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Lee M, Kotake R, Yamauchi H. Physical Activity and Mammographic Density in Japanese Women. Cancer Epidemiol Biomarkers Prev 2024; 33:365-370. [PMID: 38147061 PMCID: PMC10905669 DOI: 10.1158/1055-9965.epi-23-0777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/11/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Dense breast is one of the strong risk factors for breast cancer among women. While it has been established that physical activity is associated with decreased risk for breast cancer, results have been inconsistent in terms of mammographic density. Thus, we examined physical activity in relation to mammographic density among Japanese women in Tokyo. METHODS We used 123,026 records from 33,698 Japanese women without a history of breast cancer who got mammograms at St. Luke's International Hospital in Tokyo, Japan from 2004 to 2019. Mammographic density was classified according to the Breast Imaging Reporting and Data System (BI-RADS), and women self-reported their physical activity level over the past year. ORs were estimated using logistic generalized estimating equations after adjusting for age, body mass index, menopausal status, parity, family history of breast or ovarian cancer, hormone therapy use, smoking status, alcohol consumption, and year. RESULTS We observed inverse associations of physical activity with dense breasts. Adjusted ORs were 0.96 (95% confidence interval: 0.91-1.00) for women with physical exercise for 1-2 days per week, 0.94 (0.88-0.99) for those with physical exercise for 3-5 days per week, and 0.91 (0.84-0.99) for those with daily physical exercise when compared with those reported seldom physical exercise. CONCLUSIONS Higher levels of physical activity may be associated with decreased mammographic density levels in Japanese women. IMPACT Increasing physical activity may serve as a reasonable intervention to reduce mammographic density, and thereby, to mitigate the risk of breast cancer in Asian women.
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Affiliation(s)
- Mihye Lee
- St. Luke's School of Public Health, Tokyo, Japan
| | - Rina Kotake
- St. Luke's School of Public Health, Tokyo, Japan
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2
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Rostami-Moez M, Masoumi SZ, Otogara M, Farahani F, Alimohammadi S, Oshvandi K. Examining the Health-Related Needs of Females during Menopause: A Systematic Review Study. J Menopausal Med 2023; 29:1-20. [PMID: 37160298 PMCID: PMC10183767 DOI: 10.6118/jmm.22033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/19/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023] Open
Abstract
Menopause is one the most crucial stages in a female's life. Identifying the education gaps regarding menopause is important, thus this study aims to explain the health-related needs of females during menopause. Scopus, PubMed, Scientific Information Database, and Web of Science databases were searched for the available observational (cohort, case-control, and cross-sectional), systematic review, meta-analysis, and clinical trial studies (2007-2021) using keywords, such as 'Educational Needs Assessment,' 'Assessment of Healthcare Needs,' 'menopause,' 'climacteric,' 'premenopause,' and 'postmenopause.' A total of 180 out of 5,705 papers were evaluated after considering the inclusion and exclusion criteria. The educational needs of females during menopause in the reviewed studies include osteoporosis, oral and dental problems, metabolic disorders, cardiovascular diseases, hypertension, lung diseases, infectious diseases, musculoskeletal problems, urinary problems, breast cancer, defecation problems, genital disorders, special diseases such as eye diseases and hypothyroidism and hormone therapy, mental disorders, cognitive function, sleep disorders, sexual disorders, physical activity, supplement consumption, public health issues, health education, fall, and nutrition. The study results reveal that females during postmenopause require training, counseling, and support in all aspects to get through this challenging time, and providing these services, infrastructure, appropriate policy, and the use and support of the medical team's capacity are all required.
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Affiliation(s)
- Masoumeh Rostami-Moez
- Research Center for Health Sciences, Education Development Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Marzieh Otogara
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farhad Farahani
- Department of Ear, Nose and Throat, School of Medicine, Hearing Disorder Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shohreh Alimohammadi
- Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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3
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Edmonds CE, O'Brien SR, Conant EF. Mammographic Breast Density: Current Assessment Methods, Clinical Implications, and Future Directions. Semin Ultrasound CT MR 2023; 44:35-45. [PMID: 36792272 DOI: 10.1053/j.sult.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Mammographic breast density is widely accepted as an independent risk factor for the development of breast cancer. In addition, because dense breast tissue may mask breast malignancies, breast density is inversely related to the sensitivity of screening mammography. Given the risks associated with breast density, as well as ongoing efforts to stratify individual risk and personalize breast cancer screening and prevention, numerous studies have sought to better understand the factors that impact breast density, and to develop and implement reproducible, quantitative methods to assess mammographic density. Breast density assessments have been incorporated into risk assessment models to improve risk stratification. Recently, novel techniques for analyzing mammographic parenchymal complexity, or texture, have been explored as potential means of refining mammographic tissue-based risk assessment beyond breast density.
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Affiliation(s)
- Christine E Edmonds
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA.
| | - Sophia R O'Brien
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Emily F Conant
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
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4
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Dietary Patterns, Dietary Interventions, and Mammographic Breast Density: A Systematic Literature Review. Nutrients 2022; 14:nu14245312. [PMID: 36558470 PMCID: PMC9781545 DOI: 10.3390/nu14245312] [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: 10/06/2022] [Revised: 12/01/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common and deadliest malignancy among women. High mammographic breast density (MBD) is an established modifiable risk marker for BC, and it is of interest, for prevention purposes, to consider lifestyle factors that may modulate both MBD and BC risk. Here, we conducted a systematic review of the most up-to-date evidence on the association between diet as a whole and MBD. METHODS We considered as eligible for inclusion in our review (PROSPERO registration code CRD42022335289) the studies published until 31 December 2021, that reported on the association between a priori or a posteriori dietary patterns (in observational studies) or dietary interventions (in randomized controlled trials) and MBD. RESULTS In total, twelve studies were included. MBD tended to be inversely associated with adherence to dietary patterns characterized by high consumption of plant-based foods and low in meat, animal fats, and alcohol, defined both a priori (e.g., Mediterranean diet and WCRF/AICR guidelines) or a posteriori (e.g., "fruit-vegetable-cereal" and "salad-sauce-pasta/grains" patterns). Findings from intervention studies were in fair agreement with those from observational studies. CONCLUSIONS While further studies are needed, we found suggestive evidence that the adoption of a healthy diet is associated with lower MBD.
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Chalfant JS, Hoyt AC. Breast Density: Current Knowledge, Assessment Methods, and Clinical Implications. JOURNAL OF BREAST IMAGING 2022; 4:357-370. [PMID: 38416979 DOI: 10.1093/jbi/wbac028] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Indexed: 03/01/2024]
Abstract
Breast density is an accepted independent risk factor for the future development of breast cancer, and greater breast density has the potential to mask malignancies on mammography, thus lowering the sensitivity of screening mammography. The risk associated with dense breast tissue has been shown to be modifiable with changes in breast density. Numerous studies have sought to identify factors that influence breast density, including age, genetic, racial/ethnic, prepubertal, adolescent, lifestyle, environmental, hormonal, and reproductive history factors. Qualitative, semiquantitative, and quantitative methods of breast density assessment have been developed, but to date there is no consensus assessment method or reference standard for breast density. Breast density has been incorporated into breast cancer risk models, and there is growing consciousness of the clinical implications of dense breast tissue in both the medical community and public arena. Efforts to improve breast cancer screening sensitivity for women with dense breasts have led to increased attention to supplemental screening methods in recent years, prompting the American College of Radiology to publish Appropriateness Criteria for supplemental screening based on breast density.
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Affiliation(s)
- James S Chalfant
- David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA
| | - Anne C Hoyt
- David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA
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6
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Factors Influencing Mammographic Density in Asian Women: A Retrospective Cohort Study in the Northeast Region of Peninsular Malaysia. Diagnostics (Basel) 2022; 12:diagnostics12040860. [PMID: 35453907 PMCID: PMC9032698 DOI: 10.3390/diagnostics12040860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
Mammographic density is a significant risk factor for breast cancer. In this study, we identified the risk factors of mammographic density in Asian women and quantified the impact of breast density on the severity of breast cancer. We collected data from Hospital Universiti Sains Malaysia, a research- and university-based hospital located in Kelantan, Malaysia. Multivariable logistic regression was performed to analyse the data. Five significant factors were found to be associated with mammographic density: age (OR: 0.94; 95% CI: 0.92, 0.96), number of children (OR: 0.88; 95% CI: 0.81, 0.96), body mass index (OR: 0.88; 95% CI: 0.85, 0.92), menopause status (yes vs. no, OR: 0.59; 95% CI: 0.42, 0.82), and BI-RADS classification (2 vs. 1, OR: 1.87; 95% CI: 1.22, 2.84; 3 vs. 1, OR: 3.25; 95% CI: 1.86, 5.66; 4 vs. 1, OR: 3.75; 95% CI: 1.88, 7.46; 5 vs. 1, OR: 2.46; 95% CI: 1.21, 5.02; 6 vs. 1, OR: 2.50; 95% CI: 0.65, 9.56). Similarly, the average predicted probabilities were higher among BI-RADS 3 and 4 classified women. Understanding mammographic density and its influencing factors aids in accurately assessing and screening dense breast women.
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Marcus EN, Yepes M, Dietz N. Perception of Breast Density Information Among Women in Miami, FL: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:188-195. [PMID: 32506252 DOI: 10.1007/s13187-020-01778-2] [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] [Indexed: 06/11/2023]
Abstract
The US Food and Drug Administration has proposed requiring that all women undergoing mammography receive written information about their breast density. Past research suggests many women may misperceive the meaning of breast density. Additionally, women with dense breasts may not understand the risks and benefits of pursuing additional imaging studies. The goal of this study was to explore women's beliefs about breast density and their preferences for how this information is conveyed. Women with increased breast density detected on mammography at a university-based breast imaging center in South Florida were recruited for a series of focus groups. Twenty-five women participated, ranging in age from 42 to 65 years. Nine women (36%) self-identified as Hispanic/Latina, eight (32%) as Black, four (16%) as White, three (12%) as Asian, and one as "other." Four focus groups were conducted in English and one in Spanish by professional moderators using a semi-structured format. A constant comparative method was used to identify common themes using a general inductive approach. Areas explored included understanding of the term breast density; personal reaction to being informed of dense breasts; questions about breast density; understanding of supplemental screening; and preferences for how to convey breast density information. Subthemes identified included a misperception that breast density is palpable; a feeling of fear on learning of increased breast density results; a concern about what causes increased breast density and whether it can be reversed; a desire to proceed with supplemental ultrasound imaging; and a preference for simple messages explaining the concept of breast density in multiple formats including video. Participants voiced the incorrect belief that caffeine intake could increase breast density and stated that they wanted to know specific details about their personal results. There is a need for better tools to communicate breast density in a way that allays anxiety while enabling women to make fully informed decisions about their breast health. Clinicians and cancer educators should be aware of misperceptions women may have about breast density. Policymakers should keep in mind potential public confusion about this complex topic when crafting density notification rules.
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Affiliation(s)
- Erin N Marcus
- Division of General Medicine, Miller School of Medicine, University of Miami, 1120 NW 14th St., CRB #964 (C-223), Miami, FL, 33136, USA.
- Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Miami, FL, 33136, USA.
| | - Monica Yepes
- Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Miami, FL, 33136, USA
- Department of Radiology, Miller School of Medicine, University of Miami, 1115 NW 14th St., Miami, FL, 33136, USA
| | - Noella Dietz
- Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Miami, FL, 33136, USA
- Broward Health Medical Center, 1600 South Andrews Avenue, Fort Lauderdale, FL, 33316, USA
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Yoon L, Corvalán C, Pereira A, Shepherd J, Michels KB. Sugar-sweetened beverage consumption and breast composition in a longitudinal study of Chilean girls. Breast Cancer Res 2022; 24:3. [PMID: 34998441 PMCID: PMC8742361 DOI: 10.1186/s13058-021-01495-8] [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: 08/17/2021] [Accepted: 12/08/2021] [Indexed: 12/05/2022] Open
Abstract
Background Frequent sugar-sweetened beverage (SSB) intake has been associated with indirect markers of breast cancer risk, such as weight gain in adolescents and early menarche. How SSB intake relates to breast composition in adolescent girls has not been explored. Methods We evaluated the association between prospective intake of SSB and breast density in a cohort of 374 adolescent girls participating in the Growth and Obesity Cohort Study in Santiago, Chile. Multivariable linear regression models were used to analyze the association between average daily SSB intake quartiles and breast composition (absolute fibroglandular volume [aFGV], percent fibroglandular volume [%FGV], total breast volume [tBV]). Models were adjusted for potential confounding by BMI Z-score, age, daily energy intake (g/day), maternal education, hours of daily television watching after school, dairy intake (g/day), meat intake (g/day), waist circumference, and menarche. To examine the sensitivity of the association to the number of dietary recalls for each girl, analyses were further stratified by girls with one dietary recall and girls with > one dietary recall. Results A total of 881 dietary recalls were available for 374 girls prior to the breast density assessment. More than 60% of the cohort had > one dietary recall available. In multivariable analyses, we found no association between SSB intake quartile and aFGV (Q2 vs Q1 β: − 5.4, 95% CI − 15.1, 4.4; Q3 vs Q1 β: 1.3, 95% CI − 8.6, 11.3; Q4 vs Q1 β: 3.0, 95% CI − 7.1, 13). No associations were noted for %FGV and tBV. Among girls with at least one dietary recall, we found no significant associations between SSB intake quartiles and %FGV, aFGV, or tBV. Conclusion Overall, we observed no evidence that SSB intake was associated with breast density in adolescent Chilean girls. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-021-01495-8.
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Affiliation(s)
- Lara Yoon
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA, 90095, USA
| | - Camila Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - John Shepherd
- Epidemiology and Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA, 90095, USA. .,Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
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Atakpa EC, Thorat MA, Cuzick J, Brentnall AR. Mammographic density, endocrine therapy and breast cancer risk: a prognostic and predictive biomarker review. Cochrane Database Syst Rev 2021; 10:CD013091. [PMID: 34697802 PMCID: PMC8545623 DOI: 10.1002/14651858.cd013091.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Endocrine therapy is effective at preventing or treating breast cancer. Some forms of endocrine therapy have been shown to reduce mammographic density. Reduced mammographic density for women receiving endocrine therapy could be used to estimate the chance of breast cancer returning or developing breast cancer in the first instance (a prognostic biomarker). In addition, changes in mammographic density might be able to predict how well a woman responds to endocrine therapy (a predictive biomarker). The role of breast density as a prognostic or predictive biomarker could help improve the management of breast cancer. OBJECTIVES To assess the evidence that a reduction in mammographic density following endocrine therapy for breast cancer prevention in women without previous breast cancer, or for treatment in women with early-stage hormone receptor-positive breast cancer, is a prognostic or predictive biomarker. SEARCH METHODS We searched the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, Embase, and two trials registers on 3 August 2020 along with reference checking, bibliographic searching, and contact with study authors to obtain further data. SELECTION CRITERIA We included randomised, cohort and case-control studies of adult women with or without breast cancer receiving endocrine therapy. Endocrine therapy agents included were selective oestrogen receptor modulators and aromatase inhibitors. We required breast density before start of endocrine therapy and at follow-up. We included studies published in English. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two review authors independently extracted data and assessed risk of bias using adapted Quality in Prognostic Studies (QUIPS) and Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tools. We used the GRADE approach to evaluate the certainty of the evidence. We did not perform a quantitative meta-analysis due to substantial heterogeneity across studies. MAIN RESULTS Eight studies met our inclusion criteria, of which seven provided data on outcomes listed in the protocol (5786 women). There was substantial heterogeneity across studies in design, sample size (349 to 1066 women), participant characteristics, follow-up (5 to 14 years), and endocrine therapy agent. There were five breast density measures and six density change definitions. All studies had at least one domain as at moderate or high risk of bias. Common concerns were whether the study sample reflected the review target population, and likely post hoc definitions of breast density change. Most studies on prognosis for women receiving endocrine therapy reported a reduced risk associated with breast density reduction. Across endpoints, settings, and agents, risk ratio point estimates (most likely value) were between 0.1 and 1.5, but with substantial uncertainty. There was greatest consistency in the direction and magnitude of the effect for tamoxifen (across endpoints and settings, risk ratio point estimates were between 0.3 and 0.7). The findings are summarised as follows. Prognostic biomarker findings: Treatment Breast cancer mortality Two studies of 823 women on tamoxifen (172 breast cancer deaths) reported risk ratio point estimates of ~0.4 and ~0.5 associated with a density reduction. The certainty of the evidence was low. Recurrence Two studies of 1956 women on tamoxifen reported risk ratio point estimates of ~0.4 and ~0.7 associated with a density reduction. There was risk of bias in methodology for design and analysis of the studies and considerable uncertainty over the size of the effect. One study of 175 women receiving an aromatase inhibitor reported a risk ratio point estimate of ~0.1 associated with a density reduction. There was considerable uncertainty about the effect size and a moderate or high risk of bias in all domains. One study of 284 women receiving exemestane or tamoxifen as part of a randomised controlled trial reported risk ratio point estimates of ~1.5 (loco-regional recurrence) and ~1.3 (distance recurrence) associated with a density reduction. There was risk of bias in reporting and study confounding, and uncertainty over the size of the effects. The certainty of the evidence for all recurrence endpoints was very low. Incidence of a secondary primary breast cancer Two studies of 451 women on exemestane, tamoxifen, or unknown endocrine therapy reported risk ratio point estimates of ~0.5 and ~0.6 associated with a density reduction. There was risk of bias in reporting and study confounding, and uncertainty over the effect size. The certainty of the evidence was very low. We were unable to find data regarding the remaining nine outcomes prespecified in the review protocol. Prevention Incidence of invasive breast cancer and ductal carcinoma in situ (DCIS) One study of 507 women without breast cancer who were receiving preventive tamoxifen as part of a randomised controlled trial (51 subsequent breast cancers) reported a risk ratio point estimate of ~0.3 associated with a density reduction. The certainty of the evidence was low. Predictive biomarker findings: One study of a subset of 1065 women from a randomised controlled trial assessed how much the effect of endocrine therapy could be explained by breast density declines in those receiving endocrine therapy. This study evaluated the prevention of invasive breast cancer and DCIS. We found some evidence to support the hypothesis, with a risk ratio interaction point estimate ~0.5. However, the 95% confidence interval included unity, and data were based on 51 women with subsequent breast cancer in the tamoxifen group. The certainty of the evidence was low. AUTHORS' CONCLUSIONS There is low-/very low-certainty evidence to support the hypothesis that breast density change following endocrine therapy is a prognostic biomarker for treatment or prevention. Studies suggested a potentially large effect size with tamoxifen, but the evidence was limited. There was less evidence that breast density change following tamoxifen preventive therapy is a predictive biomarker than prognostic biomarker. Evidence for breast density change as a prognostic treatment biomarker was stronger for tamoxifen than aromatase inhibitors. There were no studies reporting mammographic density change following endocrine therapy as a predictive biomarker in the treatment setting, nor aromatase inhibitor therapy as a prognostic or predictive biomarker in the preventive setting. Further research is warranted to assess mammographic density as a biomarker for all classes of endocrine therapy and review endpoints.
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Affiliation(s)
- Emma C Atakpa
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mangesh A Thorat
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Breast Services, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jack Cuzick
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Adam R Brentnall
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Thompson PA, Huang C, Yang J, Wertheim BC, Roe D, Zhang X, Ding J, Chalasani P, Preece C, Martinez J, Chow HHS, Stopeck AT. Sulindac, a Nonselective NSAID, Reduces Breast Density in Postmenopausal Women with Breast Cancer Treated with Aromatase Inhibitors. Clin Cancer Res 2021; 27:5660-5668. [PMID: 34112707 DOI: 10.1158/1078-0432.ccr-21-0732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/26/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the effect of sulindac, a nonselective anti-inflammatory drug (NSAID), for activity to reduce breast density (BD), a risk factor for breast cancer. EXPERIMENTAL DESIGN An open-label phase II study was conducted to test the effect of 12 months' daily sulindac at 150 mg twice daily on change in percent BD in postmenopausal hormone receptor-positive breast cancer patients on aromatase inhibitor (AI) therapy. Change in percent BD in the contralateral, unaffected breast was measured by noncontrast magnetic resonance imaging (MRI) and reported as change in MRI percent BD (MRPD). A nonrandomized patient population on AI therapy (observation group) with comparable baseline BD was also followed for 12 months. Changes in tissue collagen after 6 months of sulindac treatment were explored using second-harmonic generated microscopy in a subset of women in the sulindac group who agreed to repeat breast biopsy. RESULTS In 43 women who completed 1 year of sulindac (86% of those accrued), relative MRPD significantly decreased by 9.8% [95% confidence interval (CI), -14.6 to -4.7] at 12 months, an absolute decrease of -1.4% (95% CI, -2.5 to -0.3). A significant decrease in mean breast tissue collagen fiber straightness (P = 0.032), an investigational biomarker of tissue inflammation, was also observed. MRPD (relative or absolute) did not change in the AI-only observation group (N = 40). CONCLUSIONS This is the first study to indicate that the NSAID sulindac may reduce BD. Additional studies are needed to verify these findings and determine if prostaglandin E2 inhibition by NSAIDs is important for BD or collagen modulation.
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Affiliation(s)
- Patricia A Thompson
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York. .,Department of Pathology, Stony Brook University, Stony Brook, New York
| | - Chuan Huang
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York.,Department of Radiology, Stony Brook University, Stony Brook, New York.,Department of Psychiatry, Stony Brook University, Stony Brook, New York.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - Jie Yang
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York.,Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York
| | | | - Denise Roe
- University of Arizona Cancer Center, Tucson, Arizona.,Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona
| | - Xiaoyue Zhang
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York
| | - Jie Ding
- Department of Psychiatry, Stony Brook University, Stony Brook, New York.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - Pavani Chalasani
- University of Arizona Cancer Center, Tucson, Arizona.,Department of Medicine, University of Arizona, Tucson, Arizona
| | - Christina Preece
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York.,Department of Pathology, Stony Brook University, Stony Brook, New York
| | - Jessica Martinez
- University of Arizona Cancer Center, Tucson, Arizona.,Department of Nutritional Sciences, University of Arizona, Tucson, Arizona
| | | | - Alison T Stopeck
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York.,Department of Medicine, Stony Brook University, Stony Brook, New York
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11
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Kanbayti IH, Rae WID, McEntee MF, Al-Foheidi M, Ashour S, Turson SA, Ekpo EU. Is mammographic density a marker of breast cancer phenotypes? Cancer Causes Control 2020; 31:749-765. [PMID: 32410205 DOI: 10.1007/s10552-020-01316-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/05/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate the association between mammographic density (MD) phenotypes and both clinicopathologic features of breast cancer (BC) and tumor location. METHODS MD was measured for 297 BC-affected females using qualitative (visual method) and quantitative (fully automated area-based method) approaches. Radiologists' description, visible external markers, and surgical scar were used to establish the location of tumors. Binary logistic regression models were used to assess the association between MD phenotypes and BC clinicopathologic features. RESULTS Categorical and numerical MD measures showed no association with clinicopathologic features of BC (p > 0.05). Participants with higher BI-RADS scores [(51-75% glandular) and (> 75% glandular)] (p < 0.001), and percent density (PD) categories [PD (21-49%) and PD ≥ 50%] (p = 0.01) were more likely to have tumors emanating from dense areas. Additionally, tumors were commonly found in dense regions of the breast among patients with higher medians of PD (p = 0.001), dense area (DA) (p = 0.02), and lower medians of non-dense area (NDA) (p < 0.001). Adjusted logistic regression models showed that high BI-RADS density (> 75% glandular) has an almost fivefold increased odds of tumors developing within dense areas (OR 4.99, 95% CI 0.93-25.9; p = 0.05. PD (OR 1.02, 95% CI 1-1.03, p = 0.002) and NDA (OR 0.99, 95% CI 0.991-0.997, p < 0.001) had very small effect on tumor location. Compared to tumors within non-dense areas, tumors in dense areas tended to exhibit human epidermal growth factor receptor 2 positive (p = 0.05) and carcinoma in situ (p = 0.01) characteristics. CONCLUSION MD shows no significant association with clinicopathologic features of BC. However, BC was more likely to originate from dense tissue, with tumors in dense regions having human epidermal growth receptor 2 positive and carcinoma in situ characteristics.
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Affiliation(s)
- Ibrahem H Kanbayti
- Diagnostic Radiography Technology Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah, Saudi Arabia. .,Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,Faculty of Health Science, University of Sydney, Cumberland Campus C42
- 75 East Street, Lidcombe, NSW, 2141, Australia.
| | - William I D Rae
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Mark F McEntee
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Department of Medicine Roinn na Sláinte, UG 12 Áras Watson
- Brookfield Health Sciences, Cork, T12 AK54, Ireland
| | - Meteb Al-Foheidi
- King Saud Bin Abdulaziz University for Health Science-National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Sawsan Ashour
- Radiology Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Smeera A Turson
- Radiology Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Ernest U Ekpo
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Orange Radiology, Laboratories and Research Centre, Calabar, Nigeria
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12
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Guo WY, Zeng SMZ, Deora GS, Li QS, Ruan BF. Estrogen Receptor α (ERα)-targeting Compounds and Derivatives: Recent Advances in Structural Modification and Bioactivity. Curr Top Med Chem 2019; 19:1318-1337. [PMID: 31215379 DOI: 10.2174/1568026619666190619142504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 04/29/2019] [Accepted: 05/05/2019] [Indexed: 12/17/2022]
Abstract
Breast cancer is the most common cancer suffered by female, and the second highest cause of cancer-related death among women worldwide. At present, hormone therapy is still the main treatment route and can be divided into three main categories: selective estrogen receptor modulators (SERMs), selective estrogen receptor downregulators (SERDs), and aromatase inhibitors (AIs). However, breast cancer is difficult to cure even after several rounds of anti-estrogen therapy and most drugs have serious side-effects. Here, we review the literature published over the past five years regarding the isolation and synthesis of analogs and their derivatives.
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Affiliation(s)
- Wei-Yun Guo
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Shang-Ming-Zhu Zeng
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Girdhar Singh Deora
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052, Australia
| | - Qing-Shan Li
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Ban-Feng Ruan
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
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Kanbayti IH, Rae WID, McEntee MF, Ekpo EU. Are mammographic density phenotypes associated with breast cancer treatment response and clinical outcomes? A systematic review and meta-analysis. Breast 2019; 47:62-76. [PMID: 31352313 DOI: 10.1016/j.breast.2019.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 12/15/2022] Open
Abstract
Mammographic density (MD) increases breast cancer (BC) risk, however, its association with patient outcomes is unclear. We examined the association of baseline MD (BMD), and MD reduction (MDR) following BC treatment with patient outcomes. Six databases (CINAHL, Scopus, PubMed, Web of Science, MEDLINE, and Embase) were used to identify relevant articles. The PRISMA strategy was used to extract relevant details. Study quality and risk of bias were assessed using the "Quality In Prognosis Studies" (QUIPS) tool. A Meta-analysis and pooled risk estimates were performed. Results showed that BMD is associated with contralateral breast cancer (CBC) risk (HR = 1.9; 95%CI: 1.3-3.0, p = 0.0007), recurrence (HR = 2.0; 95%CI: 1.0-4.0, p = 0.04), and mortality (HR = 1.4; 95%CI: 1.1-1.9, p = 0.003). No association was found between BMD and prognosis (HR = 3.2; 95%CI: 0.9-11.2, p = 0.06). Data on risk estimates (95%CI) from BMD for survival [RR: 1.75; 0.99-3.1 to 2.4; 1.4-4.1], ipsilateral BC [HR: 1; 0.6-1.6 to 3; 1.2-7.5], and treatment response (OR, 1.8; 0.98-3.3) are limited. MDR showed no association with mortality (HR = 0.5; 95%CI: 0.2-1.2, p = 0.13). MDR is associated with a reduced risk of recurrence [HR/RR: 0.35; 0.17-0.68 to 1.33; 0.67-2.65)], however data on MDR and outcomes such as mortality [HR/RR: 0.5; 0.27-0.93 to 0.59; 0.22-0.88], and CBC risk [RR/HR: 0.53; 0.24-0.84 to 1.3; 0.6-2.7] are limited. Evidence, although sparse, demonstrates that high BMD is associated with an increased risk of recurrence, CBC, and mortality. Conversely, MDR is associated with a reduced risk of BC recurrence, CBC, and BC-related mortality.
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Affiliation(s)
- Ibrahem H Kanbayti
- Diagnostic Radiography Technology Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Saudi Arabia; Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Australia.
| | - William I D Rae
- Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Australia
| | - Mark F McEntee
- Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Australia; Department of Medicine Roinn na Sláinte, UG 12 Áras Watson, Brookfield Health Sciences, T12 AK54, Ireland
| | - Ernest U Ekpo
- Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Australia; Orange Radiology, Laboratories and Research Centre, Calabar, Nigeria
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14
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A high AR:ERα or PDEF:ERα ratio predicts a sub-optimal response to tamoxifen therapy in ERα-positive breast cancer. Cancer Chemother Pharmacol 2019; 84:609-620. [PMID: 31297554 DOI: 10.1007/s00280-019-03891-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 06/13/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE Approximately 30% oestrogen receptor alpha (ERα)-positive breast cancer (BC) patients exhibit intrinsic or recurrent resistance to adjuvant endocrine therapy with tamoxifen. The androgen receptor (AR) is expressed in about 90% of ERα-positive patients, with particularly high expression in tamoxifen-resistant tumours. Prostate-derived Ets factor (PDEF), which is a co-regulator of AR, plays a role in tamoxifen resistance in ERα-positive BC. The purpose of this research was to analyse the potential roles of AR, PDEF and ERα levels in the response to tamoxifen resistance in ERα-positive BC. METHODS The nuclear AR:ERα and PDEF:ERα ratios were examined immunohistochemically in a cohort of 225 ERα-positive pre-menopausal BC patients who had received adjuvant tamoxifen therapy. RESULTS For both AR:ERα and PDEF:ERα ratios, the optimal cutoff value was 2.0. Patients receiving adjuvant tamoxifen treatment who had a high AR:ERα (≥ 2.0) (HR = 3.90) or PDEF:ERα ratio (≥ 2.0) (HR = 2.77) had a beyond twofold increased risk of failure. Both the AR:ERα ratio (P = 0.001) and PDEF:ERα ratio (P = 0.002) were independently associated with the risk of tamoxifen treatment failure. Furthermore, both a high ratio of AR:ERα (≥ 2.0) and PDEF:ERα (≥ 2.0) were associated with shorter disease-free survival (DFS) and shorter disease-specific survival (DSS). In addition, both the AR:ERα ratio and PDEF:ERα ratio were independent predictors of DFS (both P < 0.0001) and DSS (P = 0.001 and P < 0.0001, respectively). CONCLUSIONS AR:ERα and PDEF:ERα ratios are independent predictors of the response to conventional ERα-directed tamoxifen endocrine therapy.
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15
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Impact of hormonal therapy and other adjuvant therapies on contralateral breast volume change after implant-based breast reconstruction. Arch Plast Surg 2018; 45:432-440. [PMID: 30282414 PMCID: PMC6177640 DOI: 10.5999/aps.2018.00563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/27/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Adjuvant therapy after breast surgery, including tamoxifen or aromatase inhibitors, improves the postoperative outcomes and long-term survival of breast cancer patients. The aim of this study was to determine whether volume changes occurred in the contralateral breast during hormonal or other adjuvant therapies. METHODS This study reviewed 90 patients who underwent unilateral breast reconstruction between September 2012 and April 2018 using tissue expanders and a permanent implant after the surgical removal of breast cancer. The volume of the contralateral breast was measured using a cast before the first (tissue expander insertion) and second (permanent implant change) stages of surgery. Changes in breast volume were evaluated to determine whether adjuvant therapy such as hormonal therapy, chemotherapy, and radiation therapy influenced the volume of the contralateral breast. RESULTS The group receiving tamoxifen therapy demonstrated a significant decrease in volume compared with the group without tamoxifen (-7.8% vs. 1.0%; P=0.028). The aromatase inhibitor-treated group showed a significant increase in volume compared with those who did not receive therapy (-6.2% vs. 4.5%; P=0.023). There were no significant differences between groups treated with other hormonal therapy, chemotherapy, or radiation therapy. CONCLUSIONS Patients who received tamoxifen therapy showed a significant decrease in volume in the contralateral breast, while no significant change in weight or body mass index was found. Our findings suggest that we should choose smaller implants for premenopausal patients, who have a high likelihood of receiving tamoxifen therapy.
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16
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Albeshan SM, Hossain SZ, Mackey MG, Demchig D, Peat JK, Brennan PC. Mammographic Density Distribution in Ras Al Khaimah (RAK): Relationships with Demographic and Reproductive Factors. Asian Pac J Cancer Prev 2018; 19:1607-1616. [PMID: 29936786 PMCID: PMC6103600 DOI: 10.22034/apjcp.2018.19.6.1607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objective: Mammographic density is an important risk factor for breast cancer and determines to a large extent mammographic screening efficacy. This study aims to provide baseline data for mammographic density profiling of women living in Ras Al Khaimah (RAK) and to identify risk factors associated with high mammographic density. Methods: A cross-sectional design was used to examine a series of 366 mammography cases. The Breast Imaging Reporting and Data System (BI-RADS, 5th edition) was used to evaluate mammographic density. Pearson’s chi-squared, Mann-Whitney U test and multivariate logistic regression were used for statistical analysis. Results: Most participants (67%) fell into BI-RADS b and c mammographic density categories. Of the total sample, women who were aged ≤ 45 years (p=0.004, OR=1.9), weighed ≤ 71kg (p=<0.0001, OR=4.8), had a body mass index of ≤ 27 kg/m2 (p=<0.0001, OR=5.1) and were of non-Arab descent (p=0.007, OR=1.8) were significantly more likely to have denser breast tissue. Adjusted ethnicity regression analysis showed that Emirati women were significantly less likely to have dense breast tissue compared with Western women (p=0.04, OR=0.4). Among the sample of survey participants, increased odds of having mammographic density were among women who were full-time workers (p=0.02, OR=2.8), of Christian faith (p=0.007, OR=4.4), nulliparous (p=0.003, OR=10.8), had three or fewer children (p=0.03, OR=3.8), and had used oral contraceptives for three years or more (p=0.01, OR=6.1). Conclusion: This study indicated that because Emirati women have a low mammographic density profile, screening mammography can be considered as an effective early detection imaging modality.
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Affiliation(s)
- Salman M Albeshan
- Medical Radiation Sciences, Medical Image Optimization and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.,Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University (KSU), Kingdom of Saudi Arabia.
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17
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Ekpo EU, Alakhras M, Brennan P. Errors in Mammography Cannot be Solved Through Technology Alone. Asian Pac J Cancer Prev 2018; 19:291-301. [PMID: 29479948 PMCID: PMC5980911 DOI: 10.22034/apjcp.2018.19.2.291] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2017] [Indexed: 12/18/2022] Open
Abstract
Mammography has been the frontline screening tool for breast cancer for decades. However, high error rates in the form of false negatives (FNs) and false positives (FPs) have persisted despite technological improvements. Radiologists still miss between 10% and 30% of cancers while 80% of woman recalled for additional views have normal outcomes, with 40% of biopsied lesions being benign. Research show that the majority of cancers missed is actually visible and looked at, but either go unnoticed or are deemed to be benign. Causal agents for these errors include human related characteristics resulting in contributory search, perception and decision-making behaviours. Technical, patient and lesion factors are also important relating to positioning, compression, patient size, breast density and presence of breast implants as well as the nature and subtype of the cancer itself, where features such as architectural distortion and triple-negative cancers remain challenging to detect on screening. A better understanding of these causal agents as well as the adoption of technological and educational interventions, which audits reader performance and provide immediate perceptual feedback, should help. This paper reviews the current status of our knowledge around error rates in mammography and explores the factors impacting it. It also presents potential solutions for maximizing diagnostic efficacy thus benefiting the millions of women who undergo this procedure each year.
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Affiliation(s)
- Ernest Usang Ekpo
- Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Sydney, Australia.
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18
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Tian W, Pang W, Ge Y, He X, Wang D, Li X, Hou H, Zhou D, Feng S, Chen Z, Yang Y. Hepatocyte-generated 27-hydroxycholesterol promotes the growth of melanoma by activation of estrogen receptor alpha. J Cell Biochem 2017; 119:2929-2938. [PMID: 29130512 DOI: 10.1002/jcb.26498] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/09/2017] [Indexed: 12/17/2022]
Abstract
Cholesterol plays an important role in maintaining normal physiological function of human body. However, excessive intake will induce a series of diseases including cancer. For melanoma, the relationship between hypercholesterolemia and its incidence remains unknown. The cholesterol metabolite 27-hydroxy cholesterol (27-HC) catalyzed by CYP27A1 has been reported to activate estrogen receptor (ER). As studies have indicated that melanoma expresses ER, we designed experiments to explore whether 27-HC could link hypercholesterolemia and melanoma. In this study, hepatocyte-specific CYP27A1-/- mice were generated by CRISPR/Cas9 technology. The results revealed that high-cholesterol diet induced metabolism disorder and promoted the melanoma growth through 27-HC. Further study found that 27-HC promoted the growth of melanoma cells by activating ERα and eliciting the AKT and MAPK signaling pathway. This study puts forward the important role of 27-HC in the development of melanoma for the first time, links hypercholesterolemia with melanoma progression. The research also provides the rationale for the use of tamoxifen in melanoma therapy. The levels of 27-HC in blood could act as a novel biomarker for tamoxifen treatment in melanoma patients.
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Affiliation(s)
- Wei Tian
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Wenxiao Pang
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China.,Infectious Disease Research Office, Public Health Clinical Center of Chengdu, Chengdu, China
| | - Yao Ge
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Xiaomeng He
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Duowei Wang
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Xianjing Li
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Hui Hou
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Dewang Zhou
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Shuang Feng
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Zhen Chen
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
| | - Yong Yang
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, China
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Ekpo EU, Hogg P, Wasike E, McEntee MF. A self-directed learning intervention for radiographers rating mammographic breast density. Radiography (Lond) 2017; 23:337-342. [PMID: 28965898 DOI: 10.1016/j.radi.2017.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/18/2017] [Accepted: 05/27/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Subjective methods of mammographic breast density (MBD) assessment are prone to inter-reader variability. This work aims to assess the impact of a short self-directed, experiential learning intervention on radiographers' reproducibility of MBD assessment. METHOD The study used two sets of images (test and learning intervention) containing left craniocaudal and left mediolateral oblique views. The test set had MBD ratings from Volpara™ and radiologists using the fourth edition Breast Imaging and Data Systems (BI-RADS®). Seven radiographers rated the MBD of the test set before and after a self-directed learning intervention using the percentage descriptors in the fourth edition BI-RADS® Atlas. The inter-reader agreement, the agreement between radiographers and Volpara™ as well as radiologists, was assessed using a Weighted Kappa (кw). RESULTS Overall, radiographers' inter-reader agreement (кw) was substantial (0.79; 95% CI: 0.70-0.87) before the intervention and almost perfect (0.84; 95% CI: 0.77-0.90) after the intervention. Before the intervention, radiographers demonstrated fair agreement with radiologists (0.24; 95% CI: -0.46-0.61) and Volpara™ (0.24; 95% CI: -0.41-0.59). A fair but slightly improved agreement was also observed between radiographers and radiologists (0.31; 95% CI: -0.33-0.64) as well as Volpara™ (0.28; 95% CI: -0.34-0.61) after the intervention. CONCLUSION Findings demonstrate that a short duration self-directed, experiential learning intervention reduces inter-reader differences in MBD classification, but has a negligible impact on improving the agreement between inexperienced and expert readers.
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Affiliation(s)
- E U Ekpo
- Faculty of Health Sciences, The University of Sydney, Discipline of Medical Radiation Sciences, Cumberland Campus, 75 East Street, Lidcombe, NSW 2141, Australia; Faculty of Health Sciences, University of Calabar, Department of Radiography and Radiological Sciences, PMB 1115 Calabar, Nigeria.
| | - P Hogg
- Directorate of Radiography, Center for Health Science Research, University of Salford, UK; Center for Health Science Research, Karolinska Institute, Stockholm, Sweden
| | - E Wasike
- Faculty of Health Sciences, The University of Sydney, Discipline of Medical Radiation Sciences, Cumberland Campus, 75 East Street, Lidcombe, NSW 2141, Australia
| | - M F McEntee
- Faculty of Health Sciences, The University of Sydney, Discipline of Medical Radiation Sciences, Cumberland Campus, 75 East Street, Lidcombe, NSW 2141, Australia
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20
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Bache ST, Kappadath SC. Quantitation of tumor uptake with molecular breast imaging. Med Phys 2017; 44:4593-4607. [DOI: 10.1002/mp.12403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 01/18/2023] Open
Affiliation(s)
- Steven T. Bache
- Department of Imaging Physics; The University of Texas MD Anderson Cancer Center; Houston TX 77030 USA
| | - S. Cheenu Kappadath
- Department of Imaging Physics; The University of Texas MD Anderson Cancer Center; Houston TX 77030 USA
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21
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Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad. Diagnostics (Basel) 2017; 7:diagnostics7020030. [PMID: 28561776 PMCID: PMC5489950 DOI: 10.3390/diagnostics7020030] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 12/14/2022] Open
Abstract
Mammographic breast density (MBD) has been proven to be an important risk factor for breast cancer and an important determinant of mammographic screening performance. The measurement of density has changed dramatically since its inception. Initial qualitative measurement methods have been found to have limited consistency between readers, and in regards to breast cancer risk. Following the introduction of full-field digital mammography, more sophisticated measurement methodology is now possible. Automated computer-based density measurements can provide consistent, reproducible, and objective results. In this review paper, we describe various methods currently available to assess MBD, and provide a discussion on the clinical utility of such methods for breast cancer screening.
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22
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Tapia KA, Garvey G, Mc Entee M, Rickard M, Brennan P. Breast Cancer in Australian Indigenous Women: Incidence,
Mortality, and Risk Factors. Asian Pac J Cancer Prev 2017; 18:873-884. [PMID: 28545182 PMCID: PMC5494235 DOI: 10.22034/apjcp.2017.18.4.873] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The Indigenous people of Australia face significant health gaps compared with the general population, with lower life
expectancies, higher rates of death, and chronic illness occurring more often than in non-indigenous Australians. Cancer
is the second largest contributor to the burden of disease with breast cancer being the most common invasive cancer
diagnosed for females. Despite a lower breast cancer incidence compared with non-indigenous women, fatalities occur
at an elevated rate and breast cancers have an earlier age of onset. For indigenous women there are also more advanced
and distant tumours at diagnosis, fewer hospitalisations for breast cancer, and lower participation in breast screening.
Concomitantly there are demographic, socio-economic and lifestyle factors associated with breast cancer risks that
are heavily represented within Indigenous communities. The aim of this two-part narrative review is to examine the
available evidence on breast cancer and its risk factors in Australian Indigenous women. Part One presents a summary
of the latest incidence, survival and mortality data. Part Two presents the risk factors most strongly associated with
breast cancer including age, place of residence, family risk, genetics, reproductive history, tobacco use, alcohol intake,
physical activity, participation in screening and breast density. With increasing emphasis on personalized health care, a
clear understanding of breast cancer incidence, survival, mortality, and causal agents within the Indigenous population
is required if breast cancer prevention and management is to be optimized for Indigenous Australians.
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Affiliation(s)
- Kriscia A Tapia
- Faculty of Health Sciences, The University of Sydney, New South Wales, Australia.
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