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Al Marwani M, Alamri N, Allebdi A. Synchronous bilateral breast cancer with different histology. Radiol Case Rep 2023; 18:2491-2497. [PMID: 37214322 PMCID: PMC10196912 DOI: 10.1016/j.radcr.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 05/24/2023] Open
Abstract
Synchronous bilateral breast cancer is a rare clinical entity. And due to both an improved prognosis and growing life expectancy on early detection, we have brought interest in case of patient with synchronous breast cancer. This study reports a case of synchronous bilateral breast cancer in an asymptomatic 70-year-old woman with a positive family history of breast cancer. This woman was diagnosed through radiological screenings, including mammograms, ultrasonography, and magnetic resonance imaging (MRI). On histopathologic examination of the core biopsy, the left breast mass was a Nottingham grade I invasive carcinoma of no particular type. The right breast mass was a Nottingham grade I invasive carcinoma with a mucinous component. After lumpectomies ultrasonography of the surgical specimens confirmed a small biopsy-proven invasive ductal cancer hypoechoic mass in the left breast, with an irregular margins and proven mucinous cancer mass in the right breast. The case was finally diagnosed as synchronous bilateral breast cancer of different pathologic types (ductal and mucinous).
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Shao X, Jin X, Chen Z, Zhang Z, Chen W, Jiang J, Wang Z, Cui Y, Fan WH, Wang K, Yu X, Huang J. A comprehensive comparison of circulating tumor cells and breast imaging modalities as screening tools for breast cancer in Chinese women. Front Oncol 2022; 12:890248. [PMID: 35978805 PMCID: PMC9377692 DOI: 10.3389/fonc.2022.890248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background Circulating tumor cells (CTCs) have been recognized as a sensitive biomarker for breast cancer (BC). This study aimed to comprehensively compare CTC with imaging modalities, including ultrasonography, mammography, and contrast-enhanced magnetic resonance imaging (MRI) in screening for BC in Chinese women. Methods Three hundred forty-three participants were enrolled in this study, including 102 treatment-naive BC patients, 177 with breast benign diseases (BBD) and 64 healthy female patients. All participants underwent CTC testing and at least one of the following examinations, ultrasonography, mammography, and MRI at the Second Affiliated Hospital of Zhejiang University between December 2017 and November 2020. CTCs were quantitatively assessed using cell counting (CTC detection rate/counts) and categorically examined using a cutoff value (CTC classification). The diagnostic power of CTC tests and imaging modalities, including accuracy and capability to predict clinicopathological characteristics of BC, were evaluated and compared. Results CTC classification with a cutoff value of 2 showed a “good” diagnostic accuracy of 0.889 for early- to mid-stage BC comparable to breast imaging modalities using Breast Imaging-Reporting and Data System (BI-RADS). MRI demonstrated the highest sensitivity of 0.872 for BC, and CTC classification had the highest specificity of 0.938. A relatively low sensitivity was found for mammography in this cohort of patients. Successful detection of BC by CTC detection rate/counts, but not CTC classification, correlated with two important clinicopathological features, American Joint Committee on Cancer (AJCC) stage and tumor-node-metastasis (TNM) stage. The detection power of certain imaging modalities was also associated with AJCC stage (ultrasonography, p = 0.0438 and MRI, p = 0.0422) and lymph node metastasis (ultrasonography, 0.0157). There were clear correlations between CTC tests (counts or classification) and imaging BI-RADS scoring system in detecting positive BC cases (p < 0.05). Further correlation analysis suggested that CTC quantity, but not CTC classification, had the capability to predict clinicopathological traits of BC that were identified by ultrasonography. Conclusions CTC tests have a diagnostic potency comparable to breast imaging modalities, and may be used as an alternative screening tool for BC.
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Affiliation(s)
- Xuan Shao
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
- *Correspondence: Xuan Shao, ; Jian Huang,
| | - Xiaoyan Jin
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
- Department of Surgical Oncology, Taizhou Municipal Hospital, Taizhou, China
| | - Zhigang Chen
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Zhigang Zhang
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Wuzhen Chen
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Jingxin Jiang
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Zhen Wang
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Ying Cui
- Hangzhou Watson Biotech, Hangzhou, China
| | | | - Ke Wang
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Xiuyan Yu
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Jian Huang
- Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
- *Correspondence: Xuan Shao, ; Jian Huang,
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Martinez KA, Deshpande A, Lipold L, Rothberg MB. Change in individual physicians' screening mammography completion rates following the updated USPSTF guideline supporting shared decision making: An observational cohort study. PATIENT EDUCATION AND COUNSELING 2022; 105:166-172. [PMID: 33992485 DOI: 10.1016/j.pec.2021.05.011] [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: 08/04/2020] [Revised: 04/23/2021] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To understand changes in physician screening practices in response to the 2009 U.S. Preventive Services Task Force recommendation supporting shared decision making (SDM) for mammography in women aged 40-49 years. METHODS We assessed screening completion rates for physicians in the Cleveland Clinic Health System pre-2009 (2006-2008) and post-2009 (2010-2015), and rates for physicians new to the system post-2009. We used mixed effects logistic regression to estimate the odds of a woman receiving screening post-2009. If physicians practiced SDM, we hypothesized their screening rates would change after 2009. To test this, we included each physician's pre-2009 screening rate as a predictor in the model. RESULTS Among 125 physicians, the screening rate increased from 40% to 45% from pre-2009 to post-2009. For physicians new to the health system post-2009 the rate was 32%. In the mixed effects model (N = 17,007), the strongest predictor of mammography receipt among patients post-2009 was their physician's pre-2009 screening rate (aOR:3.57 per 10% increase in pre-2009 rate; 95%CI:1.69-7.50). CONCLUSIONS Whether a woman received a mammogram post-2009 was highly associated with her physicians' pre-2009 screening rate, suggesting physicians are not individualizing screening decisions via SDM. PRACTICE IMPLICATIONS Physicians may need support to effectively practice SDM.
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Affiliation(s)
- Kathryn A Martinez
- Cleveland Clinic Center for Value-Based Care Research, 9500 Euclid Ave, G10, Cleveland, OH 44195, USA.
| | - Abhishek Deshpande
- Cleveland Clinic Center for Value-Based Care Research, 9500 Euclid Ave, G10, Cleveland, OH 44195, USA
| | - Laura Lipold
- Cleveland Clinic, Family Medicine, 26900 Cedar Rd, Beachwood, OH 44122, USA
| | - Michael B Rothberg
- Cleveland Clinic Center for Value-Based Care Research, 9500 Euclid Ave, G10, Cleveland, OH 44195, USA
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Comparison of the diagnostic performances of circulating tumor cells and the serum tumor markers CEA, CA125, and CA15-3 for breast cancer: a retrospective case-control study. JOURNAL OF BIO-X RESEARCH 2021. [DOI: 10.1097/jbr.0000000000000093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Gao Y, Fan WH, Duan C, Zhao W, Zhang J, Kang X. Enhancing the Screening Efficiency of Breast Cancer by Combining Conventional Medical Imaging Examinations With Circulating Tumor Cells. Front Oncol 2021; 11:643003. [PMID: 34094929 PMCID: PMC8170472 DOI: 10.3389/fonc.2021.643003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/22/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Ultrasound (US) and mammogram (MMG) are the two most common breast cancer (BC) screening tools. This study aimed to assess how the combination of circulating tumor cells (CTC) with US and MMG would improve the diagnostic performance. METHODS CTC detection and imaging examinations, US and MMG, were performed in 238 treatment-naive BC patients, 217 patients with benign breast diseases (BBD), and 20 healthy females. Correlations of CTC, US and MMG with patients' clinicopathological characteristics were evaluated. Diagnostic performances of CTC, US and MMG were estimated by the receiver operating characteristic curves. RESULTS CTC, US and MMG could all distinguish BC patients from the control (p < 0.0001). Area under curve (AUC) of CTC, US and MMG are 0.855, 0.861 and 0.759, respectively. While US has the highest sensitivity of 0.79, CTC and MMG have the same specificity of 0.92. Notably, CTC has the highest accuracy of 0.83. Combination with CTC increases the AUC of US and MMG to 0.922 and 0.899, respectively. Combining MMG with CTC or US increases the sensitivity of MMG to 0.87, however "CTC + MMG" has a higher specificity of 0.85. "CTC + US" performs the best in BC diagnosis, followed by "CTC + MMG" and then "US + MMG". CONCLUSION CTC can be used as a diagnostic aid for BC screening. Combination with CTC increases the diagnostic potency of conventional BC screening imaging examinations, US and MMG, in BC diagnosis, especially for MMG.
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Affiliation(s)
- Yang Gao
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Wan-Hung Fan
- Department of Clinical Medical Affairs, Hangzhou Watson Biotech, Hangzhou, China
| | - Chaohui Duan
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wenhe Zhao
- Department of Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Zhang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xixiong Kang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
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Manning M, O'Neill S, Purrington K. Physicians' perceptions of breast density notification laws and appropriate patient follow-up. Breast J 2021; 27:586-594. [PMID: 33991030 DOI: 10.1111/tbj.14240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 12/19/2022]
Abstract
Breast density notification laws have been adopted in the absence of consistent guidelines for post-notification follow-up. This can lead to inconsistent and potentially deficient management of women's health due to inconsistent physician practices. We examined physicians' knowledge and practices regarding follow-up for patients who receive density notifications. Physicians who referred patients to a Michigan hospital network for screening mammograms were recruited to participate in survey study; 105 (29.8%) responded. The survey assessed physicians' demographics, knowledge, and awareness of breast density and breast cancer risk and of density notification laws, and perceptions of appropriate follow-up behaviors for their patients who received density notifications. Most physicians (75%) knew about the notification law, and they were generally comfortable responding to breast density questions and deciding on follow-up. Most indicated that additional breast imaging (68.0%), followed by assessing breast cancer risk (24.7%) were appropriate follow-up responses. Physicians who performed breast cancer risk assessments, and who were more comfortable with breast density questions and follow-up decision making, were more likely to propose additional imaging. Male physicians were less likely to propose assessing breast cancer risk, and less likely to propose clinical and/or breast self-examinations. Divergence between practice and guidelines when it comes to supplemental breast cancer screening, coupled with density notification language that promotes additional screening in the absence of consistent evidence, remains concerning. Improved understanding of how density notification recipients and their physicians make decisions about supplemental screening is warranted to ensure that breast cancer risk is properly considered.
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Affiliation(s)
- Mark Manning
- Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Suzanne O'Neill
- Department of Oncology, Lombardi Cancer Center, Georgetown University, Washington, DC, USA
| | - Kristen Purrington
- Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
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Houghton SC, Hankinson SE. Cancer Progress and Priorities: Breast Cancer. Cancer Epidemiol Biomarkers Prev 2021; 30:822-844. [PMID: 33947744 PMCID: PMC8104131 DOI: 10.1158/1055-9965.epi-20-1193] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/13/2020] [Accepted: 02/19/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Serena C Houghton
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts.
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts
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Kleinknecht JH, Ciurea AI, Ciortea CA. Pros and cons for breast cancer screening with tomosynthesis - a review of the literature. Med Pharm Rep 2020; 93:335-341. [PMID: 33225258 PMCID: PMC7664734 DOI: 10.15386/mpr-1698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 11/25/2022] Open
Abstract
Breast cancer screening programs using mammography proved their value in detecting breast cancer at early stages and, consequently, reducing the mortality from this disease. Due to the technological progress, the screening programs have shifted from screen-film mammography to digital mammography and nowadays digital breast tomosynthesis became the focus of breast imaging research. Using tomosynthesis in screening increases cancer detection rates and decreases recall and false-positive rates, thus improving the effectiveness of breast cancer screening programs, with positive consequences on health care costs and on patient psychology. More long-term follow-up data must be collected for assessing absolute sensitivity and specificity of digital breast tomosynthesis, together with efforts for addressing the limitations of the method.
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Affiliation(s)
| | - Anca Ileana Ciurea
- Department of Radiology, Cluj-Napoca Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristiana Augusta Ciortea
- Department of Radiology and Imaging, Cluj-Napoca County University Emergency Hospital, Cluj-Napoca, Romania
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Nachtigal E, LoConte NK, Kerch S, Zhang X, Parkes A. Variation in Breast Cancer Screening Recommendations by Primary Care Providers Surveyed in Wisconsin. J Gen Intern Med 2020; 35:2553-2559. [PMID: 32495085 PMCID: PMC7459047 DOI: 10.1007/s11606-020-05922-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 05/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cancer screening is chiefly performed by primary care providers (PCPs) who rely on organizational screening guidelines. These guidelines provide evidence-based recommendations; however, they are often without unanimity leading to divergent screening recommendations. OBJECTIVE Due to the high incidence of breast cancer, the availability of screening methods, and the presence of multiple incongruent guideline recommendations, we sought to understand breast cancer screening practices in Wisconsin to identify patterns that would allow us to improve evidence-based screening adherence. METHODS A 46-question survey on breast cancer screening beliefs and practices for average-risk women was sent to healthcare providers in Wisconsin in 2018, who provided cancer screening services to women. Providers included physicians, nurse practitioners (NPs), physician assistants (PAs), and midwives. RESULTS A total of 295 people responded to the survey, for a response rate of 28.6%. Most respondents were physicians (64.1%), followed by NPs (25.7%), PAs (5.3%), and midwives (1.5%). Of physicians, most practiced family medicine (65.3%), followed by internal medicine (25.3%) and gynecology (9.4%). The United States Preventive Services Task Force (USPSTF) was reported as being "very influential" for 60.5% of providers, followed by the American Cancer Society at 46.8%. For patients 40-49 years old, 75.6% of providers performed clinical breast exams and 58.5% recommended self-breast exams; these numbers increased for women 50+ years old to 78.7% and 61.2%, respectively. Mammography was more likely to be recommended annually for women aged 40-49 rather than biennially by non-physician clinicians compared to physicians (p < .001). CONCLUSIONS PCPs in Wisconsin continue to overestimate the efficacy of clinical and self-breast exams as well as overuse these in clinical practice. Providers find multiple screening guidelines influential but favor the USPSTF; however, these guidelines are frequently not being followed. Further research needs to be done to investigate the lack of national guideline adherence by providers to improve compliance with evidence-based screening recommendations.
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Affiliation(s)
- Emily Nachtigal
- Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. .,University of Wisconsin Carbone Cancer Center, Madison, WI, USA.
| | - Noelle K LoConte
- Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Sarah Kerch
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Xiao Zhang
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Amanda Parkes
- Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,University of Wisconsin Carbone Cancer Center, Madison, WI, USA
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Iranmakani S, Mortezazadeh T, Sajadian F, Ghaziani MF, Ghafari A, Khezerloo D, Musa AE. A review of various modalities in breast imaging: technical aspects and clinical outcomes. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00175-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Abstract
Background
Nowadays, breast cancer is the second cause of death after cardiovascular diseases. In general, about one out of eight women (about 12%) suffer from this disease during their life in the USA and European countries. If breast cancer is detected at an early stage, its survival rate will be very high. Several methods have been introduced to diagnose breast cancer with their clinical advantages and disadvantages.
Main text
In this review, various methods of breast imaging have been introduced. Furthermore, the sensitivity and specificity of each of these methods have been investigated. For each of the imaging methods, articles that were relevant to the past 10 years were selected through electronic search engines, and then the most relevant papers were selected. Finally, about 40 articles were studied and their results were categorized and presented in the form of a report as follows. Various breast cancer imaging techniques were extracted as follows: mammography, contrast-enhanced mammography, digital tomosynthesis, sonography, sonoelastography, magnetic resonance imaging, magnetic elastography, diffusion-weighted imaging, magnetic spectroscopy, nuclear medicine, optical imaging, and microwave imaging.
Conclusion
The choice of these methods depends on the patient’s state and stage, the age of the individual and the density of the breast tissue. Hybrid imaging techniques appear to be an acceptable way to improve detection of breast cancer. This review article can be useful in choosing the right method for imaging in people suspected of breast cancer.
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Automatic Grading System for Diagnosis of Breast Cancer Exploiting Co-occurrence Shearlet Transform and Histogram Features. Ing Rech Biomed 2020. [DOI: 10.1016/j.irbm.2020.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Improving mammography through effective screening, brief intervention, and referral to treatment at a rural health center. J Am Assoc Nurse Pract 2020; 33:324-330. [PMID: 31972786 DOI: 10.1097/jxx.0000000000000356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/09/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Screening mammography rates at a rural health center were below state rates, while the countywide rate of breast cancer was above the state and national rates. LOCAL PROBLEM Only 25% of patients at the practice site received a screening mammogram within the last 2 years, and standing order usage was 25%. Evidence-based guidelines and decision aids were not used consistently. The aim was to increase the rate of screening mammograms and right care at a rural health center to 55% of eligible patients in 90 days. METHODS Implementation consisted of four 2-week plan, do, study, act cycles. Interventions included screening, brief intervention with patient engagement, referral to treatment with case management log tracking, and team engagement. Aggregate data were collected twice weekly. INTERVENTION An electronic health record reminder for mammography screening, a patient mammography decision aid, a case management log, and weekly quality improvement team meetings were the four core interventions used for the project. RESULTS Screening and identification improved by 40%, patient engagement improved by 30%, and case management for right care more than doubled. Overall, the combined mammography and right care rate improved by 40%. Team engagement reached 100% with survey scores for involvement rising to 78%. CONCLUSIONS The results obtained indicate the tools and processes implemented effectively increased screening, patient engagement, and case management to improve mammography rates and right care.
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Computer-aided diagnosis system combining FCN and Bi-LSTM model for efficient breast cancer detection from histopathological images. Appl Soft Comput 2019. [DOI: 10.1016/j.asoc.2019.105765] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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