Risk factors for breast cancer for women aged 40 to 49 years: a systematic review and meta-analysis

Advancing Breast Cancer Diagnosis: The Impact of Elastography Integration Into Breast Imaging Reporting and Data System (BIRADS) Categorization

OBJECTIVE

This study evaluates the impact of integrating elastography into the Breast Imaging Reporting and Data System (BIRADS) categorization on breast cancer diagnostics in an African population. It explores the association and agreement between traditional BIRADS and those modified by elastography, as well as between quantitative and qualitative elastography methods.

METHODS

A total of 200 participants who underwent breast imaging as part of their diagnostic evaluation for breast lesions were included in the study. Participant characteristics, including age distribution and indicators for breast cancer diagnoses, were analyzed. Brightness mode (B-mode) findings without elastography were assessed using the BIRADS classification. Elastography was integrated into the BIRADS categorization to evaluate its impact on breast cancer diagnostics. The association and agreement between BIRADS with and without elastography were analyzed.

RESULTS

Participants predominantly aged 40-49 showed significant staging differences with the integration of elastography. Traditional B-mode staging identified 29 (49%) of participants in BIRADS stage IV and 14 (23%) in stage V, whereas elastography adjusted these figures significantly, enhancing diagnostic refinement. There was a fair agreement between BIRADS with and without elastography (kappa = 0.322), while a substantial agreement was found between quantitative and qualitative elastography (kappa = 0.674).

CONCLUSION

The results of the study provide evidence that the integration of elastography into BIRADS categorization can significantly improve the accuracy of breast cancer diagnosis in African women. Elastography enhanced lesion characterization, supporting more personalized and precise clinical management. Continued research is needed to fully integrate elastography into routine diagnostic workflows and understand its broader clinical implications in Africa.

Clinical significance of serum synaptophysin-like 1 protein levels in breast cancer

Background

Mammography, used for breast cancer (BC) screening, has limitations such as decreased sensitivity in dense breasts. Currently used tumor markers are insufficient in diagnosing breast cancer. In this study, we aimed to investigate the relationship between serum levels of synaptophysin-like protein 1 (SYPL1) and BC and compare SYPL1 with other blood tumor markers.

Methods

The study group consisted of 80 female patients with a histopathological diagnosis of invasive BC who received no radiotherapy/chemotherapy. The control group was 72 women with no previous history of breast disease and evaluated as Breast Imaging Reporting and Data Systems (BI-RADS 1-2) on imaging. Serum SYPL1, cancer antigen 15-3 (CA 15-3), and carcinoembryonic antigen (CEA) were measured in both groups.

Breast cancer: Epidemiology, risk factors and screening

Breast cancer is a global health concern with a significant impact on the well-being of women. Worldwide, the past several decades have witnessed changes in the incidence and mortality of breast cancer. Additionally, epidemiological data reveal distinct geographic and demographic disparities globally. A range of modifiable and non-modifiable risk factors are established as being associated with an increased risk of developing breast cancer. This review discusses genetic, hormonal, behavioral, environmental, and breast-related risk factors. Screening plays a critical role in the effective management of breast cancer. Various screening modalities, including mammography, ultrasound, magnetic resonance imaging (MRI), and physical examination, have different applications, and a combination of these modalities is applied in practice. Current screening recommendations are based on factors including age and risk, with a significant emphasis on minimizing potential harms to achieve an optimal benefits-to-harms ratio. This review provides a comprehensive insight into the epidemiology, risk factors, and screening of breast cancer. Understanding these elements is crucial for improving breast cancer management and reducing its burden on affected individuals and healthcare systems.

Awareness of symptoms, anticipated barriers and delays to help-seeking among women at higher risk of breast cancer: A UK multicentre study

Women with a family history of breast cancer have an increased lifetime risk of the disease. Delay in symptom presentation can lead to poorer outcomes. Low awareness of breast cancer symptoms and help-seeking barriers have been associated with delay in presentation in the general population. Symptom awareness and help-seeking barriers among women at increased risk of breast cancer are unknown. We conducted analysis of survey data which included women with moderate and high risk of breast cancer from 20 secondary and tertiary care clinics in England (n = 408). Women completed a validated survey assessing breast cancer symptom awareness, barriers to help-seeking and anticipated delay in help-seeking. Women recognised an average of 9.1/11 breast cancer symptoms (SD = 2.1). Nipple rash was the least recognised symptom (51.0%). Women educated to at least degree level had higher awareness than those with lower education (β = 0.14, 95% CI 0.13, 0.99, p = 0.011). Women at lower socioeconomic status (SES) had lower awareness than those at higher SES (β = -0.13, 95% CI -1.09, -0.07, p = 0.027). Women reported several anticipated help-seeking barriers (mean = 4.0/11, SD = 2.8). Waiting to see if a symptom will pass was the most commonly reported barrier to help-seeking (71.5%). Most women (376/408; 92.2%) reported that they would seek medical help within 2 weeks of discovering a breast cancer symptom. Interventions to increase awareness of non-lump breast cancer symptoms and reduce help-seeking barriers are needed, with considerations of appropriate reading levels and modalities for women with lower education and SES.

Validation of an Abridged Breast Cancer Risk Prediction Model for the General Population

PREVENTION RELEVANCE

In this prospective population-based cohort study, we show the improved performance of a new risk assessment model compared with a gold-standard model (BCRAT). The classification of at-risk women using this new model highlights the opportunity to improve risk stratification and implement existing clinical risk-reduction interventions.

A letter is not enough: Women's preferences for and experiences of receiving breast density information

OBJECTIVE

Despite evidence of disparate uptake of breast density (BD) information, little is known about diverse women's preferences for and experiences learning about BD.

METHODS

Telephone survey among 2306 racially/ethnically and literacy diverse women; qualitative interviews with 61 survey respondents. Responses by participant race/ethnicity and literacy were examined using bivariate, then multivariable analyses. Interviews were content-analyzed for themes.

RESULTS

Most women (80%) preferred learning of personal BD from providers, with higher rates among Non-Hispanic Black (85%) than Non-Hispanic White women (80%); and among Non-Hispanic White than Asian women (72%, all ps<0.05). Women with low literacy less often preferred receiving BD information from providers (76% v. 81%), more often preferring written notification (21% vs. 10%); women with high literacy more often preferred learning through an online portal (9% vs 3%). Most women (93%) received BD information from providers (no between group differences). Qualitative findings detailed women's desires for obtaining BD information from providers, written information, and visual depictions of BD.

CONCLUSIONS

When educating women about BD, one size does not fit all.

PRACTICE IMPLICATIONS

Additional educational methods are needed beyond written BD notifications to sufficiently address the varying informational needs and preferences of all USA women.

Composition and changes in breast cancer patients' diagnosis and treatment expenses under the influence of medical insurance policy reform-A study on 3 950 patients in Guangxi Medical University Cancer Hospital

OBJECTIVES

To understand the influence of medical insurance policy reforms in Guangxi on the hospitalization expenses of breast cancer patients by analyzing the composition and changing trend in breast cancer diagnosis and treatment expenses in the Guangxi Medical University Cancer Hospital, and to provide the evidence for the improvement of medical insurance policy reform.

METHODS

A total of 3 950 breast cancer patients were collected from 2014 to 2017 and analyzed. Kruskal-Wallis test and multiple linear regression model were used to discuss the breast cancer related epidemiology and analyze the composition of hospitalization expenses and its influential factors.

RESULTS

The median hospitalization cost of breast cancer patients in our hospital from 2014 to 2017 was 29 266.94 Chinese Yuan. Single factor analysis showed that the impact of year, hospitalization days, age, payment method, tumor stage, and treatment method on hospitalization cost was significant (all P<0.01). Multiple linear regression analysis showed that the power of influential factors of hospitalization costs arranged descending from 2014 to 2017 as follows: hospitalization days, treatment methods, payment method, tumor staging, and age.

CONCLUSIONS

Reasonably controlling hospitalization days and actively promoting the integration of urban and rural medical insurance can effectively reduce the economic burden for breast cancer patients.

30 years after the fall of the Berlin Wall: Regional health differences in Germany

Following the fall of the Berlin Wall in November 1989, considerable effort was made to bring the living conditions and levels of social participation in the former East German federal states into line with the former West German federal states. As a result, differences in health between the East and the West diminished significantly, in many cases as early as the 1990s, examples being life expectancy and cardiovascular mortality. In regard to health behaviour, the overall tendency has also clearly been one of convergence. Thus, only very small differences can be observed today, for example in the use of tobacco or in the prevalence of obesity. Yet the results also highlight the insufficiency of regarding the remaining differences as a simple comparison between East and West. Instead, the focus should shift towards smaller-scale approaches that take regional differences in living conditions into account.

A Case-Control Study on the p73 G4A Gene Polymorphism and Susceptibility to Breast Cancer in an Iranian Population

BACKGROUND

The tumor protein p73 (TP73) is a homolog of TP53 family. Ectopic p73 overexpression largely mimics p53 activities as a tumor suppressor and activates the transcription of p53-responsive genes and as a result induce apoptosis. This study aimed to investigate the association between p73 G4A polymorphism and the risk of breast cancer in a northeastern Iranian population.

METHODS

This case-control study was performed on 105 patients who admitted in educational hospitals of Mashhad University of Medical Sciences, Iran during 2013-2015, with breast cancer as case group and 120 healthy women as the control group. PCR-CTPP method was used to investigate the relationship between the p73 G4A polymorphism and the risk of breast cancer.

RESULTS

There was no significant association between the AA genotype of the p73 G4A polymorphism and breast cancer in case and control groups. Although G allele frequency was higher in the case group, the abundance of this allele between case and control groups was not statistically meaningful and, as a result, not associated with the risk of breast cancer in this study group.

CONCLUSION

There was no association between G4A p73 polymorphism and the risk of breast cancer in a northeastern Iranian population.

Risk Factors for Breast Cancer among Jordanian Women: A Case-control Study

BACKGROUND

The interaction between inherited mutated genes and environmental factors is believed to play a crucial role in cancer development. The main aim was to identify lifestyle-related risk factors for breast cancer among Jordanian women.

METHODS

A hospital-based multicenter case-control study was conducted in Jordan in 2016. Overall, 405 cases and 418 controls, in 3 large hospitals where cancer patients are treated, participated. The prevalence of individual and groups of cancer-related risk factors was estimated descriptively using percentages and odd ratios with their correlated 95% Confidence interval (CI). The predictors of the occurrence of breast cancer were determined using logistic regression to estimate unadjusted association and adjusted association.

RESULTS

Women in the case group (mean=49.2 yr, SD 10.2) were older than those in the control group (mean=45.9, SD 10.9). Physical activity (sufficiently active) (OR=2.76; 95% CI=1.96-3.87) and fruit and vegetable intake (good or optimal) (OR=1.71 95% CI=1.25-2.35) were found to be associated with reduced breast cancer risk. However, calcium intake (>3 times a week) (OR=0.51; 95% CI=0.34-0.77) was associated with increased risk of breast cancer.

CONCLUSION

Lifestyle risk factors were identified, and certain modifications to lifestyle are needed. Women's awareness of these factors should be raised through appropriate channels, as a priority of the health authorities. Increasing the amount of high-quality research in this area remains one of the best ways to fight breast cancer, reducing its incidence and associated morbidities.

Association Between Changes in Mammographic Image Features and Risk for Near-Term Breast Cancer Development

The purpose of this study is to develop and test a new computerized model for predicting near-term breast cancer risk based on quantitative assessment of bilateral mammographic image feature variations in a series of negative full-field digital mammography (FFDM) images. The retrospective dataset included series of four sequential FFDM examinations of 335 women. The last examination in each series ("current") and the three most recent "prior" examinations were obtained. All "prior" examinations were interpreted as negative during the original clinical image reading, while in the "current" examinations 159 cancers were detected and pathologically verified and 176 cases remained cancer-free. From each image, we initially computed 158 mammographic density, structural similarity, and texture based image features. The absolute subtraction value between the left and right breasts was selected to represent each feature. We then built three support vector machine (SVM) based risk models, which were trained and tested using a leave-one-case-out based cross-validation method. The actual features used in each SVM model were selected using a nested stepwise regression analysis method. The computed areas under receiver operating characteristic curves monotonically increased from 0.666±0.029 to 0.730±0.027 as the time-lag between the "prior" (3 to 1) and "current" examinations decreases. The maximum adjusted odds ratios were 5.63, 7.43, and 11.1 for the three "prior" (3 to 1) sets of examinations, respectively. This study demonstrated a positive association between the risk scores generated by a bilateral mammographic feature difference based risk model and an increasing trend of the near-term risk for having mammography-detected breast cancer.

Obesity and Breast Cancer: Do Age, Race and Subtype Matter?

Obesity rates within the United States are on the rise. Obesity is a known risk factor for various diseases, including cancer. Numerous studies have linked obesity to the incidence and treatment outcomes of breast cancer. However, the risk of obesity may vary between breast cancer subtypes and different racial or age groups. In this article, we review the literature regarding the impact of obesity on incidence and response for different subtypes of breast cancer within different population groups.

Lack of an association between XRCC2 R188H polymorphisms and breast cancer: an update meta-analysis involving 35,422 subjects

PURPOSE

Several studies have investigated the associations between XRCC2 R188H polymorphism and the susceptibility to breast cancer, but the results have been inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed.

METHODS

PubMed and China National Knowledge Infrastructure (CNKI) searches were carried out for relevant studies published before March 2015. Meta-analysis was performed with the Stata, version 11.0.

RESULTS

A total of 17 case-control studies, including 17,986 cases and 17,436 controls, were selected. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association in the homozygous model, dominant model, and recessive model. When all the studies were pooled into the meta-analysis, there was no evidence showing a significant association between XRCC2 R188H polymorphism and breast cancer risk (for homozygous model, OR=0.84, 95% CI=0.62-1.14; for dominant model: OR=0.76, 95% CI=0.53-1.09; and for recessive model: OR=1.04, 95% CI=0.98-1.10). In the subgroup analysis by ethnicity, no significant association was found between the polymorphism and breast cancer risk.

CONCLUSIONS

In conclusion, this meta-analysis indicates that the XRCC2 R188H polymorphism is not a risk factor for developing of breast cancer.