribution of calcifications can undergo MRI to avoid unnecessary biopsies.
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Affiliation(s)
- Shiping Li
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Fudan University, Shanghai Medical College, Shanghai, China
| | - Yihao Lin
- The First School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Guangyu Liu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Fudan University, Shanghai Medical College, Shanghai, China
| | - Zhimin Shao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Fudan University, Shanghai Medical College, Shanghai, China
| | - Yinlong Yang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
- Department of Oncology, Fudan University, Shanghai Medical College, Shanghai, China.
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Bhatt AA, Niell B. Tumor Doubling Time and Screening Interval. Radiol Clin North Am 2024; 62:571-580. [PMID: 38777534 DOI: 10.1016/j.rcl.2023.12.011] [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] [Indexed: 05/25/2024]
Abstract
The goal of screening is to detect breast cancers when still curable to decrease breast cancer-specific mortality. Breast cancer screening in the United States is routinely performed with digital mammography and digital breast tomosynthesis. This article reviews breast cancer doubling time by tumor subtype and examines the impact of doubling time on breast cancer screening intervals. By the article's end, the reader will be better equipped to have informed discussions with patients and medical professionals regarding the benefits and disadvantages of the currently recommended screening mammography intervals.
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Affiliation(s)
- Asha A Bhatt
- Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
| | - Bethany Niell
- Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA; Department of Oncologic Sciences, University of South Florida, 12901 Bruce B. Downs Boulevard MDC 44. Tampa, FL 33612, USA
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Kočo L, Balkenende L, Appelman L, Moman MR, Sponsel A, Schimanski M, Prokop M, Mann RM. Optimized, Person-Centered Workflow Design for a High-Throughput Breast MRI Screening Facility-A Simulation Study. Invest Radiol 2024; 59:538-544. [PMID: 38193779 DOI: 10.1097/rli.0000000000001059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVES This project aims to model an optimal scanning environment for breast magnetic resonance imaging (MRI) screening based on real-life data to identify to what extent the logistics of breast MRI can be optimized. MATERIALS AND METHODS A novel concept for a breast MRI screening facility was developed considering layout of the building, workflow steps, used resources, and MRI protocols. The envisioned screening facility is person centered and aims for an efficient workflow-oriented design. Real-life data, collected from existing breast MRI screening workflows, during 62 scans in 3 different hospitals, were imported into a 3D simulation software for designing and testing new concepts. The model provided several realistic, virtual, logistical pathways for MRI screening and their outcome measures: throughput, waiting times, and other relevant variables. RESULTS The total average appointment time in the baseline scenario was 25:54 minutes, with 19:06 minutes of MRI room occupation. Simulated improvements consisted of optimizing processes and resources, facility layout, and scanning protocol. In the simulation, time spent in the MRI room was reduced by introducing an optimized facility layout, dockable tables, and adoption of an abbreviated MRI scanning protocol. The total average appointment time was reduced to 19:36 minutes, and in this scenario, the MRI room was occupied for 06:21 minutes. In the most promising scenario, screening of about 68 people per day (10 hours) on a single MRI scanner could be feasible, compared with 36 people per day in the baseline scenario. CONCLUSIONS This study suggests that by optimizing workflow MRI for breast screening total appointment duration and MRI occupation can be reduced. A throughput of up to 6 people per hour may be achieved, compared with 3 people per hour in the current setup.
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Affiliation(s)
- Lejla Kočo
- From the Department of Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (L.K., L.A., M.P., R.M.M.); Department of Radiology, The Netherlands Cancer Institute (Antoni van Leeuwenhoek), Amsterdam, the Netherlands (L.B., R.M.M.); Department of Radiology, Alexander Monro Hospital, Bilthoven, the Netherlands (L.A., M.R.M.); and Siemens Healthcare GmbH, Erlangen, Germany (A.S., M.S.)
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7
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Park JY, Jeon JY, Cha S. Ultrasonographic features of the skin and subcutis: correlations with the severity of breast cancer-related lymphedema. Ultrasonography 2024; 43:284-293. [PMID: 38881309 PMCID: PMC11222127 DOI: 10.14366/usg.24059] [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: 04/07/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024] Open
Abstract
PURPOSE Assessing the severity of breast cancer-related lymphedema (BCRL) requires various clinical tools, yet no standardized methodology is available. Ultrasonography shows promise for diagnosing lymphedema and evaluating its severity. This study explored the clinical utility of ultrasonography in patients with BCRL. METHODS In this retrospective cross-sectional study, patients with unilateral BCRL were examined. The analyzed data included demographics, lymphedema location, International Society of Lymphology (ISL) stage, surgical history, treatment regimens, and arm circumference. Skin, subcutis, and muscle thicknesses were assessed ultrasonographically at predetermined sites, and the percentage of excess thickness was calculated. Multivariate logistic regression analysis was employed to identify associations between ultrasonographic measurements and advanced lymphedema (ISL 2 or 3). The Lymphedema Quality of Life arm questionnaire was used to evaluate patient-reported outcomes regarding lymphedema and their correlations with ultrasonographic findings. RESULTS Among 118 patients, 71 were classified as ISL 0-1 and 47 as ISL 2-3. Patients with advanced lymphedema were older, had higher nodal stages, underwent more axillary lymph node dissections, and had higher rates of dominant-arm lymphedema. Multivariate logistic regression revealed significant associations of greater skin thickness (adjusted odds ratio [OR], 4.634; 95% confidence interval [CI], 1.233 to 17.419), subcutis thickness (adjusted OR, 7.741; 95% CI, 1.649 to 36.347), and subcutis echogenicity (adjusted OR, 4.860; 95% CI, 1.517 to 15.566) with advanced lymphedema. Furthermore, greater skin thickness (P=0.016) and subcutis echogenicity (P=0.023) were correlated with appearance-related discomfort. CONCLUSION Ultrasonographic measurements were significantly associated with advanced lymphedema in BCRL. Ultrasonography represents a valuable diagnostic and severity assessment tool for lymphedema.
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Affiliation(s)
- Ji Youn Park
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Yong Jeon
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seungwoo Cha
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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8
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Bell KJ, Nickel B, Pathirana T, Blennerhassett M, Carter S. Breast cancer screening from age 40 in the US. BMJ 2024; 385:q1353. [PMID: 38914429 DOI: 10.1136/bmj.q1353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Affiliation(s)
- Katy Jl Bell
- Sydney School of Public Health, University of Sydney, NSW, Australia
- Wiser Healthcare Research Collaboration, Australia
| | - Brooke Nickel
- Sydney School of Public Health, University of Sydney, NSW, Australia
- Wiser Healthcare Research Collaboration, Australia
| | - Thanya Pathirana
- Wiser Healthcare Research Collaboration, Australia
- School of Medicine and Dentistry, Griffith University, Sunshine Coast, QLD, Australia
| | | | - Stacy Carter
- Wiser Healthcare Research Collaboration, Australia
- Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, University of Wollongong, NSW, Australia
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9
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Erkan M, Ozcan SGG. Breast arterial calcification is associated with sarcopenia in peri- and post-menopausal women. Clin Imaging 2024; 110:110143. [PMID: 38696996 DOI: 10.1016/j.clinimag.2024.110143] [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: 01/16/2024] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 05/04/2024]
Abstract
PURPOSE Breast arterial calcification (BAC) refers to medial calcium deposition in breast arteries and is detectable via mammography. Sarcopenia, which is characterised by low skeletal muscle mass and quality, is associated with several serious clinical conditions, increased morbidity, and mortality. Both BAC and sarcopenia share common pathologic pathways, including ageing, diabetes, and chronic kidney disease. Therefore, this study evaluated the relationship between BAC and sarcopenia as a potential indicator of sarcopenia. METHODS This study involved women aged >40. BAC was evaluated using digital mammography and was defined as vascular calcification. Sarcopenia was assessed using abdominal computed tomography. The cross-sectional skeletal mass area was measured at the third lumbar vertebra level. The skeletal mass index was obtained by dividing the skeletal mass area by height in square meters(m2). Sarcopenia was defined as a skeletal mass index of ≤38.5 cm2/m2. A multivariable model was used to evaluate the relationship between BAC and sarcopenia. RESULTS The study involved 240 participants. Of these, 36 (15 %) were patients with BAC and 204 (85 %) were without BAC. Sarcopenia was significantly higher among the patients with BAC than in those without BAC (72.2 % vs 17.2 %, P < 0.001). The multivariable model revealed that BAC and age were independently associated with sarcopenia (odds ratio[OR]: 7.719, 95 % confidence interval[CI]: 3.201-18.614, and P < 0.001 for BAC and OR: 1.039, 95 % CI: 1.007-1.073, P = 0.01 for age). CONCLUSION BAC is independently associated with sarcopenia. BAC might be used as an indicator of sarcopenia on screening mammography.
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Affiliation(s)
- Merve Erkan
- Department of Radiology, Bursa Yuksek Ihtisas Training and Research Hospital, Mimar Sinan Mah. Polis Okulu Karsisi, Emniyet Cad, 16310 Yildirim, Bursa, Turkey.
| | - Seray Gizem Gur Ozcan
- Department of Radiology, Bursa Yuksek Ihtisas Training and Research Hospital, Mimar Sinan Mah. Polis Okulu Karsisi, Emniyet Cad, 16310 Yildirim, Bursa, Turkey
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10
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Chan DNS, Li C, Law BMH, Xu B, Kwok C. Factors Influencing the Utilisation of Mammography Among Ethnic Minorities: A Framework-Driven Systematic Review and Meta-Analysis. J Immigr Minor Health 2024; 26:569-595. [PMID: 37946094 DOI: 10.1007/s10903-023-01564-4] [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] [Accepted: 10/13/2023] [Indexed: 11/12/2023]
Abstract
Ethnic minority women experience disparities in mammography screening utilisation and breast cancer outcomes. This systematic review and meta-analysis synthesised multidomain and multilevel factors that intersect to influence the utilisation of mammography among ethnic minorities. A literature search was conducted in five databases (PubMed, Ovid MEDLINE, EMBASE, CINAHL, and PsycINFO) from inception to May 2022. Guided by the National Institute on Minority Health and Health Disparity research framework, the retrieved data were synthesised using narrative summaries and meta-analyses. Among the 27 studies, most (n = 24) reported individual, interpersonal, and community factors in the health care system domain. In the sociocultural domain, interpersonal and societal (n = 8) factors, such as modesty and karma beliefs, were less frequently identified than individual (n = 20) factors in relation to acculturation. Only individual-level factors were reported for the biological and physical/built environment (e.g., rural residence) domains. In the behavioural domain, cancer screening behaviours had a high combined prediction ability (odds ratio = 18.23; I2 = 23%), whereas interpersonal (e.g., family obligations) and community (e.g., neighbourhood violence) factors discouraged mammography screening. Special focus should be given to ethnic minority women, especially those living in rural areas, those with considerable family obligations, and those who have suffered from violence and other life pressures, to increase their access to mammography services. Multidomain and multilevel efforts, culturally appropriate strategies, and equity-advancing policies such as geographic access and insurance coverage would help to mitigate the ethnic disparities in mammography screening.
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Affiliation(s)
- D N S Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Bldg, Shatin, N.T., Hong Kong, China.
| | - C Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Bldg, Shatin, N.T., Hong Kong, China
| | - B M H Law
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Bldg, Shatin, N.T., Hong Kong, China
| | - B Xu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Bldg, Shatin, N.T., Hong Kong, China
| | - C Kwok
- School of Nursing, Paramedicine and Health Care Science, Faculty of Science and Health, Charles Sturt University, Bathurst, Australia
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11
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Goerdt L, Schnaubelt R, Kraus-Tiefenbacher U, Brück V, Bauer L, Dinges S, von der Assen A, Meye H, Kaiser C, Weiss C, Clausen S, Schneider F, Abo-Madyan Y, Fleckenstein K, Berlit S, Tuschy B, Sütterlin M, Wenz F, Sperk E. Acute and Long-Term Toxicity after Planned Intraoperative Boost and Whole Breast Irradiation in High-Risk Patients with Breast Cancer-Results from the Targeted Intraoperative Radiotherapy Boost Quality Registry (TARGIT BQR). Cancers (Basel) 2024; 16:2067. [PMID: 38893184 PMCID: PMC11171237 DOI: 10.3390/cancers16112067] [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: 04/30/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
In the context of breast cancer treatment optimization, this study prospectively examines the feasibility and outcomes of utilizing intraoperative radiotherapy (IORT) as a boost in combination with standard external beam radiotherapy (EBRT) for high-risk patients. Different guidelines recommend such a tumor bed boost in addition to whole breast irradiation with EBRT for patients with risk factors for local breast cancer recurrence. The TARGIT BQR (NCT01440010) is a prospective, multicenter registry study aimed at ensuring the quality of clinical outcomes. It provides, for the first time, data from a large cohort with a detailed assessment of acute and long-term toxicity following an IORT boost using low-energy X-rays. Inclusion criteria encompassed tumors up to 3.5 cm in size and preoperative indications for a boost. The IORT boost, administered immediately after tumor resection, delivered a single dose of 20 Gy. EBRT and systemic therapy adhered to local tumor board recommendations. Follow-up for toxicity assessment (LENT SOMA criteria: fibrosis, teleangiectasia, retraction, pain, breast edema, lymphedema, hyperpigmentation, ulceration) took place before surgery, 6 weeks to 90 days after EBRT, 6 months after IORT, and then annually using standardized case report forms (CRFs). Between 2011 and 2020, 1133 patients from 10 centers were preoperatively enrolled. The planned IORT boost was conducted in 90%, and EBRT in 97% of cases. Median follow-up was 32 months (range 1-120, 20.4% dropped out), with a median age of 61 years (range 30-90). No acute grade 3 or 4 toxicities were observed. Acute side effects included erythema grade 1 or 2 in 4.4%, palpable seroma in 9.1%, punctured seroma in 0.3%, and wound healing disorders in 2.1%. Overall, chronic teleangiectasia of any grade occurred in 16.2%, fibrosis grade ≥ 2 in 14.3%, pain grade ≥ 2 in 3.4%, and hyperpigmentation in 1.1%. In conclusion, a tumor bed boost through IORT using low-energy X-rays is a swift and feasible method that demonstrates low rates in terms of acute or long-term toxicity profiles in combination with whole breast irradiation.
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Affiliation(s)
- Lukas Goerdt
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (L.G.)
| | - Robert Schnaubelt
- Radiation Oncology, MVZ Rheinland Klinikum Neuss, 41462 Neuss, Germany
| | - Uta Kraus-Tiefenbacher
- Department of Radiation Oncology, Krankenhaus Nordwest, 60488 Frankfurt am Main, Germany
| | - Viktoria Brück
- Breast Center, Asklepios Klinik Barmbek, 22307 Hamburg, Germany
| | - Lelia Bauer
- Breast Center, GRN Klinik Weinheim, 69469 Weinheim, Germany
| | - Stefan Dinges
- Department of Radiation Oncology, Städtisches Klinikum Lüneburg, 21339 Lüneburg, Germany
| | - Albert von der Assen
- Breast Center, Department of Senology, Franziskus Hospital Harderberg—Niels Stensen Kliniken, 49124 Georgsmarienhütte, Germany
| | - Heidrun Meye
- Department of Radiation Oncology, MVZ Gesundheit Nordhessen, 34125 Kassel, Germany
| | - Christina Kaiser
- University Medical Center Bonn, Medical Faculty Bonn, Bonn University, 53113 Bonn, Germany
| | - Christel Weiss
- Department of Medical Biometry, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Sven Clausen
- Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Frank Schneider
- Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Yasser Abo-Madyan
- Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Katharina Fleckenstein
- Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Sebastian Berlit
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (L.G.)
| | - Benjamin Tuschy
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (L.G.)
| | - Marc Sütterlin
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (L.G.)
| | - Frederik Wenz
- University Hospital Freiburg, 79106 Freiburg, Germany
| | - Elena Sperk
- Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
- Mannheim Cancer Center, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
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12
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Alvarenga P, Park JY, Pinto R, Parente D, Lajkosz K, Westergard S, Ghai S, Kim R, Kulkarni S, Au F, Chamadoira J, Freitas V. Decoding the Prevalent High-Risk Breast Cancers: Demographics, Pathological, Imaging Insights, and Long-Term Outcome. Can Assoc Radiol J 2024:8465371241253254. [PMID: 38795027 DOI: 10.1177/08465371241253254] [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: 05/27/2024] Open
Abstract
Objective: To investigate the features and outcomes of breast cancer in high-risk subgroups. Materials and Methods: REB approved an observational study of women diagnosed with breast cancer from 2010 to 2019. Three radiologists, using the BI-RADS lexicon, blindly reviewed mammogram and MRI screenings without a washout period. Consensus was reached with 2 additional reviewers. Inter-rater agreement was measured by Fleiss Kappa. Statistical analysis included Mann-Whitney U, Chi-square tests for cohort analysis, and Kaplan-Meier for survival rates, with a Cox model for comparative analysis using gene mutation as a reference. Results: The study included 140 high-risk women, finding 155 malignant lesions. Significant age differences noted: chest radiation therapy (median age 44, IQR: 37.0-46.2), gene mutation (median age 49, IQR: 39.8-58.0), and familial risk (median age 51, IQR: 44.5-56.0) (P = .007). Gene mutation carriers had smaller (P = .01), higher-grade tumours (P = .002), and more triple-negative ER- (P = .02), PR- (P = .002), and HER2- (P = .02) cases. MRI outperformed mammography in all subgroups. Substantial to near-perfect inter-rater agreement observed. Over 10 years, no deaths occurred in chest radiation group, with no significant survival difference between gene mutation and familial risk groups, HR = 0.93 (95% CI: 0.27, 3.26), P = .92. Conclusion: The study highlights the importance of age and specific tumour characteristics in identifying high-risk breast cancer subgroups. MRI is confirmed as an effective screening tool. Despite the aggressive nature of cancers in gene mutation carriers, early detection is crucial for survival outcomes. These insights, while necessitating further validation with larger studies, advocate for a move toward personalized medical care, strengthening the existing healthcare guidelines.
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Affiliation(s)
- Pedro Alvarenga
- Temerty Faculty of Medicine, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Ji Yeon Park
- Department of Radiology, Inje University Ilsan Paik Hospital, Gimhae-si, Gyeongsangnam-do, Republic of Korea
| | - Renata Pinto
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
- National Cancer Institute, Rio de Janeiro, Brazil
| | | | - Katherine Lajkosz
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Shelley Westergard
- Average and High-Risk Ontario Breast Screening Program, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Sandeep Ghai
- Temerty Faculty of Medicine, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Raymond Kim
- Department of Medicine, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Sinai Health System, Hospital for Sick Children, Ontario Institute for Cancer Research, University of Toronto, Toronto, ON, Canada
| | - Supriya Kulkarni
- Temerty Faculty of Medicine, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Frederick Au
- Temerty Faculty of Medicine, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Juliana Chamadoira
- Temerty Faculty of Medicine, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Vivianne Freitas
- Temerty Faculty of Medicine, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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13
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Liu S, Zheng S, Qin M, Xie Y, Yang K, Liu X. Knowledge, attitude, and practice toward ultrasound screening for breast cancer among women. Front Public Health 2024; 12:1309797. [PMID: 38855455 PMCID: PMC11160319 DOI: 10.3389/fpubh.2024.1309797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 05/06/2024] [Indexed: 06/11/2024] Open
Abstract
Background Several obstacles can hinder breast cancer screening. This study aimed to investigate the knowledge, attitude, and practice (KAP) toward ultrasound screening for breast cancer in women. Methods This cross-sectional study recruited women who visited the breast specialist clinic of Zhongshan City People's Hospital (a tertiary hospital) between August 2022 and April 2023 through convenience sampling. KAP scores ≥70% were considered adequate. Results This study enrolled 501 participants. The mean knowledge, attitude, and practice levels were 8.56 ± 1.81/12 (possible range 0-12, 71.33%), 29.80 ± 2.71 (possible range 8-40, 74.50%), and 32.04 ± 3.09 (possible range 8-40, 80.10%). Senior high school education (vs. junior high school and below, coefficient = 1.531, 95%CI: 1.013-2.312, p = 0.044), bachelor's education and above (vs. junior high school and below, coefficient = 5.315, 95%CI: 3.546-7.966, p < 0.001), housewife or unemployed (vs. employed, coefficient = 0.671, 95%CI: 0.466-0.966, p = 0.032), and a history of breast ultrasound (vs. no, coefficient = 1.466, 95%CI: 1.121-1.917, p = 0.005) were independently and positively associated with knowledge. Knowledge (coefficient = 1.303, 95%CI: 1.100-1.544, p = 0.002) and monthly income >10,000 (vs. <5,000, coefficient = 4.364, 95%CI: 1.738-10.956, p = 0.002) were independently and positively associated with attitude. Only attitude (coefficient = 1.212, 95%CI: 1.096-1.340, p < 0.001) was independently and positively associated with the practice. A structural equation modeling (SEM) analysis was used to estimate causality among KAP dimensions, showing that knowledge directly influenced attitude (β = -1.090, p = 0.015), knowledge did not directly influence practice (β = -0.117, p = 0.681) but had an indirect influence (β = 0.826, p = 0.028), and attitude directly influenced practice (β = -0.757, p = 0.016). Conclusion Women in Zhongshan City had good knowledge, favorable attitudes, and active practice toward breast ultrasound screening for breast cancer. Women's characteristics associated with a poorer KAP were identified, allowing for more targeted interventions.
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Affiliation(s)
- Shaozhong Liu
- Department of Ultrasound Imaging, Zhongshan City People’s Hospital, Zhongshan, China
| | - Shukai Zheng
- Department of Breast Surgery, Zhongshan City People’s Hospital, Zhongshan, China
| | - Mengzhen Qin
- Department of Ultrasound Imaging, Zhongshan City People’s Hospital, Zhongshan, China
| | - Yifeng Xie
- Department of Ultrasound Imaging, Zhongshan City People’s Hospital, Zhongshan, China
| | - Kun Yang
- Department of Ultrasound Imaging, Zhongshan City People’s Hospital, Zhongshan, China
| | - Xiaozhen Liu
- Department of Ultrasound Imaging, Zhongshan City People’s Hospital, Zhongshan, China
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14
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Kerpel-Fronius A, Megyesfalvi Z, Markóczy Z, Solymosi D, Csányi P, Tisza J, Kecskés A, Baranyi B, Csánky E, Dóka A, Gálffy G, Göcző K, Győry C, Horváth Z, Juhász T, Kállai Á, Kincses ZT, Király Z, Király-Incze E, Kostyál L, Kovács A, Kovács A, Kuczkó É, Makra Z, Maurovich Horvát P, Merth G, Moldoványi I, Müller V, Pápai-Székely Z, Papp D, Polgár C, Rózsa P, Sárosi V, Szalai Z, Székely A, Szuhács M, Tárnoki D, Tavaszi G, Turóczi-Kirizs R, Tóth L, Urbán L, Vaskó A, Vigh É, Dome B, Bogos K. HUNCHEST-II contributes to a shift to earlier-stage lung cancer detection: final results of a nationwide screening program. Eur Radiol 2024; 34:3462-3470. [PMID: 37921926 DOI: 10.1007/s00330-023-10379-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVES The introduction of low-dose CT (LDCT) altered the landscape of lung cancer (LC) screening and contributed to the reduction of mortality rates worldwide. Here we report the final results of HUNCHEST-II, the largest population-based LDCT screening program in Hungary, including the screening and diagnostic outcomes, and the characteristics of the LC cases. METHODS A total of 4215 high-risk individuals aged between 50 and 75 years with a smoking history of at least 25 pack-years were assigned to undergo LDCT screening. Screening outcomes were determined based on the volume, growth, and volume doubling time of pulmonary nodules or masses. The clinical stage distribution of screen-detected cancers was compared with two independent practice-based databases consisting of unscreened LC patients. RESULTS The percentage of negative and indeterminate tests at baseline were 74.2% and 21.7%, respectively, whereas the prevalence of positive LDCT results was 4.1%. Overall, 76 LC patients were diagnosed throughout the screening rounds (1.8% of total participants), out of which 62 (1.5%) patients were already identified in the first screening round. The overall positive predictive value of a positive test was 58%. Most screen-detected malignancies were stage I LCs (60.7%), and only 16.4% of all cases could be classified as stage IV disease. The percentage of early-stage malignancies was significantly higher among HUNCHEST-II screen-detected individuals than among the LC patients in the National Koranyi Institute of Pulmonology's archive or the Hungarian Cancer Registry (p < 0.001). CONCLUSIONS HUNCHEST-II demonstrates that LDCT screening for LC facilitates early diagnosis, thus arguing in favor of introducing systematic LC screening in Hungary. CLINICAL RELEVANCE STATEMENT HUNCHEST-II is the so-far largest population-based low-dose CT screening program in Hungary. A positive test's overall positive predictive value was 58%, and most screen-detected malignancies were early-stage lesions. These results pave the way for expansive systematic screening in the region. KEY POINTS • Conducted in 18 medical facilities, HUNCHEST-II is the so far largest population-based low-dose CT screening program in Hungary. • The vast majority of screen-detected malignancies were early-stage lung cancers, and the overall positive predictive value of a positive test was 58%. • HUNCHEST-II facilitates early diagnosis, thus arguing in favor of introducing systematic lung cancer screening in Hungary.
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Affiliation(s)
| | - Zsolt Megyesfalvi
- National Koranyi Institute of Pulmonology, Budapest, Hungary
- Department of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Budapest, Hungary
- Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Zsolt Markóczy
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Diana Solymosi
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Péter Csányi
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Judit Tisza
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Anita Kecskés
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | | | - Eszter Csánky
- Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital - Semmelweis Member State Hospital, Miskolc, Hungary
| | - Adrienn Dóka
- Vas County Markusovszky University Teaching Hospital, Szombathely, Hungary
| | | | - Katalin Göcző
- Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
| | - Csilla Győry
- Petz Aladár University Teaching Hospital, Győr, Hungary
| | - Zsolt Horváth
- Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
| | - Tünde Juhász
- Szabolcs-Szatmár-Bereg County Hospitals and University Teaching, Nyíregyháza, Hungary
| | - Árpád Kállai
- Hódmezővásárhely- Makó Healthcare Services Center, Hódmezővásárhely, Hungary
| | - Zsigmond T Kincses
- Department of Radiology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Zsolt Király
- Pulmonological Institute of Veszprém County, Farkasgyepű, Hungary
| | - Enikő Király-Incze
- Fejér County Szent György University Teaching Hospital, Székesfehérvár, Hungary
| | - László Kostyál
- Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital - Semmelweis Member State Hospital, Miskolc, Hungary
| | - Anita Kovács
- Department of Radiology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - András Kovács
- Medical School and Clinical Centre, University of Pecs, Pecs, Hungary
| | - Éva Kuczkó
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
| | - Zsuzsanna Makra
- Hódmezővásárhely- Makó Healthcare Services Center, Hódmezővásárhely, Hungary
| | | | | | | | | | - Zsolt Pápai-Székely
- Fejér County Szent György University Teaching Hospital, Székesfehérvár, Hungary
| | - Dávid Papp
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
| | - Csaba Polgár
- National Institute of Oncology, Budapest, Hungary
| | - Péter Rózsa
- Medical School and Clinical Centre, University of Pecs, Pecs, Hungary
- MediConcept, Budapest, Hungary
| | - Veronika Sárosi
- Medical School and Clinical Centre, University of Pecs, Pecs, Hungary
| | | | | | - Marianna Szuhács
- Szabolcs-Szatmár-Bereg County Hospitals and University Teaching, Nyíregyháza, Hungary
| | | | - Gábor Tavaszi
- Törökbálint Institute of Pulmonology, Törökbálint, Hungary
| | | | | | | | | | - Éva Vigh
- Vas County Markusovszky University Teaching Hospital, Szombathely, Hungary
| | - Balazs Dome
- National Koranyi Institute of Pulmonology, Budapest, Hungary.
- Department of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Budapest, Hungary.
- Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
- Department of Translational Medicine, Lund University, Lund, Sweden.
| | - Krisztina Bogos
- National Koranyi Institute of Pulmonology, Budapest, Hungary
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15
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Larsen M, Olstad CF, Lee CI, Hovda T, Hoff SR, Martiniussen MA, Mikalsen KØ, Lund-Hanssen H, Solli HS, Silberhorn M, Sulheim ÅØ, Auensen S, Nygård JF, Hofvind S. Performance of an Artificial Intelligence System for Breast Cancer Detection on Screening Mammograms from BreastScreen Norway. Radiol Artif Intell 2024; 6:e230375. [PMID: 38597784 PMCID: PMC11140504 DOI: 10.1148/ryai.230375] [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: 09/06/2023] [Revised: 02/18/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
Purpose To explore the stand-alone breast cancer detection performance, at different risk score thresholds, of a commercially available artificial intelligence (AI) system. Materials and Methods This retrospective study included information from 661 695 digital mammographic examinations performed among 242 629 female individuals screened as a part of BreastScreen Norway, 2004-2018. The study sample included 3807 screen-detected cancers and 1110 interval breast cancers. A continuous examination-level risk score by the AI system was used to measure performance as the area under the receiver operating characteristic curve (AUC) with 95% CIs and cancer detection at different AI risk score thresholds. Results The AUC of the AI system was 0.93 (95% CI: 0.92, 0.93) for screen-detected cancers and interval breast cancers combined and 0.97 (95% CI: 0.97, 0.97) for screen-detected cancers. In a setting where 10% of the examinations with the highest AI risk scores were defined as positive and 90% with the lowest scores as negative, 92.0% (3502 of 3807) of the screen-detected cancers and 44.6% (495 of 1110) of the interval breast cancers were identified with AI. In this scenario, 68.5% (10 987 of 16 040) of false-positive screening results (negative recall assessment) were considered negative by AI. When 50% was used as the cutoff, 99.3% (3781 of 3807) of the screen-detected cancers and 85.2% (946 of 1110) of the interval breast cancers were identified as positive by AI, whereas 17.0% (2725 of 16 040) of the false-positive results were considered negative. Conclusion The AI system showed high performance in detecting breast cancers within 2 years of screening mammography and a potential for use to triage low-risk mammograms to reduce radiologist workload. Keywords: Mammography, Breast, Screening, Convolutional Neural Network (CNN), Deep Learning Algorithms Supplemental material is available for this article. © RSNA, 2024 See also commentary by Bahl and Do in this issue.
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Affiliation(s)
- Marthe Larsen
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Camilla F. Olstad
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Christoph I. Lee
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Tone Hovda
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Solveig R. Hoff
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Marit A. Martiniussen
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Karl Øyvind Mikalsen
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Håkon Lund-Hanssen
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Helene S. Solli
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Marko Silberhorn
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Åse Ø. Sulheim
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Steinar Auensen
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Jan F. Nygård
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
| | - Solveig Hofvind
- From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.)
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Dorji T, Wangmo S, Dargay S, Dorji N, Dorjey Y, Pradhan B, Pema D, Dema C, Choden J, Dorji T, Mynak ML, Pempa, Jamphel K. Population-level cancer screening and cancer care in Bhutan, 2020-2023: a review. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 24:100370. [PMID: 38444883 PMCID: PMC10910341 DOI: 10.1016/j.lansea.2024.100370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/25/2024] [Accepted: 02/05/2024] [Indexed: 03/07/2024]
Abstract
Screening of cancers is an important intervention in reducing the incidence and mortality related to cancers. Bhutan is one small country that is witnessing an increasing incidence and mortality related to cancers. The government implemented a time-bound population-level screening for gastric, cervical and breast cancers from 2020 to 2023 with an overall coverage of 91.2% of the eligible population. Among 370,225 individuals screened for H pylori, 32.4% tested positive; among 53,182 who underwent upper gastrointestinal endoscopy and biopsy, 255 (0.07%) had gastric cancer. Among 10,749 tested for HPV DNA, 9.3% were positive; among 9887 evaluated with colposcopy and biopsy, 154 (0.13%) had cervical cancer. For breast cancer screening, 72,283 underwent clinical breast examination, 845 mammography and cancer was detected in 73 (0.10%) individuals. In this article, we review how Bhutan implemented a population-level cancer screening programme with on boarding of multiple stakeholders and the participation of people across all districts.
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Affiliation(s)
- Thinley Dorji
- Department of Internal Medicine, Central Regional Referral Hospital, Gelephu, Bhutan
| | - Sangay Wangmo
- Department of Surgery, Central Regional Referral Hospital, Gelephu, Bhutan
| | - Sonam Dargay
- Department of Surgery, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Namkha Dorji
- Department of Obstetrics and Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Yeshey Dorjey
- Department of Obstetrics and Gynaecology, Phuentsholing General Hospital, Phuentsholing, Bhutan
| | - Birendra Pradhan
- Department of Pathology and Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Dechen Pema
- Department of Radiodiagnosis and Imaging, Central Regional Referral Hospital, Gelephu, Bhutan
| | - Choney Dema
- National Medical Services, Ministry of Health, Thimphu, Bhutan
| | - Jamyang Choden
- Department of Health Services, Ministry of Health, Thimphu, Bhutan
| | | | | | - Pempa
- Department of Health Services, Ministry of Health, Thimphu, Bhutan
| | - Kinga Jamphel
- Department of Health Services, Ministry of Health, Thimphu, Bhutan
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Lovato A, Biral M, Postiglione M, Gagliardi G, Gagliardi V, Ceccherelli F. A Possible Correlation Between Auricular Angiomas and Breast Cancer Through Auricular Acupuncture Diagnosis: An Observational Case-Control Study. Cureus 2024; 16:e60834. [PMID: 38910685 PMCID: PMC11190853 DOI: 10.7759/cureus.60834] [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] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Auricular acupuncture (AA) can be used for both diagnosis and therapy. Diagnosis done with AA has become more prominent, with inspection by evaluating skin alterations considered the most important step. Literature on AA diagnosis in cancer patients is scarce. Globally, breast cancer (BC) is the most commonly diagnosed cancer in women. Materials and methods Subjects accessing the outpatient Breast Unit Clinic of Padua for BC were evaluated for auricle angiomas, with collected data including a number of angiomas, Romoli's Sectogram sector of identified angiomas, laterality of the auricle with the angioma, age, and laterality of BC. Results Of the 438 subjects evaluated, 129 had BC, and 64 had an identifiable auricle angioma. The odds of an auricular angioma were higher in subjects with BC diagnosis, mainly localized in tumor area II and predominantly ipsilateral to the side affected by BC. Conclusions AA auricle inspection is a simple, quick, and easy diagnostic tool. Screening for the presence and location of auricular angiomas may help health practitioners refer women for BC screening for early diagnosis.
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Affiliation(s)
- Antonello Lovato
- Integrative Medicine, Pain Therapy Clinic, Vicenza, ITA
- Complementary Medicine, A.I.R.A.S. (Italian Association for the Research and the Scientific Update), Padua, ITA
| | - Mario Biral
- Complementary Medicine, A.I.R.A.S. (Italian Association for the Research and the Scientific Update), Padua, ITA
| | - Marco Postiglione
- Epidemiology and Public Health, A.I.R.A.S. (Italian Association for the Research and the Scientific Update), Padua, ITA
| | - Giuseppe Gagliardi
- Anesthesiology, AULSS 5 Polesana, Rovigo, ITA
- Pain Therapy, A.I.R.A.S. (Italian Association for the Research and the Scientific Update), Padua, ITA
| | | | - Francesco Ceccherelli
- Anesthesiology and Pain Therapy, A.I.R.A.S. (Italian Association for the Research and the Scientific Update), Padua, ITA
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Song H, Tran TXM, Kim S, Park B. Risk Factors and Mortality Among Women With Interval Breast Cancer vs Screen-Detected Breast Cancer. JAMA Netw Open 2024; 7:e2411927. [PMID: 38767918 PMCID: PMC11107304 DOI: 10.1001/jamanetworkopen.2024.11927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/17/2024] [Indexed: 05/22/2024] Open
Abstract
Importance The risk factors for interval breast cancer (IBC) compared with those for screen-detected breast cancer (SBC) and their association with mortality outcomes have not yet been evaluated among Korean women. Objective To evaluate risk factors associated with IBC and survival among Korean women with IBC compared with those with SBC. Design, Setting, and Participants This retrospective cohort study used data from the Korean National Health Insurance Service Database. Women who participated in a national mammographic breast cancer screening program between January 1, 2009, and December 31, 2012, were included. Mortality outcomes were calculated from the date of breast cancer diagnosis to the date of death or December 31, 2020. Data were analyzed from March 1 to June 30, 2023. Exposure Breast cancer diagnosed within 6 to 24 months after a negative screening result (ie, IBC) or within 6 months after a positive screening result (ie, SBC). Main Outcomes and Measures Risk factors and survival rates for IBC and SBC. Results This study included 8702 women with IBC (mean [SD] age, 53.3 [8.6] years) and 9492 women with SBC (mean [SD] age, 54.1 [9.0] years). Compared with SBC, the probability of IBC decreased as mammographic density increased. Lower body mass index, menopausal status, hormone replacement therapy (HRT) use, and lack of family history of breast cancer were associated with a higher likelihood of IBC. When stratified by detection time, younger age at breast cancer diagnosis and family history of breast cancer were associated with an increased likelihood of IBC diagnosed at 6 to 12 months but a decreased likelihood of IBC diagnosed at 12 to 24 months. Overall mortality of IBC was comparable with SBC, but total mortality and cancer-related mortality of IBC diagnosed between 6 and 12 months was higher than that of SBC. Conclusions and Relevance The findings of this cohort study suggest that breast density, obesity, and HRT use were associated with IBC compared with SBC. These findings also suggest that higher supplemental breast ultrasound use among Korean women, especially those with dense breasts, could be attributed to a lower incidence of IBC among women with dense breasts compared with women with SBC, due to greater detection. Finally, overall mortality of IBC was comparable with that of SBC.
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Affiliation(s)
- Huiyeon Song
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Soyeoun Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea
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Mars N, Kerminen S, Tamlander M, Pirinen M, Jakkula E, Aaltonen K, Meretoja T, Heinävaara S, Widén E, Ripatti S. Comprehensive Inherited Risk Estimation for Risk-Based Breast Cancer Screening in Women. J Clin Oncol 2024; 42:1477-1487. [PMID: 38422475 PMCID: PMC11095905 DOI: 10.1200/jco.23.00295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/24/2023] [Accepted: 12/20/2023] [Indexed: 03/02/2024] Open
Abstract
PURPOSE Family history (FH) and pathogenic variants (PVs) are used for guiding risk surveillance in selected high-risk women but little is known about their impact for breast cancer screening on population level. In addition, polygenic risk scores (PRSs) have been shown to efficiently stratify breast cancer risk through combining information about common genetic factors into one measure. METHODS In longitudinal real-life data, we evaluate PRS, FH, and PVs for stratified screening. Using FinnGen (N = 117,252), linked to the Mass Screening Registry for breast cancer (1992-2019; nationwide organized biennial screening for age 50-69 years), we assessed the screening performance of a breast cancer PRS and compared its performance with FH of breast cancer and PVs in moderate- (CHEK2)- to high-risk (PALB2) susceptibility genes. RESULTS Effect sizes for FH, PVs, and high PRS (>90th percentile) were comparable in screening-aged women, with similar implications for shifting age at screening onset. A high PRS identified women more likely to be diagnosed with breast cancer after a positive screening finding (positive predictive value [PPV], 39.5% [95% CI, 37.6 to 41.5]). Combinations of risk factors increased the PPVs up to 45% to 50%. A high PRS conferred an elevated risk of interval breast cancer (hazard ratio [HR], 2.78 [95% CI, 2.00 to 3.86] at age 50 years; HR, 2.48 [95% CI, 1.67 to 3.70] at age 60 years), and women with a low PRS (<10th percentile) had a low risk for both interval- and screen-detected breast cancers. CONCLUSION Using real-life screening data, this study demonstrates the effectiveness of a breast cancer PRS for risk stratification, alone and combined with FH and PVs. Further research is required to evaluate their impact in a prospective risk-stratified screening program, including cost-effectiveness.
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Affiliation(s)
- Nina Mars
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, MA
| | - Sini Kerminen
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Max Tamlander
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Matti Pirinen
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Helsinki Institute for Information Technology HIIT and Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eveliina Jakkula
- Department of Clinical Genetics, HUSLAB, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
| | - Kirsimari Aaltonen
- Department of Clinical Genetics, HUSLAB, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
| | - Tuomo Meretoja
- Breast Surgery Unit, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Sirpa Heinävaara
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Finnish Cancer Registry, Cancer Society of Finland, Helsinki, Finland
| | - Elisabeth Widén
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Da C, Duan Y, Ji Z, Chen J, Xia H, Weng Y, Zhou T, Yuan C, Cai T. Assessing the needs of patients with breast cancer and their families across various treatment phases using a Latent Dirichlet Allocation model: a text-mining approach to online health communities. Support Care Cancer 2024; 32:314. [PMID: 38683417 DOI: 10.1007/s00520-024-08513-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE This study aimed to assess the different needs of patients with breast cancer and their families in online health communities at different treatment phases using a Latent Dirichlet Allocation (LDA) model. METHODS Using Python, breast cancer-related posts were collected from two online health communities: patient-to-patient and patient-to-doctor. After data cleaning, eligible posts were categorized based on the treatment phase. Subsequently, an LDA model identifying the distinct need-related topics for each phase of treatment, including data preprocessing and LDA topic modeling, was established. Additionally, the demographic and interactive features of the posts were manually analyzed. RESULTS We collected 84,043 posts, of which 9504 posts were included after data cleaning. Early diagnosis and rehabilitation treatment phases had the highest and lowest number of posts, respectively. LDA identified 11 topics: three in the initial diagnosis phase and two in each of the remaining treatment phases. The topics included disease outcomes, diagnosis analysis, treatment information, and emotional support in the initial diagnosis phase; surgical options and outcomes, postoperative care, and treatment planning in the perioperative treatment phase; treatment options and costs, side effects management, and disease prognosis assessment in the non-operative treatment phase; diagnosis and treatment options, disease prognosis, and emotional support in the relapse and metastasis treatment phase; and follow-up and recurrence concerns, physical symptoms, and lifestyle adjustments in the rehabilitation treatment phase. CONCLUSION The needs of patients with breast cancer and their families differ across various phases of cancer therapy. Therefore, specific information or emotional assistance should be tailored to each phase of treatment based on the unique needs of patients and their families.
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Affiliation(s)
- Chaojin Da
- Department of Nursing, School of Clinical Nursing, Gansu Health Vocational College, Lanzhou, China
| | - Yiwen Duan
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Zhenying Ji
- Department of Nursing, School of Clinical Nursing, Gansu Health Vocational College, Lanzhou, China
| | - Jialin Chen
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Haozhi Xia
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Yajuan Weng
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Tingting Zhou
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Changrong Yuan
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China.
| | - Tingting Cai
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China.
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Dickson-Swift V, Adams J, Spelten E, Blackberry I, Wilson C, Yuen E. Breast cancer screening motivation and behaviours of women aged over 75 years: a scoping review. BMC Womens Health 2024; 24:256. [PMID: 38658945 PMCID: PMC11040767 DOI: 10.1186/s12905-024-03094-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND This scoping review aimed to identify and present the evidence describing key motivations for breast cancer screening among women aged ≥ 75 years. Few of the internationally available guidelines recommend continued biennial screening for this age group. Some suggest ongoing screening is unnecessary or should be determined on individual health status and life expectancy. Recent research has shown that despite recommendations regarding screening, older women continue to hold positive attitudes to breast screening and participate when the opportunity is available. METHODS All original research articles that address motivation, intention and/or participation in screening for breast cancer among women aged ≥ 75 years were considered for inclusion. These included articles reporting on women who use public and private breast cancer screening services and those who do not use screening services (i.e., non-screeners). The Joanna Briggs Institute (JBI) methodology for scoping reviews was used to guide this review. A comprehensive search strategy was developed with the assistance of a specialist librarian to access selected databases including: the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Web of Science and PsychInfo. The review was restricted to original research studies published since 2009, available in English and focusing on high-income countries (as defined by the World Bank). Title and abstract screening, followed by an assessment of full-text studies against the inclusion criteria was completed by at least two reviewers. Data relating to key motivations, screening intention and behaviour were extracted, and a thematic analysis of study findings undertaken. RESULTS A total of fourteen (14) studies were included in the review. Thematic analysis resulted in identification of three themes from included studies highlighting that decisions about screening were influenced by: knowledge of the benefits and harms of screening and their relationship to age; underlying attitudes to the importance of cancer screening in women's lives; and use of decision aids to improve knowledge and guide decision-making. CONCLUSION The results of this review provide a comprehensive overview of current knowledge regarding the motivations and screening behaviour of older women about breast cancer screening which may inform policy development.
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Affiliation(s)
- Virginia Dickson-Swift
- Violet Vines Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, 3552, Australia
| | - Joanne Adams
- Violet Vines Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, 3552, Australia.
| | - Evelien Spelten
- Violet Vines Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, 3552, Australia
| | - Irene Blackberry
- Care Economy Research Institute, La Trobe University, Wodonga, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Australia
- Melbourne School of Population and Global Health, Melbourne University, Melbourne, Australia
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Eva Yuen
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Australia
- Institute for Health Transformation, Deakin University, Burwood, Australia
- Centre for Quality and Patient Safety, Monash Health Partnership, Monash Health, Clayton, Australia
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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22
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Vanni G, Selntigia A, Marsella VE, Russo C, Pellicciaro M, Materazzo M, Rizzo G, Buonomo OC, Exacoustos C. Breast Cancer in Patients with Previous Endometriosis Showed Low Aggressive Subtype. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:625. [PMID: 38674271 PMCID: PMC11051959 DOI: 10.3390/medicina60040625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/31/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: The association between endometriosis and breast cancer still remains controversial. The aim of this study was to investigate the different subtypes of breast cancer, immunohistochemical markers, hormone receptors, and ki67 proliferation indexes in patients with and without endometriosis and/or adenomyosis. Materials and Methods: All patients with endometriosis and breast cancer were enrolled. Women with endometriosis and breast cancer (Group BC+EN+) were compared to patients with breast cancer without endometriosis (group BC+EN-) and those with endometriosis without breast cancer (group BC-EN+). General population characteristics and histological and immunohistochemical subtypes of breast cancer were compared between groups. Results: Our study included 41 cases affected by both endometriosis and/or adenomyosis and breast cancer (Group BC+EN+) that were matched (1:2) with 82 patients affected only by breast cancer (group BC+EN-) and 82 patients affected only by endometriosis and/or adenomyosis (group BC-EN+). Group BC+EN+ presented a higher percentage of ER receptor expression (83% vs. 70%, p = 0.02), as well as lower values of Ki 67% (15% vs. 24%, p < 0.0001) and HER2+ (9.8% vs. 28%, p = 0.022). These findings were more evident when comparing patients with premenopausal status, while in postmenopausal patients, this difference was no longer significant. Regarding endometriosis, no statistical differences were observed in type or specific localization of the disease among the groups with and without breast cancer. Conclusions: Patients with endometriosis presented lower aggressive breast cancer rates with higher values of ER% and lower values of Ki 67 and HER2neu+. The type and severity of endometriotic diseases seemed not to influence breast cancer occurrence.
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Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (M.M.); (O.C.B.)
| | - Aikaterini Selntigia
- Obstetrics and Gynecological Unit, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy; (A.S.); (C.R.); (C.E.)
| | - Valentina Enrica Marsella
- Breast Unit, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (M.M.); (O.C.B.)
| | - Consuelo Russo
- Obstetrics and Gynecological Unit, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy; (A.S.); (C.R.); (C.E.)
- Ph.D. Program in Translation Medicine, Department Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (M.M.); (O.C.B.)
- Ph.D. Program in Applied Medical-Surgical Sciences, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (M.M.); (O.C.B.)
- Ph.D. Program in Applied Medical-Surgical Sciences, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy
| | - Giuseppe Rizzo
- Obstetrics and Gynecological Unit, Department Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy;
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.P.); (M.M.); (O.C.B.)
- General Surgery Program, UNIBAS, University of Basilicata, Via dell’Ateneo Lucano, 10, 85100 Potenza, Italy
| | - Caterina Exacoustos
- Obstetrics and Gynecological Unit, Department of Surgical Science, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy; (A.S.); (C.R.); (C.E.)
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23
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Abbasi AB, Wu V, Lang JE, Esserman LJ. Precision Oncology in Breast Cancer Surgery. Surg Oncol Clin N Am 2024; 33:293-310. [PMID: 38401911 DOI: 10.1016/j.soc.2023.12.011] [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] [Indexed: 02/26/2024]
Abstract
Outcomes for patients with breast cancer have improved over time due to increased screening and the availability of more effective therapies. It is important to recognize that breast cancer is a heterogeneous disease that requires treatment based on molecular characteristics. Early endpoints such as pathologic complete response correlate with event-free survival, allowing the opportunity to consider de-escalation of certain cancer treatments to avoid overtreatment. This article discusses clinical trials of tailoring treatment (eg, I-SPY2) and screening (eg, WISDOM) to individual patients based on their unique risk features.
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Affiliation(s)
- Ali Benjamin Abbasi
- Department of Surgery, San Francisco Breast Care Center, University of California, Box 1710, UCSF, San Francisco, CA 94143, USA
| | - Vincent Wu
- Department of Surgery, Cleveland Clinic Breast Services, 9500 Euclid Avenue, A80, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Julie E Lang
- Department of Surgery, Cleveland Clinic Breast Services, 9500 Euclid Avenue, A80, Cleveland Clinic, Cleveland, OH 44195, USA.
| | - Laura J Esserman
- Department of Surgery, San Francisco Breast Care Center, University of California, Box 1710, UCSF, San Francisco, CA 94143, USA
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24
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Pamulapati S, Conroy M, Madireddy S, Kamaraju S, Cortina C, Moore H, Hartmann J. Applications of Viscoelastic Testing in Breast Cancer Patients: A Systematic Review Focusing on Hypercoagulability and Free Flap Thrombosis. Semin Thromb Hemost 2024; 50:413-422. [PMID: 37327882 DOI: 10.1055/s-0043-1769937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Viscoelastic testing is a clinically available method to assess hypercoagulability. This systematic review aims to provide a comprehensive overview of the existing literature and the potential use of such testing in patients with breast cancer. A systematic literature search for studies investigating the application of viscoelastic testing for patients with breast cancer was conducted. Studies were included as long as they were original, peer-reviewed, and in the English language. Studies were excluded if they were review articles, did not include breast cancer patients, or if the full text was unavailable. This review identified 10 articles that met the inclusion criteria. Two of the studies utilized rotational thromboelastometry, and an additional four studies used thromboelastography, to assess hypercoagulability in patients with breast cancer. Three of the identified articles discussed the use of thromboelastometry in free flap breast reconstruction for patients with breast cancer. One study was a retrospective chart review looking at thromboelastography and microsurgical breast reconstruction. Current literature regarding the application of viscoelastic testing in breast cancer and free flap breast reconstruction is limited, with no randomized trials thus far. However, some studies suggest that there may be potential utility in viscoelastic testing to assess risk for thromboembolism in breast cancer patients, and future research in this area is warranted.
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Affiliation(s)
| | | | | | - Sailaja Kamaraju
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Chandler Cortina
- Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Hunter Moore
- Division of Surgery-Transplant, University of Colorado School of Medicine, Aurora, Colorado
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25
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Filip CI, Cătană A, Kutasi E, Roman SA, Militaru MS, Risteiu GA, Dindelengan GC. Breast Cancer Screening and Prophylactic Mastectomy for High-Risk Women in Romania. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:570. [PMID: 38674216 PMCID: PMC11052261 DOI: 10.3390/medicina60040570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/10/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Breast cancer remains a significant contributor to morbidity and mortality within oncology. Risk factors, encompassing genetic and environmental influences, significantly contribute to its prevalence. While germline mutations, notably within the BRCA genes, are commonly associated with heightened breast cancer risk, a spectrum of other variants exists among affected individuals. Diagnosis relies on imaging techniques, biopsies, biomarkers, and genetic testing, facilitating personalised risk assessment through specific scoring systems. Breast cancer screening programs employing mammography and other imaging modalities play a crucial role in early detection and management, leading to improved outcomes for affected individuals. Regular screening enables the identification of suspicious lesions or abnormalities at earlier stages, facilitating timely intervention and potentially reducing mortality rates associated with breast cancer. Genetic mutations guide screening protocols, prophylactic interventions, treatment modalities, and patient prognosis. Prophylactic measures encompass a range of interventions, including chemoprevention, hormonal inhibition, oophorectomy, and mastectomy. Despite their efficacy in mitigating breast cancer incidence, these interventions carry potential side effects and psychological implications, necessitating comprehensive counselling tailored to individual cases.
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Affiliation(s)
- Claudiu Ioan Filip
- Department of Plastic Surgery and Burn Unit, Emergency District Hospital, 400535 Cluj-Napoca, Romania; (C.I.F.); (G.C.D.)
- First Surgical Clinic, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania
| | - Andreea Cătană
- Department of Molecular Sciences, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.C.); (E.K.); (S.A.R.); (G.A.R.)
- Department of Oncogeneticcs, Institute of Oncology, “Prof. Dr. I. Chiricuță”, 400015 Cluj-Napoca, Romania
- Regional Laboratory Cluj-Napoca, Department of Medical Genetics, Regina Maria Health Network, 400363 Cluj-Napoca, Romania
| | - Eniko Kutasi
- Department of Molecular Sciences, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.C.); (E.K.); (S.A.R.); (G.A.R.)
| | - Sara Alexia Roman
- Department of Molecular Sciences, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.C.); (E.K.); (S.A.R.); (G.A.R.)
| | - Mariela Sanda Militaru
- Department of Molecular Sciences, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.C.); (E.K.); (S.A.R.); (G.A.R.)
- Regional Laboratory Cluj-Napoca, Department of Medical Genetics, Regina Maria Health Network, 400363 Cluj-Napoca, Romania
| | - Giulia Andreea Risteiu
- Department of Molecular Sciences, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.C.); (E.K.); (S.A.R.); (G.A.R.)
| | - George Călin Dindelengan
- Department of Plastic Surgery and Burn Unit, Emergency District Hospital, 400535 Cluj-Napoca, Romania; (C.I.F.); (G.C.D.)
- First Surgical Clinic, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania
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26
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Jafari H, Mahami-Oskouei M, Spotin A, Baradaran B, Shanehbandi D, Baghbanzadeh A, Alizadeh Z. MicroRNA-1 Inhibits the Growth of Breast Cancer Cells MDA-MB-231 and MCF-7 Treated with Hydatid Cyst Fluid. J Trop Med 2024; 2024:7474039. [PMID: 38504949 PMCID: PMC10950417 DOI: 10.1155/2024/7474039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
Antigens in hydatid cyst fluid (HCF) have been discovered to bear a significant resemblance to antigens present in cancer cells. MicroRNA-1 (miR-1) is a well-known member of the tumor inhibitor miRNA family and has been shown to have pro-apoptotic and tumor-inhibitory functions. This study aimed to evaluate the ability of HCF to prevent breast cancer and to explore the underlying mechanisms that affect cancer cells. For this study, MDA-MB-231 and MCF-7 breast cancer cells were cultured and divided into two groups: one group received HCF treatment and the other group was untreated and served as the control group. The cytotoxicity and cell viability of various HCF concentrations on breast cancer cells were evaluated using the MTT assay. In addition, the expression level of miR-1 in HCF-treated and untreated breast cancer cells was analyzed using qRT-PCR. The study found that HCF treatment reduced the growth of MDA-MB-231 and MCF-7 breast cancer cells, indicating that it was cytotoxic to the cells. Specifically, the IC50 concentration of HCF after 24 hours of treatment was 7.32 µg/mL for MDA-MB-231 cells and 13.63 µg/mL for MCF-7 cells. In addition, qRT-PCR analysis revealed that the expression level of miR-1 was significantly increased in HCF-treated MDA-MB-231 (P=0.0203) and MCF-7 (P=0.0394) cell lines compared to untreated controls. Although HCF has been shown to inhibit the growth of breast cancer cells and to upregulate miR-1, a key tumor suppressor in cancer cells, the specific mechanisms responsible for this effect remain unclear. Further studies are needed to fully understand the molecular pathways underlying HCF's antitumor activity and its potential as a therapeutic agent in cancer therapy.
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Affiliation(s)
- Hadis Jafari
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Mahami-Oskouei
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adel Spotin
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dariush Shanehbandi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Baghbanzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Alizadeh
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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27
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Tan Z, Tan SY. Numb cheek syndrome in breast cancer: a case report. Front Oncol 2024; 14:1349073. [PMID: 38529381 PMCID: PMC10961431 DOI: 10.3389/fonc.2024.1349073] [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: 12/04/2023] [Accepted: 02/16/2024] [Indexed: 03/27/2024] Open
Abstract
Background Numb cheek syndrome, a rare corollary of numb chin syndrome, is due to infra-orbital neuropathy. It can occur in association with an underlying malignancy, which can cause neuropathy by direct malignant nerve infiltration or via a paraneoplastic mechanism. Although numb cheek syndrome has been reported in association with a variety of cancers, it has previously not been reported in association with breast cancer. We report a case of left breast cancer presenting with left numb cheek syndrome. Case presentation A 65-year-old woman presented to the Neurology clinic with a 7-month history of left cheek numbness and occasional cheek tenderness. Examination revealed slightly diminished pin-prick sensation in the left cheek and a vaguely palpable left breast lump. A magnetic resonance imaging scan of the brain showed abnormal enhancement of the left maxillary nerve at the foramen rotundum, but cerebrospinal fluid analysis was normal. Mammography, ultrasound scans, and core biopsy of the left breast confirmed the diagnosis of invasive left breast carcinoma (estrogen and progesterone receptor negative, c-erb-B2 equivocal, fluorescence in-situ hybridization negative). There was no evidence of distant metastases on computed tomography and bone scintigraphy scans. The patient underwent neoadjuvant chemotherapy (4 cycles of doxorubicin and cyclophosphamide, followed by 4 cycles of paclitaxel and carboplatin), and left breast wide excision and sentinel lymph node biopsy, and a repeat magnetic resonance imaging scan performed 2 months after surgical resection showed resolution of the left maxillary nerve enhancement. The patient's left numb cheek symptoms improved over a course of 5 months after cancer resection but did not completely resolve. Conclusions Our case represents the first reported left numb cheek syndrome in association with breast cancer, due to maxillary neuropathy without any discrete mass or compressive cause. To avoid delays in diagnosing malignancy, physicians and surgeons should be aware that numb cheek syndrome can occur in association with an underlying malignancy, and that breast cancer should be counted amongst the possibilities.
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Affiliation(s)
- Zhibin Tan
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Neuroscience Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Si Ying Tan
- SingHealth Duke-NUS Breast Centre, SingHealth, Singapore, Singapore
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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28
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Iacob R, Iacob ER, Stoicescu ER, Ghenciu DM, Cocolea DM, Constantinescu A, Ghenciu LA, Manolescu DL. Evaluating the Role of Breast Ultrasound in Early Detection of Breast Cancer in Low- and Middle-Income Countries: A Comprehensive Narrative Review. Bioengineering (Basel) 2024; 11:262. [PMID: 38534536 DOI: 10.3390/bioengineering11030262] [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: 02/19/2024] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/28/2024] Open
Abstract
Breast cancer, affecting both genders, but mostly females, exhibits shifting demographic patterns, with an increasing incidence in younger age groups. Early identification through mammography, clinical examinations, and breast self-exams enhances treatment efficacy, but challenges persist in low- and medium-income countries due to limited imaging resources. This review assesses the feasibility of employing breast ultrasound as the primary breast cancer screening method, particularly in resource-constrained regions. Following the PRISMA guidelines, this study examines 52 publications from the last five years. Breast ultrasound, distinct from mammography, offers advantages like radiation-free imaging, suitability for repeated screenings, and preference for younger populations. Real-time imaging and dense breast tissue evaluation enhance sensitivity, accessibility, and cost-effectiveness. However, limitations include reduced specificity, operator dependence, and challenges in detecting microcalcifications. Automatic breast ultrasound (ABUS) addresses some issues but faces constraints like potential inaccuracies and limited microcalcification detection. The analysis underscores the need for a comprehensive approach to breast cancer screening, emphasizing international collaboration and addressing limitations, especially in resource-constrained settings. Despite advancements, notably with ABUS, the primary goal is to contribute insights for optimizing breast cancer screening globally, improving outcomes, and mitigating the impact of this debilitating disease.
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Affiliation(s)
- Roxana Iacob
- Department of Anatomy and Embriology, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Doctoral School, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Faculty of Mechanics, Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, 'Politehnica' University Timișoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
| | - Emil Radu Iacob
- Department of Pediatric Surgery, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Emil Robert Stoicescu
- Doctoral School, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Faculty of Mechanics, Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, 'Politehnica' University Timișoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
- Department of Radiology and Medical Imaging, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Delius Mario Ghenciu
- Doctoral School, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Daiana Marina Cocolea
- Doctoral School, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Amalia Constantinescu
- Department of Radiology and Medical Imaging, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Laura Andreea Ghenciu
- Discipline of Pathophysiology, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Diana Luminita Manolescu
- Department of Radiology and Medical Imaging, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
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29
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Wu DY, Vo DT, Seiler SJ. Long overdue national big data policies hinder accurate and equitable cancer detection AI systems. J Med Imaging Radiat Sci 2024; 55:101387. [PMID: 38443215 DOI: 10.1016/j.jmir.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/04/2024] [Accepted: 02/09/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Dolly Y Wu
- Volunteer Services, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Dat T Vo
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Stephen J Seiler
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
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30
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Jadhav BN, Abdul Azeez EP, Mathew M, Senthil Kumar AP, Snegha MR, Yuvashree G, Mangalagowri SN. Knowledge, attitude, and practice of breast self-examination is associated with general self-care and cultural factors: a study from Tamil Nadu, India. BMC Womens Health 2024; 24:151. [PMID: 38431649 PMCID: PMC10909289 DOI: 10.1186/s12905-024-02981-9] [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: 11/22/2023] [Accepted: 02/18/2024] [Indexed: 03/05/2024] Open
Abstract
AIM Breast cancer is the most prevalent type of cancer among women. One form of care related to early detection of breast cancer is breast self-examination (BSE). However, evidence on knowledge, attitude, and practice (KAP) of BSE and its determining factors are minuscule in an Indian context. Therefore, the present study primarily examined the prevalence of KAP of BSE. Further, its association with general self-care and cultural factors was determined. METHODS This cross-sectional study obtained data from 412 women (Mn age = 26.63) from two rural localities of Vellore district, Tamil Nadu, India. Self-reported questionnaires of KAP of BSE, self-care, and cultural factors were applied. Statistical analyses include independent sample t-test and binomial logistic regression. RESULTS The majority of the sample had inadequate knowledge (58%), unfavourable attitudes (73.8%), and poor practice (89.6%) of BSE. The general self-care among the sample was moderate. Self-care was found to be a significant predictor of knowledge (b = 0.07, p < .05) and attitude (b = 0.092, p < .05) toward BSE. Shyness was identified as a negative predictor of KAP. Discouraged breast health discussions predicted inadequate knowledge, and not being educated by family/friends had a negative impact on knowledge and practice. A preference for same-gender physicians led to an unfavourable attitude toward BSE. CONCLUSION The observed negative trends in KAP of BSE are concerning. The results imply that girls and women should be educated and encouraged to practice BSE and promote self-care behaviours. At the same time, efforts to reduce cultural barriers may be helpful to promote the KAP of BSE.
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Affiliation(s)
- Bhoomika N Jadhav
- School of Social Sciences and Languages, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, 632014, India
| | - E P Abdul Azeez
- School of Social Sciences and Languages, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, 632014, India.
| | - Manoj Mathew
- Department of Social Work, Kalinga University, Raipur, India
| | | | - M R Snegha
- School of Social Sciences and Languages, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, 632014, India
| | - G Yuvashree
- School of Social Sciences and Languages, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, 632014, India
| | - S N Mangalagowri
- School of Social Sciences and Languages, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, 632014, India
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Wu DY, Fang YV, Vo DT, Spangler A, Seiler SJ. Detailed Image Data Quality and Cleaning Practices for Artificial Intelligence Tools for Breast Cancer. JCO Clin Cancer Inform 2024; 8:e2300074. [PMID: 38552191 PMCID: PMC10994436 DOI: 10.1200/cci.23.00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/30/2023] [Accepted: 02/13/2024] [Indexed: 04/02/2024] Open
Abstract
Standardizing image-data preparation practices to improve accuracy/consistency of AI diagnostic tools.
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Affiliation(s)
- Dolly Y. Wu
- Volunteer Services, UT Southwestern Medical Center, Dallas, TX
| | - Yisheng V. Fang
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX
| | - Dat T. Vo
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX
| | - Ann Spangler
- Retired, Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX
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Wu L, Chen GZ, Zeng ZR, Ji CW, Zhang AQ, Xia JH, Liu GC. Analysis of Breast Cancer Screening Results and Influencing Factors of Breast Cancer in Guangdong Province from 2017 to 2021. J Epidemiol Glob Health 2024; 14:131-141. [PMID: 38224387 PMCID: PMC11043295 DOI: 10.1007/s44197-023-00176-3] [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: 07/20/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUNDS Breast cancer screening plays an important role in the early detection, diagnosis and treatment of breast cancer. The aim of this study was to evaluate the screening results and explore the influencing factors of breast cancer detection rate in Guangdong. METHODS This cross-sectional study was conducted among 2,024,960 women aged 35-64 in Guangdong Province during 2017-2021. The data about breast cancer screening information were collected from the Guangdong maternal and child health information system. Descriptive statistical analysis was used to explain demographic characteristics and results of breast cancer screening. The generalized linear regression model was applied to analyze the related influencing factors of breast cancer detection rate. RESULTS The estimated detection rate of breast cancer in Guangdong Province is 70.32/105, with an early diagnosis rate of 82.06%. After adjusting covariates, those women with older age (45-55 [OR (95% CI) 2.174 (1.872, 2.526)], 55-65 [OR (95% CI) 2.162 (1.760, 2.657)]), education for high school ([OR (95% CI) 1.491 (1.254, 1.773)]) and older age at first birth ([OR (95% CI) 1.632 (1.445, 1.844)]) were more likely to have higher detection rate of breast cancer. No history of surgery or biopsy ([OR (95% CI) 0.527 (0.387, 0.718)]), no history of breast cancer check ([OR (95% CI) 0.873 (0.774, 0.985)]) and no family history of breast cancer ([OR (95% CI) 0.255 (0.151, 0.432)]) women were more likely to screen negative for breast cancer (P < 0.05). CONCLUSION The detection rate of breast cancer in screening showed an increasing trend year by year in Guangdong Province. Older age, education for high school and older age at first birth were risk factors for breast cancer detection rate, while no surgery or biopsy history, no family history of breast cancer and no history of breast cancer check were protective factors.
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Affiliation(s)
- Li Wu
- Guangdong Women and Children Hospital, Xingnan Road 521, Guangzhou, 511442, Guangdong, China
| | - Guo-Zhen Chen
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Zu-Rui Zeng
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Cun-Wei Ji
- Guangdong Women and Children Hospital, Xingnan Road 521, Guangzhou, 511442, Guangdong, China
| | - An-Qin Zhang
- Guangdong Women and Children Hospital, Xingnan Road 521, Guangzhou, 511442, Guangdong, China
| | - Jian-Hong Xia
- Guangdong Women and Children Hospital, Xingnan Road 521, Guangzhou, 511442, Guangdong, China.
| | - Guo-Cheng Liu
- Guangdong Women and Children Hospital, Xingnan Road 521, Guangzhou, 511442, Guangdong, China.
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Li Y, Zhang Y, Yu Q, He C, Yuan X. Intelligent scoring system based on dynamic optical breast imaging for early detection of breast cancer. BIOMEDICAL OPTICS EXPRESS 2024; 15:1515-1527. [PMID: 38495695 PMCID: PMC10942703 DOI: 10.1364/boe.515135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/06/2024] [Accepted: 01/31/2024] [Indexed: 03/19/2024]
Abstract
Early detection of breast cancer can significantly improve patient outcomes and five-year survival in clinical screening. Dynamic optical breast imaging (DOBI) technology reflects the blood oxygen metabolism level of tumors based on the theory of tumor neovascularization, which offers a technical possibility for early detection of breast cancer. In this paper, we propose an intelligent scoring system integrating DOBI features assessment and a malignancy score grading reporting system for early detection of breast cancer. Specifically, we build six intelligent feature definition models to depict characteristics of regions of interest (ROIs) from location, space, time and context separately. Similar to the breast imaging-reporting and data system (BI-RADS), we conclude the malignancy score grading reporting system to score and evaluate ROIs as follows: Malignant (≥ 80 score), Likely Malignant (60-80 score), Intermediate (35-60 score), Likely Benign (10-35 score), and Benign (<10 score). This system eliminates the influence of subjective physician judgments on the assessment of the malignant probability of ROIs. Extensive experiments on 352 Chinese patients demonstrate the effectiveness of the proposed system compared to state-of-the-art methods.
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Affiliation(s)
- Yaoyao Li
- Hangzhou Institute of Technology, Xidian University, Qiannong Dong Road No. 8, Hangzhou, Zhejiang, 311231, China
| | - Yipei Zhang
- Hangzhou Institute of Technology, Xidian University, Qiannong Dong Road No. 8, Hangzhou, Zhejiang, 311231, China
| | - Qiang Yu
- Hangzhou Institute of Technology, Xidian University, Qiannong Dong Road No. 8, Hangzhou, Zhejiang, 311231, China
| | - Chenglong He
- Hangzhou Institute of Technology, Xidian University, Qiannong Dong Road No. 8, Hangzhou, Zhejiang, 311231, China
| | - Xiguo Yuan
- Hangzhou Institute of Technology, Xidian University, Qiannong Dong Road No. 8, Hangzhou, Zhejiang, 311231, China
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Li M, Wang H, Qu N, Piao H, Zhu B. Breast cancer screening and early diagnosis in China: a systematic review and meta-analysis on 10.72 million women. BMC Womens Health 2024; 24:97. [PMID: 38321439 PMCID: PMC10848517 DOI: 10.1186/s12905-024-02924-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/22/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The incidence of breast cancer among Chinese women has gradually increased in recent years. This study aims to analyze the situation of breast cancer screening programs in China and compare the cancer detection rates (CDRs), early-stage cancer detection rates (ECDRs), and the proportions of early-stage cancer among different programs. METHODS We conducted a systematic review and meta-analysis of studies in multiple literature databases. Studies that were published between January 1, 2010 and June 30, 2023 were retrieved. A random effects model was employed to pool the single group rate, and subgroup analyses were carried out based on screening model, time, process, age, population, and follow-up method. RESULTS A total of 35 studies, including 47 databases, satisfied the inclusion criteria. Compared with opportunistic screening, the CDR (1.32‰, 95% CI: 1.10‰-1.56‰) and the ECDR (0.82‰, 95% CI: 0.66‰-0.99‰) were lower for population screening, but the proportion of early-stage breast cancer (80.17%, 95% CI: 71.40%-87.83%) was higher. In subgroup analysis, the CDR of population screening was higher in the urban group (2.28‰, 95% CI: 1.70‰-2.94‰), in the breast ultrasonography (BUS) in parallel with mammography (MAM) group (3.29‰, 95% CI: 2.48‰-4.21‰), and in the second screening follow-up group (2.47‰, 95% CI: 1.64‰-3.47‰), and the proportion of early-stage breast cancer was 85.70% (95% CI: 68.73%-97.29%), 88.18% (95% CI: 84.53%-91.46%), and 90.05% (95% CI: 84.07%-94.95%), respectively. CONCLUSION There were significant differences between opportunistic and population screening programs. The results of these population screening studies were influenced by the screening process, age, population, and follow-up method. In the future, China should carry out more high-quality and systematic population-based screening programs to improve screening coverage and service.
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Affiliation(s)
- Mengdan Li
- Department of Liaoning Office for Cancer Prevention and Control, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No.44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110042, China
| | - Hongying Wang
- Department of School of Public Health, China Medical University, Shenyang, Liaoning, 110122, China
| | - Ning Qu
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, 110042, China
| | - Haozhe Piao
- Department of Neurosurgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No.44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110042, China.
| | - Bo Zhu
- Department of Liaoning Office for Cancer Prevention and Control, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No.44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110042, China.
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Yur M, Özcan S, Yıldırım N, Özdede MR, Özcan M. Elevated Asprosin Levels in Breast Cancer: Insights from a Comparative Study. J Womens Health (Larchmt) 2024; 33:254-261. [PMID: 37856162 DOI: 10.1089/jwh.2023.0178] [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] [Indexed: 10/20/2023] Open
Abstract
Background: Breast cancer (BC) is the most common type of cancer in women. Diagnosis in the early stage is very important for cancer treatment. There is no good biomarker to diagnose BC in T1-T2 or N0 stage. This study aimed to evaluate asprosin (ASP) levels of BC compared with non-cancer. Materials and Methods: An enzyme-linked immunosorbent assay was used to evaluate serum ASP levels in 40 patients with BC and 40 healthy women. The cancer group included T1-T4, N1-N3, and M0-M1 patients. T stages were divided into groups as T1-T2 and T3-T4. N stages were divided into groups as N (0) and N (+). Results: ASP showed good discrimination (area under the curve = 0.767, 95% confidence interval: 0.657-0.878) between the BC group and the healthy group and acceptable discriminating ability (sensitivity = 0.825; specificity = 0.750) at the optimal cutoff value of 1.82 ng/mL. ASP indicated no difference for T, N, and M stages (p = 0.919, p = 0.859, and p = 0.225, respectively). There was a significant difference between grades within cancer patients in terms of ASP (p = 0.025). Conclusions: These findings provide evidence of a potential association between elevated ASP levels and the presence of BC. The observed higher levels of ASP in women with BC compared with healthy individuals suggest that ASP could potentially serve as a biomarker for distinguishing between the two groups. These results may contribute to our understanding of the potential role of ASP in BC detection and highlight its potential as a diagnostic marker. Further studies are required to establish whether ASP can be used to diagnose BC.
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Affiliation(s)
- Mesut Yur
- Department of Surgical Oncology and Faculty of Medicine, Firat University, Elazig, Turkey
| | - Sibel Özcan
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Nilgün Yıldırım
- Department of Medical Oncology, Firat University School of Medicine, Elazıg, Turkey
| | - Mehmet R Özdede
- Department of Physiology and Faculty of Medicine, Firat University, Elazig, Turkey
| | - Mete Özcan
- Department of Biophysics, Faculty of Medicine, Firat University, Elazig, Turkey
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Dickson-Swift V, Adams J, Spelten E, Blackberry I, Wilson C, Yuen E. Breast cancer screening motivation and behaviours of women aged over 75 years. Psychooncology 2024; 33:e6268. [PMID: 38110243 DOI: 10.1002/pon.6268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE In Australia, breast screening is offered free every two years to women aged 50-74 years. Women aged ≥75 are eligible to receive a free mammogram but do not receive an invitation. This study aimed to explore the motivations and behaviours of women living in Australia aged ≥75 years regarding ongoing breast cancer screening given the public health guidance. METHODS Sixty women aged ≥75 were recruited from metropolitan, regional, and rural areas across Australia to participate in a descriptive qualitative study. Semi-structured interviews were used to seek reflection on women's experience of screening, any advice they had received about screening beyond 75, their understanding of the value of screening and their intention to participate in the future. Thematic analysis of transcripts led to the development of themes. RESULTS Themes resulting from the study included: reasons to continue and discontinue screening, importance of inclusivity in the health system and availability of information. Regular screeners overwhelmingly wished to continue screening and had strong beliefs in the benefits of screening. Women received limited information about the benefits or harms of screening beyond age 75 and very few had discussed screening with their Primary Healthcare Provider. No longer receiving an invitation to attend screening impacted many women's decision-making. CONCLUSION More information via structured discussion with health professionals is required to inform women about the risks and benefits of ongoing screening. No longer being invited to attend screening left many women feeling confused and for some this led to feelings of discrimination.
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Affiliation(s)
- Virginia Dickson-Swift
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Joanne Adams
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Evelien Spelten
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Irene Blackberry
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Wodonga, Victoria, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, Melbourne University, Melbourne, Victoria, Australia
- La Trobe University, School of Psychology and Public Health, Bundoora, Victoria, Australia
| | - Eva Yuen
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia
- La Trobe University, School of Psychology and Public Health, Bundoora, Victoria, Australia
- Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
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Alan HY, ALMisned G, Yilmaz A, Susam LA, Ilik E, Kilic G, Ozturk G, Tuysuz B, Akkus B, Tekin HO. An investigation on protection properties of Tantalum (V) oxide reinforced glass screens on unexposed breast tissue for mammography examinations. Radiography (Lond) 2024; 30:282-287. [PMID: 38041916 DOI: 10.1016/j.radi.2023.11.020] [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: 09/27/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION The utilization of radiation shielding material positioned between the both breasts are crucial for the reduction of glandular dose and the safeguarding of the contralateral breast during mammographic procedures. This study proposes an alternative substance for shielding the contralateral breast from radiation exposure during mammography screening. METHODS In this study, we present an analysis of the shielding effectiveness of transparent glass that has been doped with Tantalum (V) oxide encoded as BTZT6. The evaluation of this shielding material was conducted using the MCNPX code, specifically for the ipsilateral and contralateral breasts. The design of the left and right breast phantoms involved the creation of three-layer heterogeneous breast phantoms, consisting of varying proportions of glandular tissue (25%, 50%, and 75%). The design of BTZT6 and lead-acrylic shielding screens is implemented using the MCNPX code. The comparative analysis of dose outcomes is conducted to assess the protective efficacy of BTZT6 and lead-acrylic shielding screens. RESULTS The utilization of BTZT6 shielding material resulted in a reduction in both breast dose and skin dose exposure when compared to the lead-acrylic shield. CONCLUSION Based on the findings acquired, the utilization of BTZT6 shielding material screens during mammography procedures involving X-rays with energy levels ranging from 26 to 30 keV is associated with a decrease in radiation dose. IMPLICATIONS FOR PRACTICE It can be inferred that the utilization of BTZT6 demonstrates potential efficacy in mitigating excessive radiation exposure to the breasts and facilitating the quantification of glandular doses in mammography procedures.
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Affiliation(s)
- H Y Alan
- Institute of Nuclear Sciences, Ankara University, 06100, Ankara, Türkey
| | - G ALMisned
- Department of Physics, College of Science, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - A Yilmaz
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - L A Susam
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - E Ilik
- Eskisehir Osmangazi University, Faculty of Science, Department of Physics, TR-26040 Eskisehir, Türkey
| | - G Kilic
- Eskisehir Osmangazi University, Faculty of Science, Department of Physics, TR-26040 Eskisehir, Türkey
| | - G Ozturk
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - B Tuysuz
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - B Akkus
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Türkey
| | - H O Tekin
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, 27272, Sharjah, United Arab Emirates; Istinye University, Faculty of Engineering and Natural Sciences, Computer Engineering Department, Istanbul 34396, Türkey.
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Yigit B, Kilicarslan G, Citgez B. Identification of Risk Factors for Mastalgia and Its Relationship with Benign or Malignant Breast Diseases. SISLI ETFAL HASTANESI TIP BULTENI 2023; 57:485-494. [PMID: 38268653 PMCID: PMC10805056 DOI: 10.14744/semb.2023.75002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/13/2023] [Accepted: 10/01/2023] [Indexed: 01/26/2024]
Abstract
Objectives Mastalgia is a medical condition that primarily affects women of all age groups. Affected individuals experience excruciating pain, tightness, or a burning sensation in the breast tissue. The aim of this study is to observe the clinicopathologic features of women with mastalgia and compare these features with asymptomatic cases. Methods A total of 524 female patients who applied to the general surgery outpatient clinic were prospectively evaluated. The patients were divided into two groups. Group 1 (G1) included patients with mastalgia, while Group 2 (G2) included asymptomatic patients. The two groups were compared in terms of clinical, radiological, and pathological features. Results This study was conducted on 524 women, among whom the prevalence of mastalgia was found to be 61.45%. There were 322 patients in G1 and 202 patients in G2. The mean age was significantly higher in G2 compared to G1 (46.33±10.33 vs. 43.58±10.33, respectively; p=0.001). Premenopausal women rates for G1 and G2 were 73.91% and 59.4%, respectively (p=0.001). The regular exercise rate in G1 was 18.01%, while it was 25.74% in G2 (p=0.034). The past history of breast cancer rate was significantly higher in G2 than in G1 (p=0.015). The consumption of analgesics was significantly lower in G2 compared to G1 (p=0.05). Non-steroidal anti-inflammatory drugs were the most commonly used analgesic drug class in both groups, with significant intergroup differences (G1: 27.63%, G2: 19.8%, p=0.043). Screening mammography with or without ultrasound examination was performed significantly more often in G2 compared to G1 (66.33% vs. 55.27% and 82.17% vs. 72.98%, p=0.012 and p=0.016, respectively). No significant difference was found concerning the frequency of benign or malignant pathologies between the groups. Conclusion Breast pain is common and should be considered physiological without other breast symptoms and after excluding non-breast causes. It is safe to provide symptom control advice and reassurance to patients who have breast pain but do not have signs or symptoms indicating a possible serious underlying condition requiring further medical intervention.
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Affiliation(s)
- Banu Yigit
- Department of General Surgery, Elazig Fethi Sekin City Hospital, Elazig, Türkiye
| | - Gulhan Kilicarslan
- Department of Radiology, Elazig Fethi Sekin City Hospital, Elazig, Türkiye
| | - Bulent Citgez
- Department of General Surgery, Uskudar University Faculty of Medicine, Memorial Hospital, Istanbul, Türkiye
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Zeghondy J, Rassy E, Lapidari P, Eid R, Pistilli B. Telehealth in breast cancer following the coronavirus disease 2019 pandemic. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2023; 4:1249-1259. [PMID: 38213534 PMCID: PMC10776597 DOI: 10.37349/etat.2023.00195] [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: 02/03/2023] [Accepted: 11/07/2023] [Indexed: 01/13/2024] Open
Abstract
Breast cancer (BC) is the second most diagnosed cancer in 2018 with around 2.3 million cases globally in 2020. In March 2020 and after its worldwide spread, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak, a respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, a pandemic. During this time, cancer patients were heavily impacted and their treatment plans were changed due to measures to fight the disease and solutions had to be found to maintain their follow-up and management from a distance. Some cancer groups worldwide have recommended then the use of telemedicine for oncology patients to ensure the continuity of medical care during the pandemic. This method was considered effective and clinicians worldwide continued using telehealth even after the cessation of worldwide restrictions. To this end, current up-to-date data on the use of telemedicine in BC patient after the COVID-19 outbreak are summarized in this narrative review.
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Affiliation(s)
- Jean Zeghondy
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Elie Rassy
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Pietro Lapidari
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Roland Eid
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
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Patel M, Debnath M, Ojha S, Sharma D. A Single Centric Quantitative Assessment of Male Breast Cancer Knowledge, Perception, and Awareness: Breaking the Stigma in Indian Population. Indian J Surg Oncol 2023; 14:949-955. [PMID: 38187837 PMCID: PMC10767022 DOI: 10.1007/s13193-023-01834-5] [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: 06/05/2023] [Accepted: 10/03/2023] [Indexed: 01/09/2024] Open
Abstract
Most people throughout the world are still uninformed of the problem of breast cancer in men. Despite increasing awareness programs targeting women, most people are unaware that breast cancer can also affect men. Our purpose is to assess the knowledge, perception, and awareness of male breast cancer among the adult male population. A descriptive cross-sectional survey included 128 male employees who agreed to participate in our study. We distributed pre-validated questionnaires to participants and gathered data following the one-on-one interview. The mean age of the participants was 37.71 years with a standard deviation of 7.65. About 55.5% of the participants were unaware that changes in the nipple position could be a sign of breast cancer. Majority of the participants, i.e., 60.9% believe positive family history will not increase the risk of breast cancer and 93% of participants have no idea about self-breast examination to detect lumps. On the other hand, 33.6% of participants stated that diagnosis and treatment of male breast cancer is embarrassing. Majority of the participants have no idea about the screening methods, 59.4% of participants have not heard about mammography, which is considered a modality of choice for early detection of breast cancer. The male university staff were lacking in knowledge and awareness about male breast cancer. In Indian community, because of shyness, they feel very embarrassed when it comes to openly discussing breast cancer. Because of this, it needs to receive more attention and to educate the male population about male breast cancer.
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Affiliation(s)
- Mukti Patel
- Department of Medical Imaging Technology, Bapubhai Desaibhai Patel Institute of Paramedical Sciences, Charotar University of Science and Technology, Off. Nadiad - Petlad Rd, Changa, Anand, Gujarat India
| | - Manna Debnath
- Department of Medical Imaging Technology, Bapubhai Desaibhai Patel Institute of Paramedical Sciences, Charotar University of Science and Technology, Off. Nadiad - Petlad Rd, Changa, Anand, Gujarat India
| | - Santosh Ojha
- Department of Medical Imaging Technology, Bapubhai Desaibhai Patel Institute of Paramedical Sciences, Charotar University of Science and Technology, Off. Nadiad - Petlad Rd, Changa, Anand, Gujarat India
| | - Dolly Sharma
- Department of Medical Imaging Technology, Bapubhai Desaibhai Patel Institute of Paramedical Sciences, Charotar University of Science and Technology, Off. Nadiad - Petlad Rd, Changa, Anand, Gujarat India
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Liyanage UA, Sirisena ND, Deshapriya PC, Dissanayake VHW. Breast cancer surveillance in BRCA positive Sri Lankan women: health equity for a high-risk group at a limited resource setting. BMC Womens Health 2023; 23:636. [PMID: 38017478 PMCID: PMC10685476 DOI: 10.1186/s12905-023-02797-z] [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: 06/01/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND BRCA1 and BRCA2 pathogenic variants account for 90% of hereditary breast malignancies, incurring a lifetime breast cancer risk of 85% and 40-45% respectively, in affected individuals. Well-resourced health care settings offer genetic counselling and genetic screening for susceptible individuals, followed by intense breast cancer surveillance programmes for those identified at high risk of breast cancer. Such high standards of care are not available in countries with limited resources. This study assessed breast cancer surveillance behaviors among a cohort of BRCA positive Sri Lankan women. METHODS A retrospective case review of all patients diagnosed with pathogenic variants in BRCA1 and BRCA2 genes from 2015 to 2022 at the Human Genetics Unit, Faculty of Medicine, University of Colombo was carried out followed by telephone interviews of the respondents. Patients who were not contactable, deceased, undergone bilateral mastectomy and males were excluded from the interview component of the study. Standard descriptive statistics were used to analyze the data using SPSS statistics version 25. RESULTS Only 25 patients were diagnosed during the study period:14/25 women responded (6/25 deceased, 3/25 non-contactable; 2/25 excluded). 71.4% (10/14) had performed breast self-examination during the preceding month; 35.7% (5/14) had a clinical breast examination (CBE), and 50% (7/14) had undergone a screening/diagnostic mammogram during the last one year. 28.5% (4/14) had undergone both mammography and CBE; 21.45% (3/14) mammogram only, 7.1% (1/14) had CBE only. 42.8%(6/14) had not undergone any surveillance(mammography, CBE or MRI). None had dual screening with mammogram and MRI. 85.71% (12/14) women expressed willingness to participate in a regular screening programme if made available. CONCLUSION Fifty percent of BRCA1/2 positive women in our study had not undergone annual imaging-based surveillance by mammography or MRI, and none had undergone annual dual screening with mammography and MRI, indicating inadequate breast cancer surveillance in this high-risk group.
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Affiliation(s)
- Udari Apsara Liyanage
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Nirmala Dushyanthi Sirisena
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Mohan R, Thulaseedharan JV. Breast screening practices of 35-65 years old women - A cross-sectional survey in Alappuzha, Kerala, India. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:402. [PMID: 38333159 PMCID: PMC10852167 DOI: 10.4103/jehp.jehp_301_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/03/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Enhancing cancer literacy, promoting early detection, and avoiding treatment delays are essential for reducing breast cancer mortality and ensuring a good quality of life among women in less developed countries. The present paper describes the breast screening practices of women in the Alappuzha district of Kerala state, India. MATERIALS AND METHODS A multi-stage cluster sampling method was used to select study participants. Data were collected using a structured questionnaire, entered using Kobo Toolbox, and analyzed using IBM SPSS Statistics-25 for Windows. The proportions of women who practiced breast examinations were estimated with 95% confidence intervals. The Chi-square test was used to test the associations, and binary logistic regression was used to estimate odds ratios. RESULTS Among 320 women, 55% were less than 50 years old, 45% had higher secondary education or above, and six were already diagnosed with breast cancer (1.9%, 95% CI: 0.4%-3.4%). Of the 314 women, 73.2% were practicing breast self-examination (95% CI: 68.4%-78.1%), and 25.2% ever attended clinical breast examination (95% CI: 20.4%-30.0%). Working/retired/self-employed women with higher secondary education and above had almost 10 times higher odds (OR = 10, 95% CI: 3.35-29.86) of practicing breast self-examination (BSE) compared to homemakers or women working under rural employment schemes with a low level of education. CONCLUSION A higher percentage of women practicing BSE and clinical breast examination (CBE) in the present study indicates that women in this population are more concerned about breast cancer. Women should be educated more on the symptoms and risk factors, the proper ways of practicing BSE, and the importance of consulting a health practitioner for CBE. Also, it is crucial to ensure that awareness and screening programs reach marginalized women.
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Affiliation(s)
- Reshmy Mohan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Jissa V. Thulaseedharan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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Webster JL, Goldstein ND, Rowland JP, Tuite CM, Siegel SD. A catchment and location-allocation analysis of mammography access in Delaware, US: implications for disparities in geographic access to breast cancer screening. Breast Cancer Res 2023; 25:137. [PMID: 37941020 PMCID: PMC10631173 DOI: 10.1186/s13058-023-01738-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Despite a 40% reduction in breast cancer mortality over the last 30 years, not all groups have benefited equally from these gains. A consistent link between later stage of diagnosis and disparities in breast cancer mortality has been observed by race, socioeconomic status, and rurality. Therefore, ensuring equitable geographic access to screening mammography represents an important priority for reducing breast cancer disparities. Access to breast cancer screening was evaluated in Delaware, a state that experiences an elevated burden from breast cancer but is otherwise representative of the US in terms of race and urban-rural characteristics. We first conducted a catchment analysis of mammography facilities. Finding evidence of disparities by race and rurality, we next conducted a location-allocation analysis to identify candidate locations for the establishment of new mammography facilities to optimize equitable access. METHODS A catchment analysis using the ArcGIS Pro Service Area analytic tool characterized the geographic distribution of mammography sites and Breast Imaging Centers of Excellence (BICOEs). Poisson regression analyses identified census tract-level correlates of access. Next, the ArcGIS Pro Location-Allocation analytic tool identified candidate locations for the placement of additional mammography sites in Delaware according to several sets of breast cancer screening guidelines. RESULTS The catchment analysis showed that for each standard deviation increase in the number of Black women in a census tract, there were 68% (95% CI 38-85%) fewer mammography units and 89% (95% CI 60-98%) fewer BICOEs. The more rural counties in the state accounted for 41% of the population but only 22% of the BICOEs. The results of the location-allocation analysis depended on which set of screening guidelines were adopted, which included increasing mammography sites in communities with a greater proportion of younger Black women and in rural areas. CONCLUSIONS The results of this study illustrate how catchment and location-allocation analytic tools can be leveraged to guide the equitable selection of new mammography facility locations as part of a larger strategy to close breast cancer disparities.
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Affiliation(s)
- Jessica L Webster
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Neal D Goldstein
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Jennifer P Rowland
- Department of Radiology, Breast Imaging Section, Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE, USA
| | - Catherine M Tuite
- Department of Radiology, Breast Imaging Section, Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE, USA
| | - Scott D Siegel
- Cawley Center for Translational Cancer Research, Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, 4701 Ogletown-Stanton Road, Newark, DE, 19713, USA.
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Qiu S, Zhuang S, Li B, Wang J, Zhuang Z. Prospective assessment of breast lesions AI classification model based on ultrasound dynamic videos and ACR BI-RADS characteristics. Front Oncol 2023; 13:1274557. [PMID: 38023255 PMCID: PMC10656688 DOI: 10.3389/fonc.2023.1274557] [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: 08/10/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction AI-assisted ultrasound diagnosis is considered a fast and accurate new method that can reduce the subjective and experience-dependent nature of handheld ultrasound. In order to meet clinical diagnostic needs better, we first proposed a breast lesions AI classification model based on ultrasound dynamic videos and ACR BI-RADS characteristics (hereafter, Auto BI-RADS). In this study, we prospectively verify its performance. Methods In this study, the model development was based on retrospective data including 480 ultrasound dynamic videos equivalent to 18122 static images of pathologically proven breast lesions from 420 patients. A total of 292 breast lesions ultrasound dynamic videos from the internal and external hospital were prospectively tested by Auto BI-RADS. The performance of Auto BI-RADS was compared with both experienced and junior radiologists using the DeLong method, Kappa test, and McNemar test. Results The Auto BI-RADS achieved an accuracy, sensitivity, and specificity of 0.87, 0.93, and 0.81, respectively. The consistency of the BI-RADS category between Auto BI-RADS and the experienced group (Kappa:0.82) was higher than that of the juniors (Kappa:0.60). The consistency rates between Auto BI-RADS and the experienced group were higher than those between Auto BI-RADS and the junior group for shape (93% vs. 80%; P = .01), orientation (90% vs. 84%; P = .02), margin (84% vs. 71%; P = .01), echo pattern (69% vs. 56%; P = .001) and posterior features (76% vs. 71%; P = .0046), While the difference of calcification was not significantly different. Discussion In this study, we aimed to prospectively verify a novel AI tool based on ultrasound dynamic videos and ACR BI-RADS characteristics. The prospective assessment suggested that the AI tool not only meets the clinical needs better but also reaches the diagnostic efficiency of experienced radiologists.
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Affiliation(s)
- Shunmin Qiu
- Department of Ultrasound, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Shuxin Zhuang
- School of Biomedical Engineering, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Bin Li
- Product Development Department, Shantou Institute of Ultrasonic Instruments, Shantou, Guangdong, China
| | - Jinhong Wang
- Department of Ultrasound, Shantou Chaonan Minsheng Hospital, Shantou, Guangdong, China
| | - Zhemin Zhuang
- Engineering College, Shantou University, Shantou, Guangdong, China
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Moore L, Drager J, Freire G, Yanchar N, Miller AN, Ben Abdel A, Bérubé M, Tardif PA, Gnanvi J, Stelfox HT, Beaudin M, Stang A, Beno S, Weiss M, Labrosse M, Zemek R, Gagnon IJ, Beaulieu E, Berthelot S, Klassen T, Turgeon AF, Lauzier F, Gabbe B, Carsen S. Clinical Practice Guideline Recommendations in Pediatric Orthopaedic Injury: A Systematic Review. J Pediatr Orthop 2023; 43:e790-e797. [PMID: 37606069 DOI: 10.1097/bpo.0000000000002496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND Lack of adherence to recommendations on pediatric orthopaedic injury care may be driven by lack of knowledge of clinical practice guidelines (CPGs), heterogeneity in recommendations or concerns about their quality. We aimed to identify CPGs for pediatric orthopaedic injury care, appraise their quality, and synthesize the quality of evidence and the strength of associated recommendations. METHODS We searched Medline, Embase, Cochrane CENTRAL, Web of Science and websites of clinical organizations. CPGs including at least one recommendation targeting pediatric orthopaedic injury populations on any diagnostic or therapeutic intervention developed in the last 15 years were eligible. Pairs of reviewers independently extracted data and evaluated CPG quality using the Appraisal of Guidelines Research and Evaluation (AGREE) II tool. We synthesized recommendations from high-quality CPGs using a recommendations matrix based on the GRADE Evidence-to-Decision framework. RESULTS We included 13 eligible CPGs, of which 7 were rated high quality. Lack of stakeholder involvement and applicability (i.e., implementation strategies) were identified as weaknesses. We extracted 53 recommendations of which 19 were based on moderate or high-quality evidence. CONCLUSIONS We provide a synthesis of recommendations from high-quality CPGs that can be used by clinicians to guide treatment decisions. Future CPGs should aim to use a partnership approach with all key stakeholders and provide strategies to facilitate implementation. This study also highlights the need for more rigorous research on pediatric orthopaedic trauma. LEVEL OF EVIDENCE Level II-therapeutic study.
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Affiliation(s)
- Lynne Moore
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus)
- Department of Social and Preventative Medicine
| | - Justin Drager
- Division of Orthopaedic Surgery, Children's Hospital of Eastern Ontario (CHEO)
| | | | | | - Anna N Miller
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO
| | - Anis Ben Abdel
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus)
| | - Mélanie Bérubé
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus)
- Faculty of Nursing
| | - Pier-Alexandre Tardif
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus)
| | - Janyce Gnanvi
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus)
| | - Henry T Stelfox
- Departments of Critical Care Medicine, Medicine and Community Health Sciences, O'Brien Institute for Public Health
| | - Marianne Beaudin
- Department of Pediatric surgery, CHU Sainte-Justine, Université de Montréal
| | - Antonia Stang
- Department of Pediatrics, Emergency Medicine, and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB
| | - Suzanne Beno
- Division of Emergency Medicine, Hospital for Sick Children, University of Toronto, Toronto, ON
| | - Matthew Weiss
- Département de pédiatrie, Faculté de médecine, Centre Hospitalier Universitaire de Québec
| | - Melanie Labrosse
- Department of Pediatrics, Division of Emergency Medicine, CHU Sainte-Justine, Université de Montréal
| | | | - Isabelle J Gagnon
- Division of Pediatric Emergency Medicine, McGill University Health Centre, Montreal Children's Hospital, Montréal, QC, Canada
| | - Emilie Beaulieu
- Département de pédiatrie, Faculté de médecine, Centre Hospitalier Universitaire de Québec
| | - Simon Berthelot
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus)
| | - Terry Klassen
- George & Fay Yee Centre for Health Care Innovation, Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Alexis F Turgeon
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus)
- Department of Social and Preventative Medicine
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval
| | - François Lauzier
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus)
- Department of Social and Preventative Medicine
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sasha Carsen
- Division of Orthopaedic Surgery, Children's Hospital of Eastern Ontario, Ottawa
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Jost E, Kosian P, Jimenez Cruz J, Albarqouni S, Gembruch U, Strizek B, Recker F. Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology. J Clin Med 2023; 12:6833. [PMID: 37959298 PMCID: PMC10649694 DOI: 10.3390/jcm12216833] [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: 09/21/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Artificial intelligence (AI) has gained prominence in medical imaging, particularly in obstetrics and gynecology (OB/GYN), where ultrasound (US) is the preferred method. It is considered cost effective and easily accessible but is time consuming and hindered by the need for specialized training. To overcome these limitations, AI models have been proposed for automated plane acquisition, anatomical measurements, and pathology detection. This study aims to overview recent literature on AI applications in OB/GYN US imaging, highlighting their benefits and limitations. For the methodology, a systematic literature search was performed in the PubMed and Cochrane Library databases. Matching abstracts were screened based on the PICOS (Participants, Intervention or Exposure, Comparison, Outcome, Study type) scheme. Articles with full text copies were distributed to the sections of OB/GYN and their research topics. As a result, this review includes 189 articles published from 1994 to 2023. Among these, 148 focus on obstetrics and 41 on gynecology. AI-assisted US applications span fetal biometry, echocardiography, or neurosonography, as well as the identification of adnexal and breast masses, and assessment of the endometrium and pelvic floor. To conclude, the applications for AI-assisted US in OB/GYN are abundant, especially in the subspecialty of obstetrics. However, while most studies focus on common application fields such as fetal biometry, this review outlines emerging and still experimental fields to promote further research.
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Affiliation(s)
- Elena Jost
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Philipp Kosian
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Jorge Jimenez Cruz
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Shadi Albarqouni
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
- Helmholtz AI, Helmholtz Munich, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Ulrich Gembruch
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Brigitte Strizek
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Florian Recker
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
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Alruily M, Said W, Mostafa AM, Ezz M, Elmezain M. Breast Ultrasound Images Augmentation and Segmentation Using GAN with Identity Block and Modified U-Net 3. SENSORS (BASEL, SWITZERLAND) 2023; 23:8599. [PMID: 37896692 PMCID: PMC10610596 DOI: 10.3390/s23208599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
One of the most prevalent diseases affecting women in recent years is breast cancer. Early breast cancer detection can help in the treatment, lower the infection risk, and worsen the results. This paper presents a hybrid approach for augmentation and segmenting breast cancer. The framework contains two main stages: augmentation and segmentation of ultrasound images. The augmentation of the ultrasounds is applied using generative adversarial networks (GAN) with nonlinear identity block, label smoothing, and a new loss function. The segmentation of the ultrasounds applied a modified U-Net 3+. The hybrid approach achieves efficient results in the segmentation and augmentation steps compared with the other available methods for the same task. The modified version of the GAN with the nonlinear identity block overcomes different types of modified GAN in the ultrasound augmentation process, such as speckle GAN, UltraGAN, and deep convolutional GAN. The modified U-Net 3+ also overcomes the different architectures of U-Nets in the segmentation process. The GAN with nonlinear identity blocks achieved an inception score of 14.32 and a Fréchet inception distance of 41.86 in the augmenting process. The GAN with identity achieves a smaller value in Fréchet inception distance (FID) and a bigger value in inception score; these results prove the model's efficiency compared with other versions of GAN in the augmentation process. The modified U-Net 3+ architecture achieved a Dice Score of 95.49% and an Accuracy of 95.67%.
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Affiliation(s)
- Meshrif Alruily
- College of Computer and Information Sciences, Jouf University, Sakaka 72388, Saudi Arabia; (M.A.); (M.E.)
| | - Wael Said
- Computer Science Department, Faculty of Computers and Informatics, Zagazig University, Zagazig 44511, Egypt;
- Computer Science Department, College of Computer Science and Engineering, Taibah University, Medina 42353, Saudi Arabia
| | - Ayman Mohamed Mostafa
- College of Computer and Information Sciences, Jouf University, Sakaka 72388, Saudi Arabia; (M.A.); (M.E.)
| | - Mohamed Ezz
- College of Computer and Information Sciences, Jouf University, Sakaka 72388, Saudi Arabia; (M.A.); (M.E.)
| | - Mahmoud Elmezain
- Computer Science Department, Faculty of Science, Tanta University, Tanta 31527, Egypt;
- Computer Science Department, College of Computer Science and Engineering, Taibah University, Yanbu 966144, Saudi Arabia
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Revel MP, Chassagnon G. Ten reasons to screen women at risk of lung cancer. Insights Imaging 2023; 14:176. [PMID: 37857978 PMCID: PMC10587052 DOI: 10.1186/s13244-023-01512-8] [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: 06/19/2023] [Accepted: 08/29/2023] [Indexed: 10/21/2023] Open
Abstract
This opinion piece reviews major reasons for promoting lung cancer screening in at-risk women who are smokers or ex-smokers, from the age of 50. The epidemiology of lung cancer in European women is extremely worrying, with lung cancer mortality expected to surpass breast cancer mortality in most European countries. There are conflicting data as to whether women are at increased risk of developing lung cancer compared to men who have a similar tobacco exposure. The sharp increase in the incidence of lung cancer in women exceeds the increase in their smoking exposure which is in favor of greater susceptibility. Lung and breast cancer screening could be carried out simultaneously, as the screening ages largely coincide. In addition, lung cancer screening could be carried out every 2 years, as is the case for breast cancer screening, if the baseline CT scan is negative.As well as detecting early curable lung cancer, screening can also detect coronary heart disease and osteoporosis induced by smoking. This enables preventive measures to be taken in addition to smoking cessation assistance, to reduce morbidity and mortality in the female population. Key points • The epidemiology of lung cancer in European women is very worrying.• Lung cancer is becoming the leading cause of cancer mortality in European women.• Women benefit greatly from screening in terms of reduced risk of death from lung cancer.
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Affiliation(s)
- Marie-Pierre Revel
- Université Paris Cité, 85 Boulevard Saint-Germain, Paris, 75006, France.
- Department of Radiology, Assistance publique des Hôpitaux de Paris, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, Paris, 75014, France.
| | - Guillaume Chassagnon
- Université Paris Cité, 85 Boulevard Saint-Germain, Paris, 75006, France
- Department of Radiology, Assistance publique des Hôpitaux de Paris, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, Paris, 75014, France
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Wilkinson AN, Ellison LF, Billette JM, Seely JM. Impact of Breast Cancer Screening on 10-Year Net Survival in Canadian Women Age 40-49 Years. J Clin Oncol 2023; 41:4669-4677. [PMID: 37540825 PMCID: PMC10564321 DOI: 10.1200/jco.23.00348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 08/06/2023] Open
Abstract
PURPOSE In Canada, some provincial/territorial mammography screening programs include women age 40-49 years, whereas others do not. This study examines the impact of this dichotomy on the 10-year breast cancer (BC) net survival (NS) among women age 40-49 years and 50-59 years at diagnosis. METHODS Using the Canadian Cancer Registry data record linked to death information, we evaluated the cohort of Canadian women age 40-49 years and 50-59 years diagnosed with BC from 2002 to 2007. We compared 10-year NS estimates in the jurisdictions with organized screening programs that included women age 40-49 years, designated as screeners (Northwest Territories, British Columbia, Alberta, Nova Scotia, and Prince Edward Island), with comparator programs that did not (Yukon, Manitoba, Saskatchewan, Ontario, Quebec, New Brunswick, and Newfoundland and Labrador). RESULTS BC was the primary cause of 10-year mortality in women age 40-49 years diagnosed with BC (90.7% of deaths). Among these women, the 10-year NS for screeners (84.8%; 95% CI, 83.8 to 85.8) was 1.9 percentage points (pp) higher than that for comparators (82.9%; 95% CI, 82.3 to 83.5; P = .001). The difference in favor of screeners was significant among women age 45-49 years (2.6 pp; P = .001) but not among women age 40-44 years (0.9 pp; P = .328). Similarly, the incidence-based BC mortality rate was significantly lower in screener jurisdictions among women age 40-49 years and 45-49 years, but not for 40-44 years. Provincial/territorial NS increased significantly with higher mammography screening participation (P = .003). The BC incidence rate was virtually identical in screener and comparator jurisdictions among women age 40-49 years (P = .976) but was significantly higher for comparators among women age 50-59 years (P < .001). CONCLUSION Screening programs that included women in their 40s were associated with a significantly higher BC 10-year NS in women age 40-49 years, but not an increased rate of BC diagnosis. These results may inform screening guidelines for women age 40-49 years.
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Affiliation(s)
| | - Larry F. Ellison
- Centre for Population Health Data at Statistics Canada, Government of Canada, Ottawa, Canada
| | - Jean-Michel Billette
- Centre for Population Health Data at Statistics Canada, Government of Canada, Ottawa, Canada
| | - Jean M. Seely
- University of Ottawa, Department of Radiology, Ottawa Hospital Research Institute, Ottawa, Canada
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50
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Hodan R, Rodgers-Fouche L, Chittenden A, Dominguez-Valentin M, Ferriss J, Gima L, Hamnvik OPR, Idos GE, Kline K, Koeller DR, Long JM, McKenna D, Muller C, Thoman M, Wintner A, Bedrick BS. Cancer surveillance for transgender and gender diverse patients with Lynch syndrome: a practice resource of the Collaborative Group of the Americas on Inherited Gastrointestinal Cancer. Fam Cancer 2023; 22:437-448. [PMID: 37341816 DOI: 10.1007/s10689-023-00341-4] [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: 04/10/2023] [Accepted: 05/31/2023] [Indexed: 06/22/2023]
Abstract
Transgender and gender diverse (TGD) populations with hereditary cancer syndromes face unique obstacles to identifying and obtaining appropriate cancer surveillance and risk-reducing procedures. There is a lack of care provider knowledge about TGD health management. Lynch syndrome (LS) is one of the most common hereditary cancer syndromes, affecting an estimated 1 in 279 individuals. There are no clinical guidelines specific for TGD individuals with LS, highlighting a need to improve the quality of care for this population. There is an urgent need for cancer surveillance recommendations for TGD patients. This commentary provides recommendations for cancer surveillance, risk-reducing strategies, and genetic counseling considerations for TGD patients with LS.
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Affiliation(s)
- Rachel Hodan
- Cancer Genetics, Stanford Health Care and Department of Pediatrics (Genetics), Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Linda Rodgers-Fouche
- Center for Cancer Risk Assessment, Massachusetts General Hospital, Boston, MA, USA
| | - Anu Chittenden
- Division of Cancer Genetics and Prevention, Dana Farber Cancer Institute, Boston, MA, USA
| | - Mev Dominguez-Valentin
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo, Norway
| | - James Ferriss
- Department of Gynecology and Obstetrics, Kelly Gynecologic Oncology Service, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Lauren Gima
- Division of Clinical Cancer Genomics, City of Hope National Medical Center, Duarte, CA, USA
| | - Ole-Petter R Hamnvik
- Center for Transgender Health, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Gregory E Idos
- Division of Gastroenterology, City of Hope National Medical Center, Duarte, CA, USA
| | - Kevin Kline
- Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Diane R Koeller
- Division of Cancer Genetics and Prevention, Dana Farber Cancer Institute, Boston, MA, USA
| | - Jessica M Long
- Division of Hematology and Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Danielle McKenna
- Division of Hematology and Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Charles Muller
- Division of Gastroenterology and Hepatology, Northwestern University, Chicago, IL, USA
| | - Maxton Thoman
- Department of Urology, Massachusetts General Hospital, Boston, MA, USA
| | - Anton Wintner
- Department of Urology, Massachusetts General Hospital, Boston, MA, USA
| | - Bronwyn S Bedrick
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
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