1
|
Zhang Z, Zhang X, Chen J, Takane Y, Yanagaki S, Mori N, Ichiji K, Kato K, Yanagaki M, Ebata A, Miyashita M, Ishida T, Homma N. Risk Analysis of Breast Cancer by Using Bilateral Mammographic Density Differences: A Case-Control Study. TOHOKU J EXP MED 2023; 261:139-150. [PMID: 37558417 DOI: 10.1620/tjem.2023.j066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
The identification of risk factors helps radiologists assess the risk of breast cancer. Quantitative factors such as age and mammographic density are established risk factors for breast cancer. Asymmetric breast findings are frequently encountered during diagnostic mammography. The asymmetric area may indicate a developing mass in the early stage, causing a difference in mammographic density between the left and right sides. Therefore, this paper aims to propose a quantitative parameter named bilateral mammographic density difference (BMDD) for the quantification of breast asymmetry and to verify BMDD as a risk factor for breast cancer. To quantitatively evaluate breast asymmetry, we developed a semi-automatic method to estimate mammographic densities and calculate BMDD as the absolute difference between the left and right mammographic densities. And then, a retrospective case-control study, covering the period from July 2006 to October 2014, was conducted to analyse breast cancer risk in association with BMDD. The study included 364 women diagnosed with breast cancer and 364 matched control patients. As a result, a significant difference in BMDD was found between cases and controls (P < 0.001) and the case-control study demonstrated that women with BMDD > 10% had a 2.4-fold higher risk of breast cancer (odds ratio, 2.4; 95% confidence interval, 1.3-4.5) than women with BMDD ≤ 10%. In addition, we also demonstrated the positive association between BMDD and breast cancer risk among the subgroups with different ages and the Breast Imaging Reporting and Data System (BI-RADS) mammographic density categories. This study demonstrated that BMDD could be a potential risk factor for breast cancer.
Collapse
Affiliation(s)
- Zhang Zhang
- Department of Intelligent Biomedical Systems Engineering Laboratory, Graduate School of Biomedical Engineering, Tohoku University
| | - Xiaoyong Zhang
- Smart-Aging Research Center, Institute of Development, Aging and Cancer, Tohoku University
- Department of General Engineering, National Institute of Technology, Sendai College
| | - Jiaqi Chen
- Department of Radiological Imaging and Informatics, Tohoku University Graduate School of Medicine
| | - Yumi Takane
- Clinical Technology Department, Tohoku University Hospital
| | - Satoru Yanagaki
- Department of Diagnostic Radiology, Tohoku University Hospital
| | - Naoko Mori
- Department of Radiology, Akita University Graduate School of Medicine
| | - Kei Ichiji
- Department of Radiological Imaging and Informatics, Tohoku University Graduate School of Medicine
| | | | | | - Akiko Ebata
- Department of Surgery, Tohoku University Hospital
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine
| | - Minoru Miyashita
- Department of Surgery, Tohoku University Hospital
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine
| | - Takanori Ishida
- Department of Surgery, Tohoku University Hospital
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine
| | - Noriyasu Homma
- Department of Intelligent Biomedical Systems Engineering Laboratory, Graduate School of Biomedical Engineering, Tohoku University
- Department of Radiological Imaging and Informatics, Tohoku University Graduate School of Medicine
| |
Collapse
|
2
|
Ahern TP, Sprague BL, Farina NH, Tsai E, Cuke M, Kontos D, Wood ME. Lifestyle, Behavioral, and Dietary Risk Factors in Relation to Mammographic Breast Density in Women at High Risk for Breast Cancer. Cancer Epidemiol Biomarkers Prev 2021; 30:936-944. [PMID: 33619019 DOI: 10.1158/1055-9965.epi-20-1567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Women at high risk for breast cancer due to genetics or risk factor profiles are counseled to adopt lifestyle, behavioral, and dietary changes to help reduce their risk. These recommendations are based on studies of women at average risk, so their effectiveness in high-risk women is unclear. METHODS We evaluated the impact of physical activity, smoking, alcohol consumption, and intake of folate and carotenoids on mammographic breast density-a proxy for breast cancer risk-among 387 high-risk women. Exposures were self-reported on questionnaires. Breast dense area, nondense area, and percent dense area were measured from screening mammograms with Library for Breast Radiodensity Assessment software. Cross-sectional associations were estimated with multivariable quantile regression models. RESULTS After adjusting for age, adiposity, reproductive history, and use of postmenopausal hormones, no breast density measure was associated with physical activity level, smoking status, alcohol consumption, or estimated intake of folate, alpha-carotene, beta-carotene, lutein/zeaxanthin, and beta-cryptoxanthin. Lycopene intake was associated with lower dense area when comparing the highest and lowest intake categories (adjusted difference in median = -14 cm2, 95% confidence interval: -29 to 1.3 cm2). This association may be explained by incomplete adjustment for adiposity. CONCLUSIONS Recommended lifestyle, behavioral, and dietary changes to mitigate personal risk of breast cancer do not substantially impact mammographic breast density measures. IMPACT Alternative strategies, such as increased uptake of chemoprevention, may better serve risk reduction efforts in women at high risk for breast cancer.
Collapse
Affiliation(s)
- Thomas P Ahern
- Department of Surgery, Larner College of Medicine at the University of Vermont, Burlington, Vermont. .,Department of Biochemistry, Larner College of Medicine at the University of Vermont, Burlington, Vermont
| | - Brian L Sprague
- Department of Surgery, Larner College of Medicine at the University of Vermont, Burlington, Vermont.,Department of Biochemistry, Larner College of Medicine at the University of Vermont, Burlington, Vermont.,Department of Radiology, Larner College of Medicine at the University of Vermont, Burlington, Vermont
| | - Nicholas H Farina
- Department of Biochemistry, Larner College of Medicine at the University of Vermont, Burlington, Vermont
| | - Erin Tsai
- Department of Radiology, Larner College of Medicine at the University of Vermont, Burlington, Vermont
| | - Melissa Cuke
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont
| | - Despina Kontos
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marie E Wood
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont
| |
Collapse
|
3
|
Abstract
Breast cancer screening is a recognized tool for early detection of the disease in asymptomatic women, improving treatment efficacy and reducing the mortality rate. There is raised awareness that a "one-size-fits-all" approach cannot be applied for breast cancer screening. Currently, despite specific guidelines for a minority of women who are at very high risk of breast cancer, all other women are still treated alike. This article reviews the current recommendations for breast cancer risk assessment and breast cancer screening in average-risk and higher-than-average-risk women. Also discussed are new developments and future perspectives for personalized breast cancer screening.
Collapse
Affiliation(s)
- Carolina Rossi Saccarelli
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA; Department of Radiology, Hospital Sírio-Libanês, Rua Dona Adma Jafet 91, São Paulo, SP 01308-050, Brazil
| | - Almir G V Bitencourt
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA; Department of Imaging, A.C. Camargo Cancer Center, Rua Prof. Antônio Prudente, 211, São Paulo, SP 01509-010, Brazil
| | - Elizabeth A Morris
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA.
| |
Collapse
|
4
|
Borgi M, Collacchi B, Ortona E, Cirulli F. Stress and coping in women with breast cancer:unravelling the mechanisms to improve resilience. Neurosci Biobehav Rev 2020; 119:406-421. [PMID: 33086128 DOI: 10.1016/j.neubiorev.2020.10.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
Breast cancer diagnosis, surgery, adjuvant therapies and survivorship can all be extremely stressful. In women, concerns about body image are common as a result of the disease and can affect interpersonal relationships, possibly leading to social isolation, increasing the likelihood for mood disorders. This is particularly relevant as women are at greater risk to develop anxiety and depressive symptoms in response to highly stressful situations. Here we address the mechanisms and the pathways activated as a result of stress and contributing to changes in the pathophysiology of breast cancer, as well as the potential of stress management factors and interventions in buffering the deleterious effects of chronic stress in a gender perspective. An improved understanding of the biological mechanisms linking stress-management resources to health-relevant biological processes in breast cancer patients could reveal novel therapeutic targets and help clarifying which psychosocial interventions can improve cancer outcomes, ultimately offering a unique opportunity to improve contemporary cancer treatments.
Collapse
Affiliation(s)
- Marta Borgi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Barbara Collacchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Elena Ortona
- Center for Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| |
Collapse
|
5
|
Xu J, Sram RJ, Cebulska-Wasilewska A, Miloradov MV, Sardas S, Au WW. Challenge-comet assay, a functional and genomic biomarker for precision risk assessment and disease prevention among exposed workers. Toxicol Appl Pharmacol 2020; 397:115011. [PMID: 32305282 DOI: 10.1016/j.taap.2020.115011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 04/12/2020] [Accepted: 04/14/2020] [Indexed: 02/05/2023]
Abstract
Advancements in genomic technologies have ushered application of innovative changes into biomedical sciences and clinical medicine. Consequently, these changes have created enormous opportunities to implement precision population/occupational disease prevention and target-specific disease intervention (or personalized medicine). To capture the opportunities, however, it is necessary is to develop novel, especially genomic-based, biomarkers which can provide precise and individualized health risk assessment. In this review, development of the Challenge-comet assay is used as an example to demonstrate how assays need to be validated for its sensitivity, specificity, and functional and quantitative features, and how assays can be used to provide individualized health risk assessment for precision prevention and intervention. Other examples of genomic-based novel biomarkers will also be discussed. Furthermore, no biomarkers can be used alone therefore their integrated usage with other biomarkers and with personal data bases will be discussed.
Collapse
Affiliation(s)
- Jianzhen Xu
- Shantou University Medical College, Shantou, China
| | - Radim J Sram
- Institute of Experimental Medicine AS, CR, Prague, Czech Republic
| | | | | | - Semra Sardas
- Istinye University, Zeytinburnu, Istanbul, Turkey
| | - William W Au
- University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania; University of Texas Medical Branch, Galveston, TX, USA.
| |
Collapse
|
6
|
Nassar FJ, Chamandi G, Tfaily MA, Zgheib NK, Nasr R. Peripheral Blood-Based Biopsy for Breast Cancer Risk Prediction and Early Detection. Front Med (Lausanne) 2020; 7:28. [PMID: 32118013 PMCID: PMC7026666 DOI: 10.3389/fmed.2020.00028] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 01/20/2020] [Indexed: 12/17/2022] Open
Abstract
Among women, breast cancer (BC) is not only the most common cancer worldwide but also the leading cause of cancer death. Only 5–10% of breast cancer cases are attributed to inherited mutations (BRCA1, BRCA2, and other breast cancer susceptibility genes). Breast cancer incidence has been rising particularly in young women who are not eligible for mammography, and it has been acting as a burden especially in developing countries that lack screening and awareness programs. For this reason, research has shifted to use minimally invasive liquid biopsies especially blood-based biomarkers with potential value for breast cancer risk prediction and early detection. This mini-review will tackle the different blood-based biomarkers focusing mainly on circulating miRNA, circulating proteins, cell-free nucleic acids, methylation patterns, and exosomes. It also introduces the potential opportunities for the clinical use of these blood-based biomarkers for breast cancer risk prediction.
Collapse
Affiliation(s)
- Farah J Nassar
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghada Chamandi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohamad Ali Tfaily
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nathalie Khoueiry Zgheib
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rihab Nasr
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
7
|
Update on Breast Density, Risk Estimation, and Supplemental Screening. AJR Am J Roentgenol 2020; 214:296-305. [DOI: 10.2214/ajr.19.21994] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
8
|
Bitencourt AG, Rossi Saccarelli C, Kuhl C, Morris EA. Breast cancer screening in average-risk women: towards personalized screening. Br J Radiol 2019; 92:20190660. [PMID: 31538501 DOI: 10.1259/bjr.20190660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Breast cancer screening is widely recognized for reducing breast cancer mortality. The objective in screening is to diagnose asymptomatic early stage disease, thereby improving treatment efficacy. Screening recommendations have been widely debated over the past years and controversies remain regarding the optimal screening frequency, age to start screening, and age to end screening. While there are no new trials, follow-up information of randomized controlled trials has become available. The American College of Physicians recently issued a new guidance statement on screening for breast cancer in average-risk women, with similar recommendations to the U.S. Preventive Services Task Force and to European guidelines. However, these guidelines differ from those ofother American specialty societies. The variations reflect differences in the organizations' values, the metrics used to evaluate screening results, and the differences in healthcare organization (individualized or state-organized healthcare). False-positive rates and overdiagnosis of biologically insignificant cancer are perceived as the most important potential harms associated with mammographic screening; however, there is limited evidence on their actual consequences. Most specialty societies agree that physicians should offer mammographic screening at age 40 years for average-risk women and discuss its benefits and potential harms to achieve a personalized screening strategy through a shared decision-making process.
Collapse
Affiliation(s)
- Almir Gv Bitencourt
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Carolina Rossi Saccarelli
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Radiology, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | - Christiane Kuhl
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Elizabeth A Morris
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
9
|
Toyama K, Spin JM, Mogi M, Tsao PS. Therapeutic perspective on vascular cognitive impairment. Pharmacol Res 2019; 146:104266. [PMID: 31108183 DOI: 10.1016/j.phrs.2019.104266] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 02/06/2023]
Abstract
Dementia is one of the greatest public health concerns for the modern aging world. Over the last decade, most researchers developing new therapeutic strategies for dementia have focused on amyloid-β. In contrast, numerous recent studies have indicated that vascular risk factors are associated with various forms of dementia, and that in fact most forms of dementia can be considered an extension of vascular disease. Accordingly, it is sensible to pursue treatment approaches that focus on the blood vessels. Blood-brain barrier (BBB) disruptions in the white matter of patients with vascular cognitive impairment (VCI) have been observed using imaging analysis, and might be potential targets for novel VCI treatment. Tight junctions between cerebral endothelial cells play an important role in the function of the BBB, and recent studies have demonstrated the essential role of microRNAs in regulating tight junctions. Further elucidation of the mechanisms of tight junction-disruption in dementia are likely to lead to promising novel treatments. In this article, we summarize current knowledge regarding microRNAs and vascular cognitive impairment and the possibility of utilizing microRNAs as biomarkers for BBB dysfunction, and seek to envision future therapeutic strategies.
Collapse
Affiliation(s)
- Kensuke Toyama
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan.
| | - Joshua M Spin
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, United States; VA Palo Alto Health Care System, Palo Alto, CA, United States
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Philip S Tsao
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, United States; VA Palo Alto Health Care System, Palo Alto, CA, United States
| |
Collapse
|