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Yoshida T, Urikura A, Endo M. Vendor-Specific Correction Software for Apparent Diffusion Coefficient Bias Due to Gradient Nonlinearity in Breast Diffusion-Weighted Imaging Using Ice-Water Phantom. J Comput Assist Tomogr 2024:00004728-990000000-00329. [PMID: 38896760 DOI: 10.1097/rct.0000000000001632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVE This study aimed to evaluate a vendor-specific correction software for apparent diffusion coefficient (ADC) bias due to gradient nonlinearity in breast diffusion-weighted magnetic resonance imaging using an ice-water phantom. METHODS The phantom consists of 5 plastic tubes with a length of 100 mm and a diameter of 15 mm, filled with distilled water and immersed in an ice-water bath. Diffusion-weighted images were acquired by echo-planar imaging sequence on a 3.0-T scanner. ADC maps with and without correction were calculated using 4 b-values (0, 100, 600, and 800 s/mm2). The mean ADCs were measured using a rectangular profile with 5 × 40 pixels in the anterior-posterior (AP) and a square region of interest with 5 × 5 pixels in the right-left (RL) and superior-inferior (SI) directions on the ADC map. ADC was compared with and without correction using a paired t test. Additionally, ADC of the ice-water phantom was measured at the magnet isocenter. RESULTS ADC increased in the AP and RL directions and decreased in the SI direction with increasing distance from the isocenter before correction. After the correction, ADC at the off-center positions in the AP, RL, and SI directions was reduced to within 5% of the expected value. There were significant differences in the ADC at the off-center positions without and with correction (P < 0.001); however, ADC at the magnet isocenter did not vary after correction (1.08 ± 0.02 × 10-3 mm2/s). CONCLUSIONS The vendor-specific software corrected the ADC bias due to gradient nonlinearity at the off-center positions in the AP, RL, and SI directions. Therefore, the software will contribute to the accurate ADC assessment in breast DWI.
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Affiliation(s)
- Tsukasa Yoshida
- From the Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Atsushi Urikura
- Department of Radiological Technology, Radiological Diagnosis, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiro Endo
- From the Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
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Ramanan B, Pizano A, Solano A, Gonugunta AS, Timaran CH, Siah M, Baig S, Shih M, Guild JB, Kirkwood ML. The addition of a leaded arm sleeve to leaded aprons further decreases operator upper outer quadrant chest wall radiation dose during fluoroscopically guided interventions. J Vasc Surg 2024; 79:948-953. [PMID: 38040201 DOI: 10.1016/j.jvs.2023.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE Breast cancer most commonly occurs in the upper outer quadrant (UOQ) chest wall (CW). The effectiveness of routine leaded aprons to protect this region of the body in interventionalists during fluoroscopically guided interventions (FGIs) is unknown. Given the high lifetime attributable risks of prolonged occupational exposure to ionizing radiation and the increasing number of practicing female vascular surgeons and interventionalists, we sought to determine if the use of a leaded arm shield would offer additional protection to the lateral CW and axilla in operators compared with routine leaded aprons. METHODS Effectiveness of leaded sleeves in attenuating radiation dose to the axilla and UOQ was evaluated in clinical practice and simulated scenarios. In the clinical setting, optically stimulated luminescence nanoDot detectors were placed at the UOQ lateral CW position, both over and under a standard leaded apron vest with and without the addition of an antimony/bismuth Enviro-Lite sleeve on two vascular surgeons performing FGIs. In the simulation, nanoDots were similarly placed on an anthropomorphic phantom positioned to represent a primary operator performing right femoral access. Fluorography was performed on 12-inch-thick acrylic scatter phantom at 80 kVp for an exposure of 3 Gy reference air kerma. Experiments were done with and without the sleeve. Paired Wilcoxon and χ2 tests were performed to identify the statistical significance of radiation attenuation. RESULTS Operator UOQ CW dose was measured during 61 FGIs: 33 cases (54%) with and 28 cases (46%) without the sleeve. Median procedure reference air kerma and fluoroscopy time was 180 mGy (interquartile range [IQR], 85-447 mGy) and 21 minutes (IQR, 11-39 minutes) when the sleeve was worn vs 100 mGy (IQR, 67-270 mGy) and 11 minutes (IQR, 6.3-25 minutes) without the sleeve. Radiation dose to the operator's UOQ was reduced by 96% (IQR, 85%-96%) when the sleeve was present and by 62% (IQR, 44%-82%; P < .001) without the sleeve. In the simulated setting, the sleeve reduced the radiation dose to the UOQ compared with the apron alone (96% vs 67%; P < .001). CONCLUSIONS Routine leaded aprons do attenuate the majority of UOQ chest wall radiation dose; however, the addition of a lead-equivalent sleeve further significantly reduces this dose. Because this area of the body has a high incidence of cancer formation, additional protection, especially to female interventionalists, seems prudent. Vascular surgeons should consider using a protective sleeve with their personal protective equipment when performing complex fluoroscopically guided procedures.
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Affiliation(s)
- Bala Ramanan
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Alejandro Pizano
- Department of Surgery, Nassau University Medical Center, East Meadow, NY
| | - Antonio Solano
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Amrit S Gonugunta
- University of Texas Southwestern Medical School, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Carlos H Timaran
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Michael Siah
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Shadman Baig
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Michael Shih
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jeffrey B Guild
- Division of Medical Physics, Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Melissa L Kirkwood
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
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Oliveira JT, Munhoz A, Fernandes JMP, Paiva C, Teixeira T, Marta S, Polónia J. Evaluation of the Influence of Geodimensional and Histological Parameters on the Need for Margin Widening in Breast Lesions Marked With Magnetic Seeds. Eur J Breast Health 2024; 20:31-37. [PMID: 38187100 PMCID: PMC10765467 DOI: 10.4274/ejbh.galenos.2023.2023-11-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024]
Abstract
Objective Breast cancer is an important topic worldwide, posing morbidity and mortality to women. Considerable efforts have been put in the early recognition of malignancy through different screening methods, such as mammography and ultrasound. The precise localization of infraclinical malignant lesions is key in surgical management and magnetic seeds gather particular interest for this purpose. As with other systems, a need for reintervention may be needed to obtain adequate surgical margins. This work evaluated the relation between the need for surgical reintervention in order to obtain negative margins and geodimensional and histological parameters. The main objective was the identification of parameters significantly associated with reintervention for margin widening. Materials and Methods A retrospective analysis of 198 patients from a single centre was performed. The association between pre-defined geodimensional and histological parameters and the need for margin widening in infraclinical lesions marked with magnetic seed was evaluated. Results Results showed that reintervention to widen margins was significantly higher in patients with ductal carcinoma in situ (DCIS) in the pre-operative biopsy when compared with invasive carcinoma (p = 0.03) in the bivariate analysis. No statistically significant differences were observed between the need for reintervention and lesion size (p = 0.197), breast quadrant location (p = 0.626) and distance of skin to lesion (p = 0.356). Conclusion This work suggests that a more invasive margin clearance in lesions with a pre-operative DCIS diagnosis might obviate the need for reintervention to obtain negative margins. On the other hand, it is not necessary to be surgically more invasive in larger lesions, deeply located or that are present in a certain quadrant, since there are no significant differences regarding the need for reintervention.
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Affiliation(s)
- João T. Oliveira
- Breast Surgery Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Porto, Portugal
| | - Ana Munhoz
- Breast Surgery Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - JM Preza Fernandes
- Breast Surgery Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal
| | - Cláudia Paiva
- Breast Surgery Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal
| | - Tânia Teixeira
- Breast Surgery Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal
| | - Susana Marta
- Breast Surgery Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal
| | - José Polónia
- Breast Surgery Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal
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Dung HA, Quang LH, Quang LV, Cong BT. Level-2 Oncoplastic Surgical Techniques for Breast Cancer: A Preliminary Vietnamese Report. Med Arch 2024; 78:131-138. [PMID: 38566877 PMCID: PMC10983099 DOI: 10.5455/medarh.2024.78.131-138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
Background Breast cancer is the most common malignancy and remains the first cause of death related to cancer among Vietnamese women, with an incidence of 21,555 cases in 2020. Most breast cancer patients present with invasive disease and relatively large tumor sizes. While oncoplastic surgery (OPS) are commonly applied in Western countries, data on Asian population remains relatively limited. Objective This study aims to assess the outcomes of level-2 oncoplastic techniques in breast-conserving surgeries at the Vietnam National Cancer Hospital. Methods From January 2017 to June 2021, a cohort of 257 breast cancer patients who underwent breast-conserving surgery with OPS techniques were examined. Surgical complications, cosmetic outcome, recurrence and survival rates were assessed. Results The mean age was 47.6±9.4 years, most patients had breast cup sizes B and C. The mean tumor size upon pathological examination was 2.00 ± 0.74 cm. Only 7 cases required reoperation, resulting in a mastectomy rate of 1.17%. The overall complication rate was low at 11.46%, with 9 cases (3.56%) experiencing delayed complications. Cosmetic results were rated as "excellent" in 20.6% and "good" in 60.5%, with a statistically significant difference. The rates of local recurrence, regional recurrence, and distant metastasis at five years were 2.78%, 1.19%, and 2.36%, respectively. Conclusion The level 2 oncoplastic techniques had low complication rates, favorable oncological outcomes, and cosmetically satisfying results.
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Affiliation(s)
- Hoang Anh Dung
- Departement of Oncology, Hanoi Medical University, Hanoi, Vietnam
- Departement of Breast Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Le Hong Quang
- Departement of Oncology, Hanoi Medical University, Hanoi, Vietnam
- Departement of Breast Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Le Van Quang
- Departement of Oncology, Hanoi Medical University, Hanoi, Vietnam
- Departement of Breast Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Bui Tien Cong
- Department of Nuclear Medicine, Hanoi Medical University, Hanoi, Vietnam
- Center of Nuclear Medicine and Oncology, Hanoi, Vietnam
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Shim S, Unkelbach J, Landsmann A, Boss A. Quantitative Study on the Breast Density and the Volume of the Mammary Gland According to the Patient's Age and Breast Quadrant. Diagnostics (Basel) 2023; 13:3343. [PMID: 37958239 PMCID: PMC10648521 DOI: 10.3390/diagnostics13213343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVES Breast density is considered an independent risk factor for the development of breast cancer. This study aimed to quantitatively assess the percent breast density (PBD) and the mammary glands volume (MGV) according to the patient's age and breast quadrant. We propose a regression model to estimate PBD and MGV as a function of the patient's age. METHODS The breast composition in 1027 spiral breast CT (BCT) datasets without soft tissue masses, calcifications, or implants from 517 women (57 ± 8 years) were segmented. The breast tissue volume (BTV), MGV, and PBD of the breasts were measured in the entire breast and each of the four quadrants. The three breast composition features were analyzed in the seven age groups, from 40 to 74 years in 5-year intervals. A logarithmic model was fitted to the BTV, and a multiplicative inverse model to the MGV and PBD as a function of age was established using a least-squares method. RESULTS The BTV increased from 545 ± 345 to 676 ± 412 cm3, and the MGV and PBD decreased from 111 ± 164 to 57 ± 43 cm3 and from 21 ± 21 to 11 ± 9%, respectively, from the youngest to the oldest group (p < 0.05). The average PBD over all ages were 14 ± 13%. The regression models could predict the BTV, MGV, and PBD based on the patient's age with residual standard errors of 386 cm3, 67 cm3, and 13%, respectively. The reduction in MGV and PBD in each quadrant followed the ones in the entire breast. CONCLUSIONS The PBD and MGV computed from BCT examinations provide important information for breast cancer risk assessment in women. The study quantified the breast mammary gland reduction and density decrease over the entire breast. It established mathematical models to estimate the breast composition features-BTV, MGV, and PBD, as a function of the patient's age.
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Affiliation(s)
- Sojin Shim
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (A.L.); (A.B.)
| | - Jan Unkelbach
- Department of Radiation Oncology, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Anna Landsmann
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (A.L.); (A.B.)
| | - Andreas Boss
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (A.L.); (A.B.)
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Lin ZM, Wang TT, Zhu JY, Xu YY, Chen F, Huang PT. A nomogram based on combining clinical features and contrast enhanced ultrasound is not able to identify Her-2 over-expressing cancer from other breast cancers. Front Oncol 2023; 13:1035645. [PMID: 36776315 PMCID: PMC9909531 DOI: 10.3389/fonc.2023.1035645] [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: 09/03/2022] [Accepted: 01/02/2023] [Indexed: 01/27/2023] Open
Abstract
Objective The aim of this study was to evaluate whether a predictive model based on a contrast enhanced ultrasound (CEUS)-based nomogram and clinical features (Clin) could differentiate Her-2-overexpressing breast cancers from other breast cancers. Methods A total of 152 pathology-proven breast cancers including 55 Her-2-overexpressing cancers and 97 other cancers from two units that underwent preoperative CEUS examination, were included and divided into training (n = 102) and validation cohorts (n = 50). Multivariate regression analysis was utilized to identify independent indicators for developing predictive nomogram models. The area under the receiver operating characteristic (AUC) curve was also calculated to establish the diagnostic performance of different predictive models. The corresponding sensitivities and specificities of different models at the cutoff nomogram value were compared. Results In the training cohort, 7 clinical features (menstruation, larger tumor size, higher CA153 level, BMI, diastolic pressure, heart rate and outer upper quarter (OUQ)) + enlargement in CEUS with P < 0.2 according to the univariate analysis were submitted to the multivariate analysis. By incorporating clinical information and enlargement on the CEUS pattern, independently significant indicators for Her-2-overexpression were used for further predictive modeling as follows: Model I, nomogram model based on clinical features (Clin); Model II, nomogram model combining enlargement (Clin + Enlargement); Model III, nomogram model based on typical clinical features combining enlargement (MC + BMI + diastolic pressure (DP) + outer upper quarter (OUQ) + Enlargement). Model II achieved an AUC value of 0.776 at nomogram cutoff score value of 190, which was higher than that of the other models in the training cohort without significant differences (all P>0.05). In the test cohort, the diagnostic efficiency of predictive model was poor (all AUC<0.6). In addition, the sensitivity and specificity were not significantly different between Models I and II (all P>0.05), in either the training or the test cohort. In addition, Clin exhibited an AUC similar to that of model III (P=0.12). Moreover, model III exhibited a higher sensitivity (70.0%) than the other models with similar AUC and specificity, only in the test cohort. Conclusion The main finding of the study was that the predictive model based on a CEUS-based nomogram and clinical features could not differentiate Her-2-overexpressing breast cancers from other breast cancers.
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Affiliation(s)
- Zi-mei Lin
- Department of Ultrasound in Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Ting-ting Wang
- Department of Ultrasound in Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Jun-Yan Zhu
- Department of Ultrasound, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yong-yuan Xu
- Department of Ultrasound in Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Fen Chen
- Department of Ultrasound, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Pin-tong Huang
- Department of Ultrasound in Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China,*Correspondence: Pin-tong Huang,
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Enomoto M, Igaki T. Cell-cell interactions that drive tumorigenesis in Drosophila. Fly (Austin) 2022; 16:367-381. [PMID: 36413374 PMCID: PMC9683056 DOI: 10.1080/19336934.2022.2148828] [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] [Indexed: 11/23/2022] Open
Abstract
Cell-cell interactions within tumour microenvironment play crucial roles in tumorigenesis. Genetic mosaic techniques available in Drosophila have provided a powerful platform to study the basic principles of tumour growth and progression via cell-cell communications. This led to the identification of oncogenic cell-cell interactions triggered by endocytic dysregulation, mitochondrial dysfunction, cell polarity defects, or Src activation in Drosophila imaginal epithelia. Such oncogenic cooperations can be caused by interactions among epithelial cells, mesenchymal cells, and immune cells. Moreover, microenvironmental factors such as nutrients, local tissue structures, and endogenous growth signalling activities critically affect tumorigenesis. Dissecting various types of oncogenic cell-cell interactions at the single-cell level in Drosophila will greatly increase our understanding of how tumours progress in living animals.
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Affiliation(s)
- Masato Enomoto
- Laboratory of Genetics, Graduate School of Biostudies, Kyoto University, Yoshida-Konoecho, Kyoto, Japan
| | - Tatsushi Igaki
- Laboratory of Genetics, Graduate School of Biostudies, Kyoto University, Yoshida-Konoecho, Kyoto, Japan,CONTACT Tatsushi Igaki
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Support vector machine based methodology for classification of thermal images pertaining to breast cancer. J Therm Biol 2022; 110:103337. [DOI: 10.1016/j.jtherbio.2022.103337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/05/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022]
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Shah A, Haider G, Abro N, Hashmat S, Chandio S, Shaikh A, Abbas K. Correlation Between Site and Stage of Breast Cancer in Women. Cureus 2022; 14:e22672. [PMID: 35386160 PMCID: PMC8967127 DOI: 10.7759/cureus.22672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Breast cancer is a worldwide public health issue and a primary cause of death among women. The present study aimed to assess the correlation between site and stage of breast cancer with respect to age among females. Methods A prospective observational study was conducted at the Medical Oncology Department, Jinnah Postgraduate Medical Centre, Karachi, Pakistan from May 2020 to June 2021. Female patients of 18 years or older with a confirmed diagnosis of breast cancer were included in the study. Histopathological reports were evaluated for tumor characteristics such as histological type, laterality, location, tumor size, grade, lymph node status, and stage of the tumor. Results The majority of the patients presented with advanced stages of tumor. Among all stages of breast tumor, the upper outer quadrant was the most frequent location of the tumor. The majority of the patients with cancer in the upper inner quadrant were diagnosed with stage I (28.57%) (p = 0.011). In contrast, the majority of the upper outer quadrant lesions were identified as stage III and stage IV (p < 0.0001). In patients of age <40 years, statistically significant differences in proportions of tumor location with respect to the stage of the tumor were observed (p = 0.018). Conclusion The upper outer quadrant and stage III of tumor are the most common site and stage of breast tumor in our population. There is a significant relationship between site and stage of breast tumor. Younger-aged patients had a significantly higher rate of cancers located in the upper outer quadrant in advance stages as compared to other quadrants.
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Affiliation(s)
- Aamera Shah
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Ghulam Haider
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Nargis Abro
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Sana Hashmat
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Sanam Chandio
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Abdulla Shaikh
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Kiran Abbas
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
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Sanli DET, Yildirim D. Evaluation of the Effect of Age, Menopausal Status, and Parity on Breast Parenchyma Stiffness by Multiparametric Shear Wave Elastography. Acad Radiol 2022; 29 Suppl 1:S62-S68. [PMID: 34702676 DOI: 10.1016/j.acra.2021.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/15/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the relationship between quantitative breast parenchyma stiffness by using multiparametric shear wave elastography (mpSWE) and the potential risk factors of breast cancer. MATERIAL AND METHODS The Vmean, Vmax, Vmin, Vsd values were measured with mpSWE from each breast and each quadrant in all cases under and over the age of 40. Statistical analysis was performed to evaluate the relationship between breast stiffness and age, side, quadrant, menopausal status, mammographic breast density, and obstetric history. RESULTS The study cohort included 964 breasts of 482 patients, where 342 patients were ≥40 years of age; and 140 cases were <40 years of age with a mean age of 45.07 ± 10.96. No significant difference in breast stiffness was detected between right and left breasts (p > 0.05); however, upper quadrants were found to be stiffer than the lower quadrants (p < 0.05). The effect of age on all values was found to be significant (p < 0.05), and stiffness increased with age. All mpSWE values of post-menopausal cases were significantly higher (p < 0.05) than premenopausal cases. Nulliparous cases had higher values than cases with prior parity (p < 0.05). Cases with Type C and D breast density had higher stiffness values than those with Type A and Type B breast density. CONCLUSION Breast parenchyma shows increased stiffness in in post-menopausal, nulliparous and older patients and patients with dense breast density. Similar to the mammographic increased breast density, elastographically increased breast parenchymal stiffness may be used as a possible risk factor for breast cancer or as a predictor of breast cancer.
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Affiliation(s)
- Deniz Esin Tekcan Sanli
- Department of Medical Imaging Techniques, Vocational School of Health Services, Istanbul Rumeli University, Istanbul, Turkey; Department of Radiology, Acibadem Kozyatagi Hospital, Istanbul, Turkey.
| | - Duzgun Yildirim
- Department of Medical Imaging Techniques, Vocational School of Health, Acibadem University, Istanbul, Turkey
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Richey WL, Heiselman JS, Luo M, Meszoely IM, Miga MI. Impact of deformation on a supine-positioned image-guided breast surgery approach. Int J Comput Assist Radiol Surg 2021; 16:2055-2066. [PMID: 34382176 DOI: 10.1007/s11548-021-02452-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 07/06/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To reduce reoperation rates for image-guided breast-conserving surgery, the enhanced sensitivity of magnetic resonance (MR) supine imaging may be leveraged. However, accurate tissue correspondence between images and their physical counterpart in the surgical presentation is challenging due to breast deformations (e.g., from patient/arm position changes, and operating room table rotation differences). In this study, standard rigid registration methods are employed and tissue deformation is characterized. METHODS On n = 10 healthy breasts, surface displacements were measured by comparing intraoperative fiducial locations as the arm was moved from conventional MR scanning positions (arm-down and arm-up) to the laterally extended surgical configuration. Supine MR images in the arm-down and arm-up positions were registered to mock intraoperative presentations. RESULTS Breast displacements from a supine MR imaging configuration to a mock surgical presentation were 28.9 ± 9.2 mm with shifts occurring primarily in the inferior/superior direction. With respect to supine MR to surgical alignment, the average fiducial, target, and maximum target registration errors were 9.0 ± 1.7 mm, 9.3 ± 1.7 mm, and 20.0 ± 7.6 mm, respectively. Even when maintaining similar arm positions in the MR image and mock surgery, the respective averages were 6.0 ± 1.0 mm, 6.5 ± 1.1 mm, and 12.5 ± 2.8 mm. CONCLUSION From supine MR positioning to surgical presentation, the breast undergoes large displacements (9.9-70.1 mm). The data also suggest that significant nonrigid deformations (9.3 ± 1.7 mm with 20.0 mm average maximum) exist that need to be considered in image guidance and modeling applications.
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Affiliation(s)
- Winona L Richey
- Department of Biomedical Engineering, Vanderbilt University, 1225 Stevenson Center Ln, Nashville, 37235, USA.
- Vanderbilt Institute for Surgery and Engineering, 1161 21st Ave. S, Nashville, 37204, USA.
- Vanderbilt University, 1225 Stevenson Center Ln, Stevenson Center 5824, Nashville, TN, 37240, USA.
| | - Jon S Heiselman
- Department of Biomedical Engineering, Vanderbilt University, 1225 Stevenson Center Ln, Nashville, 37235, USA
- Vanderbilt Institute for Surgery and Engineering, 1161 21st Ave. S, Nashville, 37204, USA
| | - Ma Luo
- Department of Biomedical Engineering, Vanderbilt University, 1225 Stevenson Center Ln, Nashville, 37235, USA
- Vanderbilt Institute for Surgery and Engineering, 1161 21st Ave. S, Nashville, 37204, USA
| | - Ingrid M Meszoely
- Vanderbilt Institute for Surgery and Engineering, 1161 21st Ave. S, Nashville, 37204, USA
- Division of Surgical Oncology, Vanderbilt University Medical Center, 719 Thompson Ln Suite 22100, Nashville, 37232, USA
| | - Michael I Miga
- Department of Biomedical Engineering, Vanderbilt University, 1225 Stevenson Center Ln, Nashville, 37235, USA
- Vanderbilt Institute for Surgery and Engineering, 1161 21st Ave. S, Nashville, 37204, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. S, Nashville, 37232, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
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Dervisevic M, Alba M, Adams TE, Prieto-Simon B, Voelcker NH. Electrochemical immunosensor for breast cancer biomarker detection using high-density silicon microneedle array. Biosens Bioelectron 2021; 192:113496. [PMID: 34274623 DOI: 10.1016/j.bios.2021.113496] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
Electrochemical devices for transdermal monitoring of key biomarkers are the potential next frontier of wearable technologies for point-of-care disease diagnosis, including Cancer in which Cancer is the leading cause of death worldwide with estimated 10 million deaths in 2018 according to the World Health Organization and breast cancer is one of the five most common causes of cancer death with over two million cases recorded in 2018. Early diagnosis and prognosis based on monitoring of breast cancer biomarkers is of high importance. In this work, high-density gold coated silicon microneedle arrays (Au-Si-MNA) were simultaneously used as biomarker extraction platform and electrochemical transducer, enabling the selective immunocapture of epidermal growth factor receptor 2 (ErbB2), a key breast cancer biomarker, and its subsequent quantification. The analytical performance of the device was tested in artificial interstitial fluid exhibiting a linear response over a wide concentration range from 10 to 250 ng/mL, with a detection limit of 4.8 ng/mL below the biomarker levels expected in breast cancer patients. As a proof of concept, the immunosensor demonstrated its ability to successfully extract ErbB2 from a phantom gel mimicking the epidermis and dermis layers, and subsequently quantify it showing a linear range from 50 to 250 ng/mL and a detection limit of 25 ng/mL. The uniqueness of this sensing platform combining direct transdermal biomarker extraction and quantification opens up new avenues towards the development of high performing wearable point-of-care devices.
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Affiliation(s)
- Muamer Dervisevic
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, 3052, Australia
| | - Maria Alba
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, 3052, Australia; Commonwealth Scientific and Industrial Research Organization (CSIRO), Clayton, Victoria, 3168, Australia
| | - Timothy E Adams
- Commonwealth Scientific and Industrial Research Organization (CSIRO), Clayton, Victoria, 3168, Australia
| | - Beatriz Prieto-Simon
- Department of Electronic Engineering, Universitat Rovira i Virgili, 43007, Tarragona, Spain; ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
| | - Nicolas H Voelcker
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, 3052, Australia; Commonwealth Scientific and Industrial Research Organization (CSIRO), Clayton, Victoria, 3168, Australia; Melbourne Centre for Nanofabrication, Victorian Node of the Australian National Fabrication Facility, Clayton, Victoria, 3168, Australia; Materials Science and Engineering, Monash University, Clayton, Victoria, 3168, Australia.
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Ranaivomanana M, Hasiniatsy NRE, Rakotomahenina H, Rafaramino F. [Epidemiology and clinical features of patients with breast cancers hospitalized in the Department of Oncology in Fianarantsoa, Madagascar from 2011 to 2018]. Pan Afr Med J 2021; 38:264. [PMID: 34122691 PMCID: PMC8180002 DOI: 10.11604/pamj.2021.38.264.20031] [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: 08/10/2019] [Accepted: 03/01/2021] [Indexed: 01/12/2023] Open
Abstract
Introduction à notre connaissance, il s´agit d´une première étude épidémiologique des cancers du sein à Fianarantsoa. Notre objectif était de décrire les caractéristiques épidémio-cliniques de ces cancers au Service d´Oncologie de Fianarantsoa. Méthodes il s´agissait d´une étude rétrospective descriptive au Service d´Oncologie du Centre Hospitalier Universitaire de Tambohobe pendant 8 ans (2011 à 2018). Nous avons inclus toutes les patientes atteintes de cancer du sein avec une confirmation cytologique et/ou histologique. Les paramètres étudiés étaient l´âge, la profession, les antécédents familiaux de cancer du sein, la ménarche, la ménopause, la parité, la prise de contraception orale, le tabagisme, les circonstances de découverte, les symptômes mammaires, les signes d´extension, la localisation tumorale et le stade de la maladie. Résultats nous avons inclus 62 patientes d´âge moyen de 52,83 ± 10,47 ans. Les femmes au foyer constituaient 39% (n = 24) des cas. Aucune patiente n´avait une ménarche précoce. La ménopause tardive était survenue chez 6,45% (n = 4) et des antécédents familiaux de cancer du sein étaient retrouvés chez 8,06% (n = 5). La prise de tabac à chiquer a été retrouvée chez 17,74% (n = 11) des cas. Les symptômes mammaires étaient observés dans 95,2% (n = 59) des cas. Le quadrant supéro-externe était touché dans 53,23% (n = 33) des cas. Le stade III s´observait dans 55% (n = 34) des cas et le stade IV dans 32% (n = 20). Conclusion diagnostiqués à un stade avancé, les facteurs de risque de cancer du sein étaient peu observés.
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Affiliation(s)
- Mampionona Ranaivomanana
- Service d´Oncologie, Centre Hospitalier Universitaire de Tambohobe Fianarantsoa, Faculté de Médecine de Fianarantsoa, Fianarantsoa, Madagascar
| | | | - Hajanirina Rakotomahenina
- Service de Gynécologie et Obstétrique, Centre Hospitalier Universitaire de Tambohobe Fianarantsoa, Faculté de Médecine de Fianarantsoa, Fianarantsoa, Madagascar
| | - Florine Rafaramino
- Faculté de Médecine d´Antananarivo, Université d´Antananarivo, Antananarivo, Madagascar
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Zhou P, Jin C, Lu J, Xu L, Zhu X, Lian Q, Gong X. The Value of Nomograms in Pre-Operative Prediction of Lymphovascular Invasion in Primary Breast Cancer Undergoing Modified Radical Surgery: Based on Multiparametric Ultrasound and Clinicopathologic Indicators. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:517-526. [PMID: 33277109 DOI: 10.1016/j.ultrasmedbio.2020.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/07/2020] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to explore the value of pre-operative prediction of lymphovascular invasion (LVI) in primary breast cancer patients undergoing modified radical mastectomy and to develop a nomogram based on multiparametric ultrasound and clinicopathologic indicators. All patients with primary breast cancer confirmed by pre-operative biopsy underwent B-mode ultrasound and contrast-enhanced ultrasound examinations. Post-operative pathology was used as the gold standard to identify LVI. Lasso regression was used to select predictors most related to LVI. A nomogram was developed to calculate the diagnostic efficacy. We bootstrapped the data for 500 times to perform internal verification, drawing a calibration curve to verify prediction ability. A total of 244 primary breast cancer patients were included. LVI was observed in 77 patients. Ten predictors associated with LVI were selected by Lasso regression. The area under the curve, sensitivity, specificity and accuracy for the nomogram were 0.918, 92.2%, 76.7% and 81.6%, respectively. And the nomogram calibration curve showed good consistency between the predicted probability and the actual probability. The nomogram developed could be used to predict LVI in primary breast cancer patients undergoing modified radical mastectomy and to help in clinical decision-making.
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Affiliation(s)
- Peng Zhou
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Chunchun Jin
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Jianghao Lu
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Lifeng Xu
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiaomin Zhu
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Qingshu Lian
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xuehao Gong
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China.
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Shibabaw T, Teferi B, Molla MD, Ayelign B. Inflammation Mediated Hepcidin-Ferroportin Pathway and Its Therapeutic Window in Breast Cancer. BREAST CANCER-TARGETS AND THERAPY 2020; 12:165-180. [PMID: 33116818 PMCID: PMC7585830 DOI: 10.2147/bctt.s276404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022]
Abstract
Experimental and clinical data strongly support that iron is an essential element which plays a big role in cancer biology. Thus, hepcidin (Hp) and ferroportin (Fpn) are molecules that regulate and maintain the metabolism of iron. A peptide hormone hepcidin limits recycled and stored iron fluxes in macrophage and hepatic hepatocyte, respectively, to the blood stream by promoting degradation of the only iron exporter, Fpn, in the target cells. Moreover, the inflammatory microenvironment of breast cancer and altered hepcidin/ferroportin pathway is intimately linked. Breast cancer exhibits an iron seeking phenotype that is accomplished by tumor-associated macrophage (TAM). Because macrophages contribute to breast cancer growth and progression, this review will discuss TAM with an emphasis on describing how TAM (M2Ф phenotypic) interacts with their surrounding microenvironment and results in dysregulated Hp/Fpn and pathologic accumulation of iron as a hallmark of its malignant condition. Moreover, the underlying stroma or tumor microenvironment releases significant inflammatory cytokines like IL-6 and bone morphogenetic proteins like BMP-2 and 6 leading in aberrant Hp/Fpn pathways in breast cancer. Inflammation is primarily associated with the high intracellular iron levels, deregulated hepcidin/ferroportin pathway, and its upstream signaling in breast cancer. Subsequently, scholars have been reported that reducing iron level and manipulating the signaling molecules involved in iron metabolism can be used as a promising strategy of tumor chemotherapy. Here, we review the key molecular aspects of iron metabolism and its regulatory mechanisms of the hepcidin/ferroportin pathways and its current therapeutic strategies in breast cancer.
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Affiliation(s)
- Tewodros Shibabaw
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Banchamlak Teferi
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meseret Derbew Molla
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhanu Ayelign
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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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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Kakudji BK, Mwila PK, Burger JR, Du Plessis JM. Epidemiological, clinical and diagnostic profile of breast cancer patients treated at Potchefstroom regional hospital, South Africa, 2012-2018: an open-cohort study. Pan Afr Med J 2020; 36:9. [PMID: 32550972 PMCID: PMC7282612 DOI: 10.11604/pamj.2020.36.9.21180] [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: 12/04/2019] [Accepted: 02/19/2020] [Indexed: 12/09/2022] Open
Abstract
Introduction Breast cancer is the second most diagnosed cancer worldwide. We aimed to depict the diagnostic approach as well as the epidemiological and clinical profile of patients with breast cancer at Potchefstroom regional hospital, South Africa. Methods This descriptive open-cohort study included patients with primary invasive breast cancer, confirmed by histology results and treated at the hospital from 01 January 2012 to 31 December 2018. Data such as demographics, patient history, histology, breast clinical findings, physical mass description and diagnostic investigations were captured from hospital registries and patient files. Result One-hundred thirty-eight patients (mean age 56.2 (SD: 14.4) (95% CI 54.6-59.7) years) met inclusion criteria. Most patients were female (98.6%), from African (67.4%) or Caucasian (23.9%) descent. Findings included mostly left-sided breast involvement (51.8%), lesions in the upper-outer quadrant (43.1%), extensions to the skin (25.6%, N = 39), and tumour size of 2 ≤ 5 cm (49.3%), or > 5 cm (39.1%). Most patients (57.9%, N = 135) were categorised as BIRADS-5, with a ductal pattern (89.6%) (p < 0.01). Patients mostly presented in stages II to IV of disease (89.1%; p < 0.05). Late-stage (stages III-IV) at time of diagnosis (n = 84) was significantly associated with mass location (p = 0.006; Cramér's V = 0.280), tumour size (p < 0.001, Cramér's V = 0.239), and skin changes (p = 0.027, Cramér's V = 0.492). Conclusion Most patients consulted at a late-stage of the disease, indicating a need for the promotion of breast awareness campaigns, early detection, and timeous referral.
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Affiliation(s)
- Baudouin Kongolo Kakudji
- Potchefstroom Hospital, Potchefstroom, North West Province, South Africa.,Department of Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Johanita Riétte Burger
- Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Jesslee Melinda Du Plessis
- Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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A review of the influence of mammographic density on breast cancer clinical and pathological phenotype. Breast Cancer Res Treat 2019; 177:251-276. [PMID: 31177342 DOI: 10.1007/s10549-019-05300-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE It is well established that high mammographic density (MD), when adjusted for age and body mass index, is one of the strongest known risk factors for breast cancer (BC), and also associates with higher incidence of interval cancers in screening due to the masking of early mammographic abnormalities. Increasing research is being undertaken to determine the underlying histological and biochemical determinants of MD and their consequences for BC pathogenesis, anticipating that improved mechanistic insights may lead to novel preventative or treatment interventions. At the same time, technological advances in digital and contrast mammography are such that the validity of well-established relationships needs to be re-examined in this context. METHODS With attention to old versus new technologies, we conducted a literature review to summarise the relationships between clinicopathologic features of BC and the density of the surrounding breast tissue on mammography, including the associations with BC biological features inclusive of subtype, and implications for the clinical disease course encompassing relapse, progression, treatment response and survival. RESULTS AND CONCLUSIONS There is reasonable evidence to support positive relationships between high MD (HMD) and tumour size, lymph node positivity and local relapse in the absence of radiotherapy, but not between HMD and LVI, regional relapse or distant metastasis. Conflicting data exist for associations of HMD with tumour location, grade, intrinsic subtype, receptor status, second primary incidence and survival, which need further confirmatory studies. We did not identify any relationships that did not hold up when data involving newer imaging techniques were employed in analysis.
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Ouyang FS, Guo BL, Huang XY, Ouyang LZ, Zhou CR, Zhang R, Wu ML, Yang ZS, Wu SK, Guo TD, Yang SM, Hu QG. A nomogram for individual prediction of vascular invasion in primary breast cancer. Eur J Radiol 2018; 110:30-38. [PMID: 30599870 DOI: 10.1016/j.ejrad.2018.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To explore the feasibility of preoperative prediction of vascular invasion (VI) in breast cancer patients using nomogram based on multiparametric MRI and pathological reports. METHODS We retrospectively collected 200 patients with confirmed breast cancer between January 2016 and January 2018. All patients underwent MRI examinations before the surgery. VI was identified by postoperative pathology. The 200 patients were randomly divided into training (n = 100) and validation datasets (n = 100) at a ratio of 1:1. Least absolute shrinkage and selection operator (LASSO) regression was used to select predictors most associated with VI of breast cancer. A nomogram was constructed to calculate the area under the curve (AUC) of receiver operating characteristics, sensitivity, specificity, accuracy, positive prediction value (PPV) and negative prediction value (NPV). We bootstrapped the data for 2000 times without setting the random seed to obtain corrected results. RESULTS VI was observed in 79 patients (39.5%). LASSO selected 10 predictors associated with VI. In the training dataset, the AUC for nomogram was 0.94 (95% confidence interval [CI]: 0.89-0.99, the sensitivity was 78.9% (95%CI: 72.4%-89.1%), the specificity was 95.3% (95%CI: 89.1%-100.0%), the accuracy was 86.0% (95%CI: 82.0%-92.0%), the PPV was 95.7% (95%CI: 90.0%-100.0%), and the NPV was 77.4% (95%CI: 67.8%-87.0%). In the validation dataset, the AUC for nomogram was 0.89 (95%CI: 0.83-0.95), the sensitivity was 70.3% (95%CI: 60.7%-79.2%), the specificity was 88.9% (95%CI: 80.0%-97.1%), the accuracy was 77.0% (95%CI: 70.0%-83.0%), the PPV was 91.8% (95%CI: 85.3%-98.0%), and the NPV was 62.7% (95%CI: 51.7%-74.0%). The nomogram calibration curve shows good agreement between the predicted probability and the actual probability. CONCLUSION The proposed nomogram could be used to predict VI in breast cancer patients, which was helpful for clinical decision-making.
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Affiliation(s)
- Fu-Sheng Ouyang
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Bao-Liang Guo
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Xi-Yi Huang
- Department of Laboratory, Lecong Hospital of Shunde, Foshan, Guangdong, PR China
| | - Li-Zhu Ouyang
- Department of Ultrasound, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Cui-Ru Zhou
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Rong Zhang
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Mei-Lian Wu
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Zun-Shuai Yang
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Shang-Kun Wu
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Tian-di Guo
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China
| | - Shao-Ming Yang
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China.
| | - Qiu-Gen Hu
- Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangdong, PR China.
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Assessment of Pattern and Shape Symmetry of Bilateral Normal Corneas by Scheimpflug Technology. Symmetry (Basel) 2018. [DOI: 10.3390/sym10100453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose: The aim of this study was to assess bilateral symmetry in normal fellow eyes by using optical and geometric morphometric parameters. Methods: All participants underwent complete biocular examinations. Scheimpflug tomography data from 66 eyes of 33 patients were registered. The interocular symmetry was based on five patterns: morphogeometric symmetry, axial symmetry at the corneal vertex, angular-spatial symmetry, direct symmetry (equal octants), and enantiomorphism (mirror octants). Results: No statistically significant differences were found between right and left eyes in corneal morphogeometric (p ≥ 0.488) and aberrometric parameters (p ≥ 0.102). Likewise, no statistically significant differences were found in any of the axial symmetry parameters analyzed (p ≥ 0.229), except in the surface rotation angle beta (p = 0.102) and translation coordinates X0 and Y0 (p < 0.001) for the anterior corneal surface, and the rotation angle gamma (p < 0.001) for the posterior surface. Similarly, no statistically significant differences were identified for direct symmetry (p ≥ 0.20) and enantiomorphism (p ≥ 0.75), except for some elevation data in the posterior surface (p < 0.01). Conclusions: The level of symmetry of both corneas of a healthy individual is high, with only some level of disparity between fellow corneas in rotation and translation references. Abnormalities in this pattern of interocular asymmetry may be useful as a diagnostic tool.
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