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Yang Y, Du P, Hou X, Yan K, Dai Y, Sun Z, Wu Q, Li S, Yan Y, Wang Z, Qi L, Chen M, Zheng H, Gao W, Gao M, Xue W, Zhang X. Early cancer screening surveillance in one medical center of China. PeerJ 2024; 12:e18179. [PMID: 39351369 PMCID: PMC11441387 DOI: 10.7717/peerj.18179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 09/04/2024] [Indexed: 10/04/2024] Open
Abstract
Objectives Cancer screening aims to detect and treat malignant lesions at an early stage and to prolong patients' lifetime. There is still a lack of effective cancer screening programs in China. We initiated a screening project in 2018 and this study presented the cancer screening status in China. Methods We conducted a cross-sectional study in one cancer-care medical center of China. The screening program included routine blood tests, plasma tumor markers, gastric endoscopy, colonoscopy, ultrasound, and computed tomography (CT) scans. Screening results were presented as sensitivity, specificity and positive predictive values (PPVs). Results Twenty-three (1.46%) out of 1,576 participants were eventually diagnosed with malignant tumors or high-grade intraepithelial neoplasia (HGIN). A family history of malignancy (78.26% in diagnosed cancer and HGIN vs. 46.36% in the others) was the only statistically significant parameter associated with cancer detection (p = 0.002). None of the common tumor markers were associated with the cancers screened. Except for colonoscopy (50.00%) and ultrasound for renal cancer (66.67%), the sensitivities of most screening methods were 100%. The specificities of all the screening means were above 96%. Most PPVs ranged from 30-60%. Conclusion We emphasized risk stratification for early cancer screening, such as a family history of cancer. The survey illustrated that gastric endoscopy, colonoscopy, ultrasound, and lung CT for early cancer screening had high specificity, reasonable sensitivity, and PPV. We anticipated this report would motivate larger-sample studies to estimate the risk-to-benefit ratio of cancer screening and urge the establishment of a native Chinese screening project and even guidelines.
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Affiliation(s)
- Ying Yang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital & Institute, Beijing, China
| | - Peng Du
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Urology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaolu Hou
- Western Beijing Cancer Hospital, Beijing, China
| | - Kun Yan
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Ultrasonography, Peking University Cancer Hospital & Institute, Beijing, China
| | - Ying Dai
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Ultrasonography, Peking University Cancer Hospital & Institute, Beijing, China
| | - ZhiYing Sun
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Ultrasonography, Peking University Cancer Hospital & Institute, Beijing, China
| | - Qi Wu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Endoscopy, Peking University Cancer Hospital & Institute, Beijing, China
| | - Shijie Li
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Endoscopy, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yan Yan
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Endoscopy, Peking University Cancer Hospital & Institute, Beijing, China
| | - Zhilong Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Liping Qi
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Mailin Chen
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Hong Zheng
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Gynecologic Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Weijiao Gao
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Gynecologic Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Min Gao
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Gynecologic Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Weicheng Xue
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaodong Zhang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital & Institute, Beijing, China
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Nogueira MC, Guerra MR, Bustamante-Teixeira MT, Azevedo E Silva G, Tomazelli J, Pereira DDA, Ribeiro CM, Naghavi M, Malta DC. Mortality due to cervical and breast cancer in health regions of Brazil: impact of public policies on cancer care. Public Health 2024; 236:239-246. [PMID: 39276562 DOI: 10.1016/j.puhe.2024.07.034] [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: 04/08/2024] [Revised: 07/12/2024] [Accepted: 07/25/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVE This analysis assessed the association between regional income, screening coverage for cervical and breast cancer, and temporal trends in mortality from these cancers in different Brazilian health regions. STUDY DESIGN Spatiotemporal ecological study across 450 health regions of Brazil. METHODS Data from 2010 Demographic Census were used to assess income. Variations in income distribution within health regions were measured using the Gini index. Data on screening coverage were obtained from the Ambulatory Information System (SIA/SUS). Mortality was assessed from the Global Burden of Disease Study 2019 data. The average annual percentage change (AAPC) in cervical and breast cancer mortality rates, 2010-2018, was calculated by health regions. Results were presented in regional maps. The associations between income, screening coverage and mortality changes were estimated by bivariate spatial correlation. RESULTS Health regions located in the South and Southeast regions of Brazil had the greatest percentages of screening coverage and highest per capita incomes with the lowest Gini index values. From 2010 to 2018, mortality rates for cervical cancer were highest in the North and Northeast health regions. Breast cancer mortality rates were highest in the South and Southeast health regions. The AAPC in breast and cervical cancer mortality had a negative association with per capita income and screening coverage, and a positive association with the Gini index. CONCLUSIONS There are large regional variations in income, screening coverage, and mortality rates for women with breast and cervical cancer. These inequities could be mitigated by policies to address income disparities and improved access to screening.
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Affiliation(s)
- M C Nogueira
- Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brazil.
| | - M R Guerra
- Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brazil.
| | - M T Bustamante-Teixeira
- Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brazil.
| | - G Azevedo E Silva
- Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brazil.
| | - J Tomazelli
- Instituto Nacional de Câncer, Divisão de Pesquisa Populacional, Rio de Janeiro, RJ, Brazil.
| | | | - C M Ribeiro
- Instituto Nacional de Câncer, Divisão de Detecção Precoce e Apoio à Organização de Rede, Rio de Janeiro, RJ, Brazil.
| | - M Naghavi
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA.
| | - D C Malta
- Universidade Federal de Minas Gerais, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brazil.
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Nagadi DA, Elsayed NM. Magnetic resonance imaging of the breast: Could it be used as a screening test? Saudi Med J 2024; 45:799-807. [PMID: 39074890 PMCID: PMC11288493 DOI: 10.15537/smj.2024.45.8.20230748] [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: 10/06/2023] [Accepted: 07/04/2024] [Indexed: 07/31/2024] Open
Abstract
OBJECTIVES To investigate whether magnetic resonance imaging (MRI) best detects early malignancy in high-risk women. METHODS A retrospective, cross-sectional study, carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, included 419 female breast cancer patients aged 16-84 years (mean age of 49). Data were collected from the radiological department's database to compare the MRI, ultrasound (US), and mammography results, with or without tissue biopsy. RESULTS In diagnosing benign versus malignant lesions, MRI showed significant agreement with tissue biopsy, with high sensitivity (70%) and specificity (87%); its positive predictive value (PPV) was 92% and negative predictive value (NPV) was 56%. While US has a PPV of 84% and NPV of 63%; with a sensitivity (79%) and specificity (71%). In patients without tissue biopsy, there was little difference between mammography and US compared with MRI results. CONCLUSION Magnetic resonance imaging is more effective than US and mammography for early detection of BC. It showed high sensitivity in detecting breast lesions and high specificity in characterizing their nature when correlated with pathological results. Ultrasound screening followed by MRI is suggested for undetected or suspected lesions. This will increase the breast lesion detection rate, reduce unneeded tissue biopsies, and enhance the disease's survival rate.
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Affiliation(s)
- Deema A. Nagadi
- From the Department of Diagnostic Radiology (Nagadi), King Abdulaziz University Hospital, from the Department of Radiologic Sciences (Nagadi, Elsayed), Faculty of Applied Medical Science, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia,and from the Department of Diagnostic Radiology (Elsayed), Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Naglaa M. Elsayed
- From the Department of Diagnostic Radiology (Nagadi), King Abdulaziz University Hospital, from the Department of Radiologic Sciences (Nagadi, Elsayed), Faculty of Applied Medical Science, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia,and from the Department of Diagnostic Radiology (Elsayed), Faculty of Medicine, Cairo University, Cairo, Egypt.
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Zaki-Metias KM, Wang H, Tawil TF, Miles EB, Deptula L, Agrawal P, Davis KM, Spalluto LB, Seely JM, Yong-Hing CJ. Breast Cancer Screening in the Intermediate-Risk Population: Falling Through the Cracks? Can Assoc Radiol J 2024; 75:593-600. [PMID: 38420877 DOI: 10.1177/08465371241234544] [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] [Indexed: 03/02/2024] Open
Abstract
Breast cancer screening guidelines vary for women at intermediate risk (15%-20% lifetime risk) for developing breast cancer across jurisdictions. Currently available risk assessment models have differing strengths and weaknesses, creating difficulty and ambiguity in selecting the most appropriate model to utilize. Clarifying which model to utilize in individual circumstances may help determine the best screening guidelines to use for each individual.
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Affiliation(s)
- Kaitlin M Zaki-Metias
- Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, MI, USA
| | - Huijuan Wang
- Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, MI, USA
| | - Tima F Tawil
- Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, MI, USA
| | - Eda B Miles
- Department of Internal Medicine, Arnot Ogden Medical Center, Elmira, NY, USA
| | - Lisa Deptula
- Ross University School of Medicine, Bridgetown, Barbados
| | - Pooja Agrawal
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
- Department of Internal Medicine, HCA Houston Healthcare Kingwood, Houston, TX, USA
| | - Katie M Davis
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lucy B Spalluto
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Ingram Cancer Center, Nashville, TN, USA
- Veterans Health Administration, Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Nashville, TN, USA
| | - Jean M Seely
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Charlotte J Yong-Hing
- Diagnostic Imaging, BC Cancer Vancouver, Vancouver, BC, Canada
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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5
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Pinto-Carbó M, Vanaclocha-Espí M, Martín-Pozuelo J, Romeo-Cervera P, Hernández-García M, Ibáñez J, Castán-Cameo S, Salas D, van Ravesteyn NT, de Koning H, Zurriaga Ó, Molina-Barceló A. Impact of different age ranges on the benefits and harms of the breast cancer screening programme by the EU-TOPIA tool. Eur J Public Health 2024; 34:806-811. [PMID: 38578614 PMCID: PMC11293820 DOI: 10.1093/eurpub/ckae068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The recommendation for the implementation of mammography screening in women aged 45-49 and 70-74 is conditional with moderate certainty of the evidence. The aim of this study is to simulate the long-term outcomes (2020-50) of using different age range scenarios in the breast cancer screening programme of the Valencia Region (Spain), considering different programme participation rates. METHODS Three age range scenarios (S) were simulated with the EU-TOPIA tool, considering a biennial screening interval: S1, 45-69 years old (y); S2, 50-69 y and S3, 45-74 y. Simulations were performed for four participation rates: A = current participation (72.7%), B = +5%, C = +10% and D = +20%. Considered benefits: number (N°) of in situ and invasive breast cancers (BC) (screen vs. clinically detected), N° of BC deaths and % BC mortality reduction. Considered harms: N° of false positives (FP) and % overdiagnosis. RESULTS The results showed that BC mortality decreased in all scenarios, being higher in S3A (32.2%) than S1A (30.6%) and S2A (27.9%). Harms decreased in S2A vs. S1A (N° FP: 236 vs. 423, overdiagnosis: 4.9% vs. 5.0%) but also benefits (BC mortality reduction: 27.9% vs. 30.6%, N° screen-detected invasive BC 15/28 vs. 18/25). In S3A vs. S1A, an increase in benefits was observed (BC mortality reduction: 32.2% vs. 30.6%), N° screen-detected in situ B: 5/2 vs. 4/3), but also in harms (N° FP: 460 vs. 423, overdiagnosis: 5.8% vs. 5.0%). Similar trends were observed with increased participation. CONCLUSIONS As the age range increases, so does not only the reduction in BC mortality, but also the probability of FP and overdiagnosis.
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Affiliation(s)
- Marina Pinto-Carbó
- Cancer and Public Health Research Unit, Foundation for the Promotion of
Health and Biomedical Research of Valencia Region (FISABIO-Public
Health), Valencia, Spain
| | - Mercedes Vanaclocha-Espí
- Cancer and Public Health Research Unit, Foundation for the Promotion of
Health and Biomedical Research of Valencia Region (FISABIO-Public
Health), Valencia, Spain
| | - Javier Martín-Pozuelo
- Cancer and Public Health Research Unit, Foundation for the Promotion of
Health and Biomedical Research of Valencia Region (FISABIO-Public
Health), Valencia, Spain
| | - Paula Romeo-Cervera
- Cancer and Public Health Research Unit, Foundation for the Promotion of
Health and Biomedical Research of Valencia Region (FISABIO-Public
Health), Valencia, Spain
| | - Marta Hernández-García
- Environmental Health Service, Utiel Public Health Centre, Ministry of
Universal and Public Health, Utiel, Valencia Region, Spain
| | - Josefa Ibáñez
- Cancer and Public Health Research Unit, Foundation for the Promotion of
Health and Biomedical Research of Valencia Region (FISABIO-Public
Health), Valencia, Spain
- Healthcare Integration Service, Directorate General for Health Care,
Regional Ministry of Health, Valencia, Spain
| | - Susana Castán-Cameo
- Cancer and Public Health Research Unit, Foundation for the Promotion of
Health and Biomedical Research of Valencia Region (FISABIO-Public
Health), Valencia, Spain
- Screening Programs Service, General Directorate of Public Health, Regional
Ministry of Health, Valencia, Spain
| | - Dolores Salas
- Cancer and Public Health Research Unit, Foundation for the Promotion of
Health and Biomedical Research of Valencia Region (FISABIO-Public
Health), Valencia, Spain
| | | | - Harry de Koning
- Department of Public Health, Erasmus MC University Medical
Center, Rotterdam, The Netherlands
| | - Óscar Zurriaga
- Department of Preventive Medicine and Public Health, Food Sciences,
Toxicology and Legal Medicine, University of Valencia, Valencia,
Spain
- Joint Research Unit on Rare Diseases, FISABIO-University of Valencia
(FISABIO-UVEG), Valencia, Spain
| | - Ana Molina-Barceló
- Cancer and Public Health Research Unit, Foundation for the Promotion of
Health and Biomedical Research of Valencia Region (FISABIO-Public
Health), Valencia, Spain
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Dehar N, Jabs D, Hopman W, Mates M. A Retrospective Analysis of Diagnostic Breast Imaging Outcomes in Young Women at a Tertiary Care Center. Curr Oncol 2024; 31:3939-3948. [PMID: 39057163 PMCID: PMC11276166 DOI: 10.3390/curroncol31070291] [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: 05/22/2024] [Revised: 06/29/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Purpose: The purpose of this study was to describe the outcomes of diagnostic breast imaging and the incidence of delayed breast cancer diagnosis in the study population. (2) Methods: We collected the outcome data from diagnostic mammograms and/or breast ultrasounds (USs) performed on women between the ages of 30 and 50 with symptomatic breast clinical presentations between 2018 and 2019. (3) Results: Out of 171 eligible patients, 10 patients (5.8%) had BIRADS 0, 90 patients (52.6%) had benign findings (BIRADS 1 and 2), 41 (24.0%) patients had probable benign findings requiring short-term follow-up (BIRADS 3), while 30 (17.5%) patients had findings suspicious of malignancy (BIRADS 4 and 5). In the BIRADS 3 group, 92.7% had recommended follow-up, while in BIRADS 4 and 5, only 83.3% underwent recommended biopsy at a mean time of 1.7 weeks (range 0-22 wks) from their follow-up scan. Ten (6%) patients were diagnosed with breast cancer, all of whom had BIRADS 4 or 5, with a mean time of breast cancer diagnosis from initial diagnostic imaging of 2.2 weeks (range 1-22 wks). No patients had delayed breast cancer diagnosis in our cohort. (4) Conclusions: We conclude that diagnostic mammograms and breast US are appropriate investigations for clinical breast concerns in women aged 30-50 years.
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Affiliation(s)
- Navdeep Dehar
- Department of Oncology, Queen’s School of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (D.J.); (M.M.)
- Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
| | - Doris Jabs
- Department of Oncology, Queen’s School of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (D.J.); (M.M.)
- Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
| | - Wilma Hopman
- KGH Research Institute, Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Mihaela Mates
- Department of Oncology, Queen’s School of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (D.J.); (M.M.)
- Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
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Seyedkanani E, Hosseinzadeh M, Mirghafourvand M, Sheikhnezhad L. Breast cancer screening patterns and associated factors in Iranian women over 40 years. Sci Rep 2024; 14:15274. [PMID: 38961238 PMCID: PMC11222508 DOI: 10.1038/s41598-024-66342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 07/01/2024] [Indexed: 07/05/2024] Open
Abstract
Screening is a key component of breast cancer early detection programs that can considerably reduce relevant mortality rates. The purpose of this study was to determine the breast cancer screening behavioral patterns and associated factors in women over 40 years of age. In this descriptive‑analytical cross‑sectional study, 372 over 40 years of age women visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling. The data were collected using the sociodemographic characteristics questionnaire, breast cancer perception scale, health literacy for Iranian adults scale, and the Breast Cancer Screening Behavior Checklist. The obtained data were analyzed in SPSS version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (univariate and multivariate logistic regression analyses). In total, 68.3% of all participants performed breast self‑examination (BSE) (9.9% regularly, once per month), 60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year), 51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwent sonography (3.8% regularly, twice per year). The findings also showed that women with benign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21; P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography (OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderate breast cancer perception scores were more likely to perform BSE than women with high breast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women who had a history of benign breast disease were more likely to perform screening behaviors than others (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 were more likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE (OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participation of women in regular breast cancer screening, it is suggested that health care providers highlight the need for screening at the specified intervals in their training programs. In addition, health authorities are recommended to use reminder systems to remind women, especially those over 40 years of age, of the best time for breast screening. Moreover, health care providers must seek to improve breast cancer knowledge, attitudes, and perceptions of women who visit health centers, which are the first level of contact with the healthcare system for the general population.
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Affiliation(s)
- Elham Seyedkanani
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Sheikhnezhad
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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Verboven G, Van den Bosch L, Lodewijkx I, Huizing M, Van Goethem M, Broeckx G, Tjalma WA. Retrospective cohort study on the bilateral occurrence of invasive lobular breast cancer. Eur J Obstet Gynecol Reprod Biol 2024; 298:175-181. [PMID: 38762954 DOI: 10.1016/j.ejogrb.2024.04.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
OBJECTIVE Invasive lobular carcinoma (ILC) is the second most common histological subtype of invasive breast cancer, following the no special type (NST) invasive carcinoma. It has historically been assumed that ILC occurs bilaterally in 20-29 % of cases, which has influenced the inclusion of MRI in the standard workup of ILC according to European guidelines. However, challenging this long-held belief regarding the bilateral occurrence of ILC opens up the possibility of revising the guidelines and using MRI only for more specific indications. This study aims to evaluate whether the previously reported high percentage of bilaterality still holds true and to question the added value of MRI in the standard workup of ILC. STUDY DESIGN A retrospective cohort study was conducted following approval from the institutional review board (EC 21/18/249) at Antwerp University Hospital (UZA). The cohort comprised female patients of all ages who had been diagnosed with either ILC or NST invasive carcinoma and had sought consultation at the UZA breast clinic. A comprehensive database was established to collect information on patient characteristics, imaging, and pathology. RESULTS A total of 271 patients with ILC were included in the study, with incidence dates ranging from 01/01/2007 to 01/01/2023. Among these patients, a synchronous bilateral ILC lesion was observed in 1.85 % (5/271) of cases. This proportion is significantly lower than the reported percentage of patients with a bilateral lesion in the literature population, which stands at 4.95 %. The reference group consisted of 809 patients with NST invasive carcinoma, with incidence dates ranging from 01/01/2017 to 01/01/2023. In the control group, a synchronous bilateral NST lesion was observed in 3.96 % (32/809) of cases. There is no significant difference in the bilaterality rates between the group of ILC patients and the group of NST patients. Furthermore, MRI did not detect any histopathologically confirmed contralateral ILC lesion that had not already been detected by mammography or ultrasound. CONCLUSIONS The study results indicate a lower occurrence of bilateral ILC than previously assumed. Additionally, the incidence of synchronous bilateral lesions in ILC patients is not higher compared to patients with NST invasive carcinoma. Performing an MRI does not provide additional value in detecting bilateral carcinomas in ILC. Consequently, it is recommended that the current European guidelines be reassessed, and the indications for undergoing an MRI should be adjusted accordingly.
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Affiliation(s)
- Griet Verboven
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Laura Van den Bosch
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Imke Lodewijkx
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Manon Huizing
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium; Biobank Antwerp, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium.
| | - Mireille Van Goethem
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium; Multidisciplinary Breast Clinic-Unit Antwerp University Hospital, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Glenn Broeckx
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium; Department of Pathology PA(2), GZA-ZNA Hospitals, Lindendreef 1, 2020 Antwerp, Belgium.
| | - Wiebren A Tjalma
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium; Multidisciplinary Breast Clinic-Unit Antwerp University Hospital, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
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AlSaleh N, AlRammah T, Alatabani A, Alsalem A, Alsheikh T, AlRabah R, Al-Qattan N, Alhomod A, Alkhaldi T. Mammographic density in relationships with relevant contributing factors: a multicentric study from Riyadh, Saudi Arabia. Gland Surg 2024; 13:844-851. [PMID: 39015703 PMCID: PMC11247587 DOI: 10.21037/gs-23-374] [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: 09/07/2023] [Accepted: 06/11/2024] [Indexed: 07/18/2024]
Abstract
Background Mammographic breast density (MBD), a well-established factor linked to breast cancer, is the focus of this preliminary report among women across multiple centers in Riyadh. The study aims to identify risk factors associated with high breast density. Methods MBD was assessed at three hospitals in Riyadh, Saudi Arabia, using the American College of Radiology (ACR) categories: A (almost entirely fatty), B (scattered areas of fibroglandular density), C (heterogeneously dense), and D (extremely dense). Breast density distributions were analyzed in relation to age, body mass index (BMI), family history, parity, and hormonal therapy usage. Results The study included 1,530 women, revealing an inverse association between dense breast proportion and age/BMI. Notably, 43.3% [95% confidence interval (CI): 43.2% to 43.5%] of women aged 40-79 years exhibited heterogeneously or highly dense breasts, with this proportion inversely correlated with age and BMI. Conclusions Healthcare providers should consider breast density for appropriate screening and, if necessary, recommend supplemental methods. Policymakers and healthcare providers, when discussing breast density notification legislation, should be mindful of its high prevalence, ensuring women notified have opportunities to evaluate breast cancer risk and pursue supplemental screening options if deemed appropriate.
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Affiliation(s)
- Nuha AlSaleh
- Department of Surgery, College of Medicine, King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia
| | - Tamrah AlRammah
- Department of Surgery, Diriayah Hospital, Riyadh Third Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | - Alaa Alatabani
- Department of Surgery, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia
| | | | - Tamara Alsheikh
- Faculty of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Razan AlRabah
- Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Noha Al-Qattan
- Department of Surgery, College of Medicine, King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia
| | | | - Turki Alkhaldi
- Department of Surgery, College of Medicine, King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia
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10
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Bayrakçeken E, Yaralı S, Alkan Ö. Identify risk factors affecting participation of Turkish women in mammography screening for breast cancer prevention. Breast Cancer Res Treat 2024; 205:487-495. [PMID: 38453780 PMCID: PMC11101495 DOI: 10.1007/s10549-024-07296-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/09/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Cancer screening is a public health intervention aiming to reduce cancer-caused deaths. This study aims to determine the factors affecting the mammography screening time among women aged 40-69. METHODS The micro dataset obtained from the Türkiye Health Survey conducted by the Turkish Statistical Institute (TurkStat) in 2019 and 2022 was used in the present study. Stereotype logistic regression was used to determine the variables affecting mammography screening and period for breast cancer prevention in women in Türkiye. RESULTS Given the results achieved from the analysis, it was found that factors such as age, marital status, general health condition, comorbidity, receiving psychosocial support, high blood lipid levels, and performing breast self-examinations affected women's adherence to cancer screening programs. CONCLUSION Since adherence to mammography increases with age, it is recommended to pay importance to education for women approaching the age of mammography screening. Educated individuals are expected to have access to multiple sources of information as to cancer and to access this information more easily. In order to gain more insight into the recommended preventive measures and outcomes related to cancer, it is suggested to review policies, which will increase the educational level of women, and provide privileges in the field of education.
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Affiliation(s)
- Esra Bayrakçeken
- Department of Medical Services and Techniques, Vocational School of Health Services, Ataturk University, Yakutiye/Erzurum, Türkiye
| | - Süheyla Yaralı
- Department of Public Health Nursing, Faculty of Nursing, Ataturk University, 2nd Floor, No:49, Yakutiye/Erzurum, Türkiye
| | - Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, 2nd Floor, No:222, Yakutiye/Erzurum, Türkiye.
- Master Araştırma Eğitim ve Danışmanlık Hizmetleri Ltd. şti., Ata Teknokent, Erzurum, TR-25240, Türkiye.
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11
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Riganti P, Ruiz Yanzi MV, Escobar Liquitay CM, Sgarbossa NJ, Alarcon-Ruiz CA, Kopitowski KS, Franco JV. Shared decision-making for supporting women's decisions about breast cancer screening. Cochrane Database Syst Rev 2024; 5:CD013822. [PMID: 38726892 PMCID: PMC11082933 DOI: 10.1002/14651858.cd013822.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
BACKGROUND In breast cancer screening programmes, women may have discussions with a healthcare provider to help them decide whether or not they wish to join the breast cancer screening programme. This process is called shared decision-making (SDM) and involves discussions and decisions based on the evidence and the person's values and preferences. SDM is becoming a recommended approach in clinical guidelines, extending beyond decision aids. However, the overall effect of SDM in women deciding to participate in breast cancer screening remains uncertain. OBJECTIVES To assess the effect of SDM on women's satisfaction, confidence, and knowledge when deciding whether to participate in breast cancer screening. SEARCH METHODS We searched the Cochrane Breast Cancer Group's Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform on 8 August 2023. We also screened abstracts from two relevant conferences from 2020 to 2023. SELECTION CRITERIA We included parallel randomised controlled trials (RCTs) and cluster-RCTs assessing interventions targeting various components of SDM. The focus was on supporting women aged 40 to 75 at average or above-average risk of breast cancer in their decision to participate in breast cancer screening. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion and conducted data extraction, risk of bias assessment, and GRADE assessment of the certainty of the evidence. Review outcomes included satisfaction with the decision-making process, confidence in the decision made, knowledge of all options, adherence to the chosen option, women's involvement in SDM, woman-clinician communication, and mental health. MAIN RESULTS We identified 19 studies with 64,215 randomised women, mostly with an average to moderate risk of breast cancer. Two studies covered all aspects of SDM; six examined shortened forms of SDM involving communication on risks and personal values; and 11 focused on enhanced communication of risk without other SDM aspects. SDM involving all components compared to control The two eligible studies did not assess satisfaction with the SDM process or confidence in the decision. Based on a single study, SDM showed uncertain effects on participant knowledge regarding the age to start screening (risk ratio (RR) 1.18, 95% confidence interval (CI) 0.61 to 2.28; 133 women; very low certainty evidence) and frequency of testing (RR 0.84, 95% CI 0.68 to 1.04; 133 women; very low certainty evidence). Other review outcomes were not measured. Abbreviated forms of SDM with clarification of values and preferences compared to control Of the six included studies, none evaluated satisfaction with the SDM process. These interventions may reduce conflict in the decision made, based on two measures, Decisional Conflict Scale scores (mean difference (MD) -1.60, 95% CI -4.21 to 0.87; conflict scale from 0 to 100; 4 studies; 1714 women; very low certainty evidence) and the proportion of women with residual conflict compared to control at one to three months' follow-up (rate of women with a conflicted decision, RR 0.75, 95% CI 0.56 to 0.99; 1 study; 1001 women, very low certainty evidence). Knowledge of all options was assessed through knowledge scores and informed choice. The effect of SDM may enhance knowledge (MDs ranged from 0.47 to 1.44 higher scores on a scale from 0 to 10; 5 studies; 2114 women; low certainty evidence) and may lead to higher rates of informed choice (RR 1.24, 95% CI 0.95 to 1.63; 4 studies; 2449 women; low certainty evidence) compared to control at one to three months' follow-up. These interventions may result in little to no difference in anxiety (MD 0.54, 95% -0.96 to 2.14; scale from 20 to 80; 2 studies; 749 women; low certainty evidence) and the number of women with worries about cancer compared to control at four to six weeks' follow-up (RR 0.88, 95% CI 0.73 to 1.06; 1 study, 639 women; low certainty evidence). Other review outcomes were not measured. Enhanced communication about risks without other SDM aspects compared to control Of 11 studies, three did not report relevant outcomes for this review, and none assessed satisfaction with the SDM process. Confidence in the decision made was measured by decisional conflict and anticipated regret of participating in screening or not. These interventions, without addressing values and preferences, may result in lower confidence in the decision compared to regular communication strategies at two weeks' follow-up (MD 2.89, 95% CI -2.35 to 8.14; Decisional Conflict Scale from 0 to 100; 2 studies; 1191 women; low certainty evidence). They may result in higher anticipated regret if participating in screening (MD 0.28, 95% CI 0.15 to 0.41) and lower anticipated regret if not participating in screening (MD -0.28, 95% CI -0.42 to -0.14). These interventions increase knowledge (MD 1.14, 95% CI 0.61 to 1.62; scale from 0 to 10; 4 studies; 2510 women; high certainty evidence), while it is unclear if there is a higher rate of informed choice compared to regular communication strategies at two to four weeks' follow-up (RR 1.27, 95% CI 0.83 to 1.92; 2 studies; 1805 women; low certainty evidence). These interventions result in little to no difference in anxiety (MD 0.33, 95% CI -1.55 to 0.99; scale from 20 to 80) and depression (MD 0.02, 95% CI -0.41 to 0.45; scale from 0 to 21; 2 studies; 1193 women; high certainty evidence) and lower cancer worry compared to control (MD -0.17, 95% CI -0.26 to -0.08; scale from 1 to 4; 1 study; 838 women; high certainty evidence). Other review outcomes were not measured. AUTHORS' CONCLUSIONS Studies using abbreviated forms of SDM and other forms of enhanced communications indicated improvements in knowledge and reduced decisional conflict. However, uncertainty remains about the effect of SDM on supporting women's decisions. Most studies did not evaluate outcomes considered important for this review topic, and those that did measured different concepts. High-quality randomised trials are needed to evaluate SDM in diverse cultural settings with a focus on outcomes such as women's satisfaction with choices aligned to their values.
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Affiliation(s)
- Paula Riganti
- Family and Community Medicine Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M Victoria Ruiz Yanzi
- Family and Community Medicine Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Nadia J Sgarbossa
- Health Department, Universidad Nacional de La Matanza, Buenos Aires, Argentina
| | - Christoper A Alarcon-Ruiz
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Karin S Kopitowski
- Family and Community Medicine Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Juan Va Franco
- Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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12
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Mignozzi S, Santucci C, Medina HN, Negri E, La Vecchia C, Pinheiro PS. Cancer mortality in Germany-born Americans and Germans. Cancer Epidemiol 2024; 88:102519. [PMID: 38183748 DOI: 10.1016/j.canep.2023.102519] [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: 10/05/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Comparing cancer mortality and associated risk factors among immigrant populations in a host country to those in their country of origin reveals disparities in cancer risk, access to care, diagnosis, and disease management. This study compares cancer mortality between the German resident population and Germany-born individuals who migrated to the US. METHODS Cancer mortality data from 2008-2018 were derived for Germans from the World Health Organization database and for Germany-born Americans resident in four states (California, Florida, Massachusetts, and New York) from respective Departments of Vital Statistics. We calculated age-standardized mortality rates (ASMRs) using the European standard population and standardized mortality ratios (SMR) compared to the German resident population along with 95% confidence intervals (CIs). RESULTS Germany-born American males had lower ASMRs (253.8 per 100,000) than German resident population (325.6 per 100,000). The difference in females was modest, with ASMRs of 200.7 and 203.7 per 100,000, respectively. For all cancers, Germany-born American males had an SMR of 0.72 (95% CI: 0.70-0.74) and females 0.98 (95% CI: 0.95-1.00). Male SMRs among Germany-born Americans were significantly below one for oral cavity, stomach, colorectal, liver, lung, prostate, and kidney cancer. Among females, SMRs were below one for oral cavity, stomach, colorectal, gallbladder, breast, cervix uteri, and kidney cancer. For both sexes, SMRs were over one for bladder cancer (1.14 for males, 1.21 for females). Mortality was higher for lung cancer (SMR: 1.68), non-Hodgkin's lymphoma (1.18) and uterine cancer (1.22) among Germany-born American females compared to the German resident population. CONCLUSION Germany-born American males but not females showed lower cancer mortality than German resident population. Disparities may stem from variations in risk factors (e.g., smoking and alcohol use) as well as differences in screening practices and participation, cancer treatment, besides some residual potential "healthy immigrant effect".
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Affiliation(s)
- Silvia Mignozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Claudia Santucci
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Heidy N Medina
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paulo S Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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13
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Rolle LD, Chery MJ, Larson M, Lopez-Pentecost M, Calfa CJ, Schlumbrecht MP, Crane TE. The Effect of Disability and Social Determinants of Health on Breast and Cervical Cancer Screenings During the COVID-19 Pandemic. Prev Chronic Dis 2024; 21:E05. [PMID: 38271492 PMCID: PMC10833830 DOI: 10.5888/pcd21.230234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Introduction The objective of this study was to examine the effect of disability status and social determinants of health (SDOH) on adherence to breast and cervical cancer screening recommendations during the COVID-19 pandemic. Methods We conducted a secondary analysis of the 2018 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) data sets. We defined adherence to screenings according to the US Preventive Services Task Force guidelines for breast and cervical cancer screening. The analysis included respondents assigned female at birth, aged 50 to 74 years (breast cancer screening) or aged 21 to 65 years (cervical cancer screening). We performed logistic regression to evaluate breast and cervical cancer screening adherence, by disability status and SDOH (health insurance coverage, marital status, and urban residency), independently and simultaneously. Results Our analysis included 27,526 BRFSS respondents in 2018 and 2020. In 2018, women with disabilities had lower adjusted odds than women without disabilities of being up to date with mammograms (adjusted odds ratio [AOR] = 0.76, 95% CI, 0.63-0.93) and Pap (Papanicolaou) tests (AOR = 0.73; 95% CI, 0.59-0.89). In 2020, among women with disabilities, the adjusted odds of mammogram and Pap test adherence decreased (AOR = 0.69; 95% CI, 0.54-0.89; AOR = 0.59; 95% CI, 0.47-0.75, respectively). In 2018, the adjusted odds of mammogram adherence among rural residents with and without disabilities were 0.83 (95% CI, 0.70-0.98), which decreased to 0.76 (95% CI, 0.62-0.93) in 2020. Conclusion The findings of this study highlight the effect of disability status and SDOH on breast and cervical cancer screening rates during the COVID-19 pandemic. Public health strategies that acknowledge and address these disparities are crucial in preparing for future public health crises.
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Affiliation(s)
- LaShae D Rolle
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
- University of Miami, 1120 NW 14th St, Miami, FL 33136
| | - Maurice J Chery
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Michaela Larson
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Melissa Lopez-Pentecost
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Carmen J Calfa
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Matthew P Schlumbrecht
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Miller School of Medicine, Miami, Florida
| | - Tracy E Crane
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
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14
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Han HJ, Huang CS, Lu TP, Tseng LM, Chie WC, Huang CC. Evaluating clinical efficacy of hospital-based surveillance with mammography and ultrasonography for breast cancer. J Formos Med Assoc 2024; 123:78-87. [PMID: 37400295 DOI: 10.1016/j.jfma.2023.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/01/2022] [Accepted: 06/07/2023] [Indexed: 07/05/2023] Open
Abstract
Periodic mammography and/or sonography examinations are conducted across numerous hospitals nationalwidely, especially for antedees with a positive mammography screening. Despite the regular practice, clinical efficacy of hospital-based breast cancer surveillance remains unclear. Specifically, the impact of surveillance interval upon survival and prognostic surrogates stratified by menopausal status, as well as malignant transition rate should be deciphered. We retrieved cancer registry to ascertain 841 breast cancers with surveillance history through administration data. Healthy controls underwent breast surveillance and were concurrently free of cancer. More benign diseases rather than cancers were identified from premenopausal women (age ≤50 years) with sonography alone within one year, as well as older women (age >50) with both mammography and sonography one to two years before a cancer or benign diagnosis. Among breast cancers, mammography alone during the antecedent one to two years had a protective effect for diagnosing carcinoma in situ rather than invasive cancer (age-adjusted odds ratio: 0.048, P = 0.016). Three-state time homogeneous Markov model showed that hospital-based breast surveillance within 2 years of disease onset reduced the malignant transition rate by 65.16% (59.79-76.74%). The clinical efficacy of breast cancer surveillance was evidenced.
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Affiliation(s)
- Hsin-Ju Han
- Department of Surgery, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Ching-Shui Huang
- Department of Surgery, Cathay General Hospital, Taipei City, Taiwan; School of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Tzu-Pin Lu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City, Taiwan
| | - Ling-Ming Tseng
- Department of Surgery, Taipei Veterans General Hospital, Taipei City, Taiwan; Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
| | - Wei-Chu Chie
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City, Taiwan.
| | - Chi-Cheng Huang
- Department of Surgery, Taipei Veterans General Hospital, Taipei City, Taiwan; Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei City, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City, Taiwan.
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15
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Krolewska-Daszczynska P, Smycz-Kubanska M, Kruszniewska-Rajs C, Kabut J, Olczyk P, Gola J, Mielczarek-Palacz A. Evaluation of potential prevalence of onconeural antibodies in women with breast cancer. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2024; 52:5-9. [PMID: 38518226 DOI: 10.36740/merkur202401101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
OBJECTIVE Aim: To analyse onconeural antibodies in the blood serum of breast cancer patients without neurological symptoms.. PATIENTS AND METHODS Materials and Methods: The study included 48 women with breast cancer. Paraneoplastic Neurologic Syndromes 12 Ag (IgG) Euroline by EUROIMMUN test was used to determine onconeural antibodies: anti-Hu, anti-Yo, anti-Ri, anti-CV2, anti-Ma/anti-Ta, anti-amphiphysin, anti-recoverin, anti-SOX1, anti-tytin, anti-zic4, anti-GAD65 and anti-Tr (DNER). RESULTS Results: The conducted analysis revealed the presence of onconeural antibodies such as: anti-recoverin, anti-CV2, anti-Zic4, anti-SOX1, anti-MA2/Ta and antititin in blood serum of women with breast cancer. CONCLUSION Conclusions: Further analysis may allow the assessment of the possible clinical usefulness of these determinations.
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Affiliation(s)
| | - Marta Smycz-Kubanska
- DEPARTMENT OF IMMUNOLOGY AND SEROLOGY, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
| | | | - Jacek Kabut
- DEPARTMENT OF IMMUNOLOGY AND SEROLOGY, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
| | - Paweł Olczyk
- DEPARTMENT OF COMMUNITY PHARMACY, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
| | - Joanna Gola
- DEPARTMENT OF MOLECULAR BIOLOGY, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
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16
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Irmici G, Cè M, Pepa GD, D'Ascoli E, De Berardinis C, Giambersio E, Rabiolo L, La Rocca L, Carriero S, Depretto C, Scaperrotta G, Cellina M. Exploring the Potential of Artificial Intelligence in Breast Ultrasound. Crit Rev Oncog 2024; 29:15-28. [PMID: 38505878 DOI: 10.1615/critrevoncog.2023048873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Breast ultrasound has emerged as a valuable imaging modality in the detection and characterization of breast lesions, particularly in women with dense breast tissue or contraindications for mammography. Within this framework, artificial intelligence (AI) has garnered significant attention for its potential to improve diagnostic accuracy in breast ultrasound and revolutionize the workflow. This review article aims to comprehensively explore the current state of research and development in harnessing AI's capabilities for breast ultrasound. We delve into various AI techniques, including machine learning, deep learning, as well as their applications in automating lesion detection, segmentation, and classification tasks. Furthermore, the review addresses the challenges and hurdles faced in implementing AI systems in breast ultrasound diagnostics, such as data privacy, interpretability, and regulatory approval. Ethical considerations pertaining to the integration of AI into clinical practice are also discussed, emphasizing the importance of maintaining a patient-centered approach. The integration of AI into breast ultrasound holds great promise for improving diagnostic accuracy, enhancing efficiency, and ultimately advancing patient's care. By examining the current state of research and identifying future opportunities, this review aims to contribute to the understanding and utilization of AI in breast ultrasound and encourage further interdisciplinary collaboration to maximize its potential in clinical practice.
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Affiliation(s)
- Giovanni Irmici
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Maurizio Cè
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Gianmarco Della Pepa
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Elisa D'Ascoli
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Claudia De Berardinis
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Emilia Giambersio
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Lidia Rabiolo
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Policlinico Università di Palermo, Palermo, Italy
| | - Ludovica La Rocca
- Postgraduation School in Radiodiagnostics, Università degli Studi di Napoli
| | - Serena Carriero
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Catherine Depretto
- Breast Radiology Unit, Fondazione IRCCS, Istituto Nazionale Tumori, Milano, Italy
| | | | - Michaela Cellina
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, Milano, Piazza Principessa Clotilde 3, 20121, Milan, Italy
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Zhang H, Ma Q, Chen Y. U structured network with three encoding paths for breast tumor segmentation. Sci Rep 2023; 13:21597. [PMID: 38062236 PMCID: PMC10703786 DOI: 10.1038/s41598-023-48883-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
Breast ultrasound segmentation remains challenging because of the blurred boundaries, irregular shapes, and the presence of shadowing and speckle noise. The majority of approaches stack convolutional layers to extract advanced semantic information, which makes it difficult to handle multiscale issues. To address those issues, we propose a three-path U-structure network (TPUNet) that consists of a three-path encoder and an attention-based feature fusion block (AFF Block). Specifically, instead of simply stacking convolutional layers, we design a three-path encoder to capture multiscale features through three independent encoding paths. Additionally, we design an attention-based feature fusion block to weight and fuse feature maps in spatial and channel dimensions. The AFF Block encourages different paths to compete with each other in order to synthesize more salient feature maps. We also investigate a hybrid loss function for reducing false negative regions and refining the boundary segmentation, as well as the deep supervision to guide different paths to capture the effective features under the corresponding receptive field sizes. According to experimental findings, our proposed TPUNet achieves more excellent results in terms of quantitative analysis and visual quality than other rival approaches.
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Affiliation(s)
- Huajie Zhang
- School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing, 210044, China
| | - Qianting Ma
- School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing, 210044, China.
| | - Yunjie Chen
- School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing, 210044, China
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18
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O’Driscoll J, Burke A, Mooney T, Phelan N, Baldelli P, Smith A, Lynch S, Fitzpatrick P, Bennett K, Flanagan F, Mullooly M. A scoping review of programme specific mammographic breast density related guidelines and practices within breast screening programmes. Eur J Radiol Open 2023; 11:100510. [PMID: 37560166 PMCID: PMC10407884 DOI: 10.1016/j.ejro.2023.100510] [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: 02/01/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction High mammographic breast density (MBD) is an independent breast cancer risk factor. In organised breast screening settings, discussions are ongoing regarding the optimal clinical role of MBD to help guide screening decisions. The aim of this scoping review was to provide an overview of current practices incorporating MBD within population-based breast screening programmes and from professional organisations internationally. Methods This scoping review was conducted in accordance with the framework proposed by the Joanna Briggs Institute. The electronic databases, MEDLINE (PubMed), EMBASE, CINAHL Plus, Scopus, and Web of Science were systematically searched. Grey literature sources, websites of international breast screening programmes, and relevant government organisations were searched to identify further relevant literature. Data from identified materials were extracted and presented as a narrative summary. Results The search identified 78 relevant documents. Documents were identified for breast screening programmes in 18 countries relating to screening intervals for women with dense breasts, MBD measurement, reporting, notification, and guiding supplemental screening. Documents were identified from 18 international professional organisations with the majority of material relating to supplemental screening guidance for women with dense breasts. Key factors collated during the data extraction process as relevant considerations for MBD practices included the evidence base needed to inform decision-making processes and resources (healthcare system costs, radiology equipment, and workforce planning). Conclusions This scoping review summarises current practices and guidelines incorporating MBD in international population-based breast screening settings and highlights the absence of consensus between organised breast screening programmes incorporating MBD in current breast screening protocols.
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Affiliation(s)
- Jessica O’Driscoll
- School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Mercer St. Lower, Dublin 2, Ireland
| | - Aileen Burke
- School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Mercer St. Lower, Dublin 2, Ireland
| | - Therese Mooney
- National Screening Service, Kings Inn House, 200 Parnell Street, Dublin 1, Ireland
| | - Niall Phelan
- BreastCheck, National Screening Service, 36 Eccles Street, Dublin 7, Ireland
| | - Paola Baldelli
- BreastCheck, National Screening Service, 36 Eccles Street, Dublin 7, Ireland
| | - Alan Smith
- National Screening Service, Kings Inn House, 200 Parnell Street, Dublin 1, Ireland
| | - Suzanne Lynch
- BreastCheck, National Screening Service, 36 Eccles Street, Dublin 7, Ireland
| | - Patricia Fitzpatrick
- National Screening Service, Kings Inn House, 200 Parnell Street, Dublin 1, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Kathleen Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Mercer St. Lower, Dublin 2, Ireland
| | - Fidelma Flanagan
- BreastCheck, National Screening Service, 36 Eccles Street, Dublin 7, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Mercer St. Lower, Dublin 2, Ireland
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Arian A, Ghazanfari Hashemi M, Talebi V, AhmadiNejad N, Eslami B, Sedighi N, Omranipour R. Abbreviated breast MRI for evaluating breast cancer before initiation of neoadjuvant chemotherapy: A cross-sectional study. Eur J Radiol Open 2023; 11:100517. [PMID: 37609046 PMCID: PMC10440387 DOI: 10.1016/j.ejro.2023.100517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
Background Although, there are accumulating evidence about diagnostic role of abbreviated breast magnetic resonance imaging (MRI) in screening setting, the implementation of abbreviated MRI in staging of breast cancer has been poorly elucidated. Objective To evaluate the diagnostic performance of abbreviated breast MRI in estimating extent of disease before initiation of neoadjuvant chemotherapy. Methods A total of 54 patients with biopsy-proven main lesion referred to evaluate by standard protocol breast MRI before initiation of neoadjuvant chemotherapy were retrospectively enrolled. From a standard protocol, a data set of abbreviated protocol consisting fat-saturated T1-weighted (T1W) pre-contrast and first two fat-saturated T1W post-contrast series with reconstruction of their subtraction including maximum intensity projection (MIP) were obtained and interpreted. The concordance rate of abbreviated with standard protocol (as a reference standard) were compared. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value were calculated, as well. Results The maximum size of the main mass was 38.6 ± 17.3 and 40.7 ± 17.9 for abbreviated and standard protocol, respectively. All of the main mass was detected by abbreviated protocol with 100% concordance. Concordance was 98.1% and 94.4% in terms of multifocal/multicentric status and for estimating of NME, respectively. The abbreviated protocol has high sensitivity and specificity with more than 90% value regarding main mass detection, measurement of the maximum size of the main mass, determination of multifocal/multicenter status and NAC involvement. Conclusion Abbreviated protocol may be a reliable surrogate for standard protocol breast MRI in evaluating extent of breast cancer.
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Affiliation(s)
- Arvin Arian
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Institute, Department of Radiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Ghazanfari Hashemi
- Cancer Institute, Department of Radiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Talebi
- Cancer Institute, Department of Radiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin AhmadiNejad
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Institute, Department of Radiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Eslami
- Breast Disease Research Center, Cancer Institute, Tehran University of Medical Science, Tehran, Iran
| | - Nahid Sedighi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramesh Omranipour
- Department of Surgical Oncology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Rangarajan K, Aggarwal P, Gupta DK, Dhanakshirur R, Baby A, Pal C, Gupta AK, Hari S, Banerjee S, Arora C. Deep learning for detection of iso-dense, obscure masses in mammographically dense breasts. Eur Radiol 2023; 33:8112-8121. [PMID: 37209125 DOI: 10.1007/s00330-023-09717-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 02/11/2023] [Accepted: 03/06/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To analyze the performance of deep learning in isodense/obscure masses in dense breasts. To build and validate a deep learning (DL) model using core radiology principles and analyze its performance in isodense/obscure masses. To show performance on screening mammography as well as diagnostic mammography distribution. METHODS This was a retrospective, single-institution, multi-centre study with external validation. For model building, we took a 3-pronged approach. First, we explicitly taught the network to learn features other than density differences: such as spiculations and architectural distortion. Second, we used the opposite breast to enable the detection of asymmetries. Third, we systematically enhanced each image by piece-wise-linear transformation. We tested the network on a diagnostic mammography dataset (2569 images with 243 cancers, January to June 2018) and a screening mammography dataset (2146 images with 59 cancers, patient recruitment from January to April 2021) from a different centre (external validation). RESULTS When trained with our proposed technique (and compared with baseline network), sensitivity for malignancy increased from 82.7 to 84.7% at 0.2 False positives per image (FPI) in the diagnostic mammography dataset, 67.9 to 73.8% in the subset of patients with dense breasts, 74.6 to 85.3 in the subset of patients with isodense/obscure cancers and 84.9 to 88.7 in an external validation test set with a screening mammography distribution. We showed that our sensitivity exceeded currently reported values (0.90 at 0.2 FPI) on a public benchmark dataset (INBreast). CONCLUSION Modelling traditional mammographic teaching into a DL framework can help improve cancer detection accuracy in dense breasts. CLINICAL RELEVANCE STATEMENT Incorporating medical knowledge into neural network design can help us overcome some limitations associated with specific modalities. In this paper, we show how one such deep neural network can help improve performance on mammographically dense breasts. KEY POINTS • Although state-of-the-art deep learning networks achieve good results in cancer detection in mammography in general, isodense, obscure masses and mammographically dense breasts posed a challenge to deep learning networks. • Collaborative network design and incorporation of traditional radiology teaching into the deep learning approach helped mitigate the problem. • The accuracy of deep learning networks may be translatable to different patient distributions. We showed the results of our network on screening as well as diagnostic mammography datasets.
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Affiliation(s)
- Krithika Rangarajan
- All India Institute of Medical Sciences, Ansari Nagar New Delhi, 110029, India.
- Indian Institute of Technology, Delhi, Hauz Khas, Delhi, 110016, India.
| | - Pranjal Aggarwal
- Indian Institute of Technology, Delhi, Hauz Khas, Delhi, 110016, India
| | - Dhruv Kumar Gupta
- Indian Institute of Technology, Delhi, Hauz Khas, Delhi, 110016, India
| | | | - Akhil Baby
- All India Institute of Medical Sciences, Ansari Nagar New Delhi, 110029, India
| | - Chandan Pal
- All India Institute of Medical Sciences, Ansari Nagar New Delhi, 110029, India
| | - Arun Kumar Gupta
- All India Institute of Medical Sciences, Ansari Nagar New Delhi, 110029, India
| | - Smriti Hari
- All India Institute of Medical Sciences, Ansari Nagar New Delhi, 110029, India
| | | | - Chetan Arora
- Indian Institute of Technology, Delhi, Hauz Khas, Delhi, 110016, India
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Salim M, Dembrower K, Eklund M, Smith K, Strand F. Differences and similarities in false interpretations by AI CAD and radiologists in screening mammography. Br J Radiol 2023; 96:20230210. [PMID: 37660400 PMCID: PMC10607417 DOI: 10.1259/bjr.20230210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVE We aimed to evaluate the false interpretations between artificial intelligence (AI) and radiologists in screening mammography to get a better understanding of how the distribution of diagnostic mistakes might change when moving from entirely radiologist-driven to AI-integrated breast cancer screening. METHODS AND MATERIALS This retrospective case-control study was based on a mammography screening cohort from 2008 to 2015. The final study population included screening examinations for 714 women diagnosed with breast cancer and 8029 randomly selected healthy controls. Oversampling of controls was applied to attain a similar cancer proportion as in the source screening cohort. We examined how false-positive (FP) and false-negative (FN) assessments by AI, the first reader (RAD 1) and the second reader (RAD 2), were associated with age, density, tumor histology and cancer invasiveness in a single- and double-reader setting. RESULTS For each reader, the FN assessments were distributed between low- and high-density females with 53 (42%) and 72 (58%) for AI; 59 (36%) and 104 (64%) for RAD 1 and 47 (36%) and 84 (64%) for RAD 2. The corresponding numbers for FP assessments were 1820 (47%) and 2016 (53%) for AI; 1568 (46%) and 1834 (54%) for RAD 1 and 1190 (43%) and 1610 (58%) for RAD 2. For ductal cancer, the FN assessments were 79 (77%) for AI CAD; with 120 (83%) for RAD 1 and with 96 (16%) for RAD 2. For the double-reading simulation, the FP assessments were distributed between younger and older females with 2828 (2.5%) and 1554 (1.4%) for RAD 1 + RAD 2; 3850 (3.4%) and 2940 (2.6%) for AI+RAD 1 and 3430 (3%) and 2772 (2.5%) for AI+RAD 2. CONCLUSION The most pronounced decrease in FN assessments was noted for females over the age of 55 and for high density-women. In conclusion, AI could have an important complementary role when combined with radiologists to increase sensitivity for high-density and older females. ADVANCES IN KNOWLEDGE Our results highlight the potential impact of integrating AI in breast cancer screening, particularly to improve interpretation accuracy. The use of AI could enhance screening outcomes for high-density and older females.
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Affiliation(s)
| | | | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Kevin Smith
- Science for Life Laboratory, KTH Royal Insitute of Technology, Stockholm, Sweden
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22
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Liu L, Kawashima M, Sugimoto M, Sonomura K, Pu F, Li W, Takeda M, Goto T, Kawaguchi K, Sato T, Toi M. Discovery of lipid profiles in plasma-derived extracellular vesicles as biomarkers for breast cancer diagnosis. Cancer Sci 2023; 114:4020-4031. [PMID: 37608343 PMCID: PMC10551607 DOI: 10.1111/cas.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/11/2023] [Accepted: 08/06/2023] [Indexed: 08/24/2023] Open
Abstract
Lipids are a major component of extracellular vesicles; however, their significance in tumorigenesis and progression has not been well elucidated. As we previously found that lipid profiles drastically changed in breast tumors upon progression, we hypothesized that lipid profiles of plasma-derived extracellular vesicles could be utilized as breast cancer biomarkers. Here, we adopted modified sucrose cushion ultracentrifugation to isolate plasma-derived extracellular vesicles from breast cancer (n = 105), benign (n = 11), and healthy individuals (n = 43) in two independent cohorts (n = 126 and n = 33) and conducted targeted lipidomic analysis. We established a breast cancer diagnostic model comprising three lipids that showed favorable performance with the area under the receiver operating characteristic curve of 0.759, 0.743, and 0.804 in the training, internal validation, and external test sets, respectively. Moreover, we identified several lipids that could effectively discriminate breast cancer progression and subtypes: phosphatidylethanolamines and phosphatidylserines were relatively higher in Stage III, whereas phosphatidylcholines and sphingomyelins were higher in Stage IV; phosphatidylcholines and ceramides were correspondingly concentrated in HER2-positive patients, while lysophosphatidylcholines and polyunsaturated triglycerides were concentrated in the triple-negative breast cancer subtype. Lipid profiling of plasma-derived extracellular vesicles is a non-invasive and promising approach for diagnosing, staging, and subtyping breast cancer.
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Affiliation(s)
- Lin Liu
- Department of Breast Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Masahiro Kawashima
- Department of Breast Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | | | - Kazuhiro Sonomura
- Center for Genomic Medicine, Graduate School of MedicineKyoto UniversityKyotoJapan
- Life Science Research Center, Technology Research LaboratoryShimadzu CorporationKyotoJapan
| | - Fengling Pu
- Department of Breast Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Wei Li
- Department of Breast Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Masashi Takeda
- Department of Urology, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Takayuki Goto
- Department of Urology, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Kosuke Kawaguchi
- Department of Breast Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Taka‐Aki Sato
- Life Science Research Center, Technology Research LaboratoryShimadzu CorporationKyotoJapan
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
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23
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Scherer TP, Saba K, Wettstein MS, Lucca I, Mortezavi A, Waisbrod S, Aujesky D, Capaul R, Strebel RT. Do Swiss urologists and Swiss internists screen themselves and their relatives for prostate cancer? A questionnaire study. Swiss Med Wkly 2023; 153:40115. [PMID: 37774392 DOI: 10.57187/smw.2023.40115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023] Open
Abstract
PURPOSE Prostate-specific antigen (PSA) screening for men at risk of prostate cancer is controversial. The current recommendation is to raise awareness of prostate cancer and offer PSA screening in accordance with shared decision- making. Whether the possibility of a PSA screen is discussed with the patient depends on the treating physician, but data on physicians' attitudes towards PSA screening are scarce. This study aimed to examine internists' and urologists' personal PSA screening activity as an indicator of their attitude towards PSA screening. MATERIALS AND METHODS Members of the Swiss Society of Urology and the Swiss Society of General Internal Medicine were asked in 08/2020 to anonymously complete an online survey about personal PSA screening behaviour for themselves, their fathers, brothers and partners. Categorical and continuous variables were compared by chi-squared tests and t-tests, respectively. RESULTS In total, 190/295 (response rate: 64%) urologists and 893/7400 (response rate: 12%) internists participated in the survey. Of the participants, 297/1083 (27.4%) were female. Male urologists >50 years of age screened themselves more often than male internists >50 years of age (89% vs 70%, p <0.05). Furthermore, urologists reported recommending screening statistically significantly more often than internists to their brother, father or partner regardless of their sex (men: 38.1% vs 18.5%; p <0.05; women: 81.8% vs 32.2%; p <0.05). CONCLUSIONS: Most participating male physicians >50 years of age have screened themselves for prostate cancer. Furthermore, PSA screening of relatives was significantly associated with the urology specialty. The reasons physicians screen themselves substantially more often than the public and why male and female urologists as well as male internists perform PSA screening more frequently in their private environment than female internists should be further examined.
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Affiliation(s)
- Thomas P Scherer
- Department of Urology, Cantonal Hospital Grisons, Chur, Switzerland
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Karim Saba
- Department of Urology, Cantonal Hospital Grisons, Chur, Switzerland
- Urology Centre, Hirslanden Klinik Aarau, Aarau, Switzerland
| | - Marian S Wettstein
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Ilaria Lucca
- Department of Urology, University Hospital Lausanne, Lausanne, Switzerland
| | - Ashkan Mortezavi
- University of Zurich, Zurich, Switzerland
- Department of Urology, University Hospital Basel, Basel, Switzerland
| | | | - Drahomir Aujesky
- Department of General Internal Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
- Swiss Society of General Internal Medicine, SGAIM, Berne, Switzerland
| | - Regula Capaul
- Swiss Society of General Internal Medicine, SGAIM, Berne, Switzerland
| | - Raeto T Strebel
- Department of Urology, Cantonal Hospital Grisons, Chur, Switzerland
- University of Zurich, Zurich, Switzerland
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Siviengphanom S, Gandomkar Z, Lewis SJ, Brennan PC. Global Radiomic Features from Mammography for Predicting Difficult-To-Interpret Normal Cases. J Digit Imaging 2023; 36:1541-1552. [PMID: 37253894 PMCID: PMC10406750 DOI: 10.1007/s10278-023-00836-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/05/2023] [Accepted: 04/13/2023] [Indexed: 06/01/2023] Open
Abstract
This work aimed to investigate whether global radiomic features (GRFs) from mammograms can predict difficult-to-interpret normal cases (NCs). Assessments from 537 readers interpreting 239 normal mammograms were used to categorise cases as 120 difficult-to-interpret and 119 easy-to-interpret based on cases having the highest and lowest difficulty scores, respectively. Using lattice- and squared-based approaches, 34 handcrafted GRFs per image were extracted and normalised. Three classifiers were constructed: (i) CC and (ii) MLO using the GRFs from corresponding craniocaudal and mediolateral oblique images only, based on the random forest technique for distinguishing difficult- from easy-to-interpret NCs, and (iii) CC + MLO using the median predictive scores from both CC and MLO models. Useful GRFs for the CC and MLO models were recognised using a scree test. The CC and MLO models were trained and validated using the leave-one-out-cross-validation. The models' performances were assessed by the AUC and compared using the DeLong test. A Kruskal-Wallis test was used to examine if the 34 GRFs differed between difficult- and easy-to-interpret NCs and if difficulty level based on the traditional breast density (BD) categories differed among 115 low-BD and 124 high-BD NCs. The CC + MLO model achieved higher performance (0.71 AUC) than the individual CC and MLO model alone (0.66 each), but statistically non-significant difference was found (all p > 0.05). Six GRFs were identified to be valuable in describing difficult-to-interpret NCs. Twenty features, when compared between difficult- and easy-to-interpret NCs, differed significantly (p < 0.05). No statistically significant difference was observed in difficulty between low- and high-BD NCs (p = 0.709). GRF mammographic analysis can predict difficult-to-interpret NCs.
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Affiliation(s)
- Somphone Siviengphanom
- Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, the University of Sydney, Sydney, NSW, 2006, Australia.
| | - Ziba Gandomkar
- Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, the University of Sydney, Sydney, NSW, 2006, Australia
| | - Sarah J Lewis
- Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, the University of Sydney, Sydney, NSW, 2006, Australia
| | - Patrick C Brennan
- Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, the University of Sydney, Sydney, NSW, 2006, Australia
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25
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Hanis TM, Ruhaiyem NIR, Arifin WN, Haron J, Wan Abdul Rahman WF, Abdullah R, Musa KI. Developing a Supplementary Diagnostic Tool for Breast Cancer Risk Estimation Using Ensemble Transfer Learning. Diagnostics (Basel) 2023; 13:diagnostics13101780. [PMID: 37238264 DOI: 10.3390/diagnostics13101780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/14/2023] [Accepted: 03/23/2023] [Indexed: 05/28/2023] Open
Abstract
Breast cancer is the most prevalent cancer worldwide. Thus, it is necessary to improve the efficiency of the medical workflow of the disease. Therefore, this study aims to develop a supplementary diagnostic tool for radiologists using ensemble transfer learning and digital mammograms. The digital mammograms and their associated information were collected from the department of radiology and pathology at Hospital Universiti Sains Malaysia. Thirteen pre-trained networks were selected and tested in this study. ResNet101V2 and ResNet152 had the highest mean PR-AUC, MobileNetV3Small and ResNet152 had the highest mean precision, ResNet101 had the highest mean F1 score, and ResNet152 and ResNet152V2 had the highest mean Youden J index. Subsequently, three ensemble models were developed using the top three pre-trained networks whose ranking was based on PR-AUC values, precision, and F1 scores. The final ensemble model, which consisted of Resnet101, Resnet152, and ResNet50V2, had a mean precision value, F1 score, and Youden J index of 0.82, 0.68, and 0.12, respectively. Additionally, the final model demonstrated balanced performance across mammographic density. In conclusion, this study demonstrates the good performance of ensemble transfer learning and digital mammograms in breast cancer risk estimation. This model can be utilised as a supplementary diagnostic tool for radiologists, thus reducing their workloads and further improving the medical workflow in the screening and diagnosis of breast cancer.
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Affiliation(s)
- Tengku Muhammad Hanis
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | | | - Wan Nor Arifin
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Juhara Haron
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Breast Cancer Awareness and Research Unit, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Wan Faiziah Wan Abdul Rahman
- Breast Cancer Awareness and Research Unit, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Rosni Abdullah
- School of Computer Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Watanabe H, Hayashi S, Kondo Y, Matsuyama E, Hayashi N, Ogura T, Shimosegawa M. Quality control system for mammographic breast positioning using deep learning. Sci Rep 2023; 13:7066. [PMID: 37127674 PMCID: PMC10151341 DOI: 10.1038/s41598-023-34380-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/28/2023] [Indexed: 05/03/2023] Open
Abstract
This study proposes a deep convolutional neural network (DCNN) classification for the quality control and validation of breast positioning criteria in mammography. A total of 1631 mediolateral oblique mammographic views were collected from an open database. We designed two main steps for mammographic verification: automated detection of the positioning part and classification of three scales that determine the positioning quality using DCNNs. After acquiring labeled mammograms with three scales visually evaluated based on guidelines, the first step was automatically detecting the region of interest of the subject part by image processing. The next step was classifying mammographic positioning accuracy into three scales using four representative DCNNs. The experimental results showed that the DCNN model achieved the best positioning classification accuracy of 0.7836 using VGG16 in the inframammary fold and a classification accuracy of 0.7278 using Xception in the nipple profile. Furthermore, using the softmax function, the breast positioning criteria could be evaluated quantitatively by presenting the predicted value, which is the probability of determining positioning accuracy. The proposed method can be quantitatively evaluated without the need for an individual qualitative evaluation and has the potential to improve the quality control and validation of breast positioning criteria in mammography.
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Affiliation(s)
- Haruyuki Watanabe
- School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan.
| | - Saeko Hayashi
- Department of Radiology, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Yohan Kondo
- Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Eri Matsuyama
- Faculty of Informatics, The University of Fukuchiyama, Fukuchiyama, Japan
| | - Norio Hayashi
- School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan
| | - Toshihiro Ogura
- School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan
| | - Masayuki Shimosegawa
- School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan
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Habbous S, Barisic A, Homenauth E, Kandasamy S, Forster K, Eisen A, Holloway C. Estimating the incidence of breast cancer recurrence using administrative data. Breast Cancer Res Treat 2023; 198:509-522. [PMID: 36422755 DOI: 10.1007/s10549-022-06812-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Breast cancer is the most common cancer among women, but most cancer registries do not capture recurrences. We estimated the incidence of local, regional, and distant recurrences using administrative data. METHODS Patients diagnosed with stage I-III primary breast cancer in Ontario, Canada from 2013 to 2017 were included. Patients were followed until 31/Dec/2021, death, or a new primary cancer diagnosis. We used hospital administrative data (diagnostic and intervention codes) to identify local recurrence, regional recurrence, and distant metastasis after primary diagnosis. We used logistic regression to explore factors associated with developing a distant metastasis. RESULTS With a median follow-up 67 months, 5,431/45,857 (11.8%) of patients developed a distant metastasis a median 23 (9, 42) months after diagnosis of the primary tumor. 1086 (2.4%) and 1069 (2.3%) patients developed an isolated regional or a local recurrence, respectively. Patients with distant metastatic disease had a median overall survival of 15.4 months (95% CI 14.4-16.4 months) from the time recurrence/metastasis was identified. In contrast, the median survival for all other patients was not reached. Patients were more likely to develop a distant metastasis if they had more advanced stage, greater comorbidity, and presented with symptoms (p < 0.0001). Trastuzumab halved the risk of recurrence [OR 0.53 (0.45-0.63), p < 0.0001]. CONCLUSION Distant metastasis is not a rare outcome for patients diagnosed with breast cancer, translating to an annual incidence of 2132 new cases (17.8% of all breast cancer diagnoses). Overall survival remains high for patients with locoregional recurrences, but was poor following a diagnosis of a distant metastasis.
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Affiliation(s)
- Steven Habbous
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada.
- Department of Epidemiology & Biostatistics, Western University, London, ON, N6A 5C1, Canada.
| | - Andriana Barisic
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
| | - Esha Homenauth
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
| | - Sharmilaa Kandasamy
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
| | - Katharina Forster
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
| | - Andrea Eisen
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
- Department of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, M4Y 1H1, Canada
| | - Claire Holloway
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
- Department of Surgery, University of Toronto, Toronto, ON, M5T1P5, Canada
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Alipour S, Orouji M, Eskandari Y, Eskandari A. Need assessment for the content of educational programs about breast cancer from the viewpoint of unaffected women. BMC Womens Health 2023; 23:92. [PMID: 36890508 PMCID: PMC9996851 DOI: 10.1186/s12905-023-02238-x] [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: 06/30/2022] [Accepted: 02/22/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Breast cancer is the most common cancer among females, and early diagnosis is possible in case the patients seek medical attention on time. For this to come true, they must know about the existence and risks of the disease and be aware of the appropriate attitude and actions toward prevention or early diagnosis. However, we see that women have unanswered questions about these issues. In this study, we sought to investigate healthy women's information needs about breast cancer from their own perspective. METHODS This prospective study was carried out by using the maximum variation sampling, and theoretical saturation to reach sample saturation. Women who came to different clinics of Arash Women's Hospital (except the Breast Clinic) during two months were entered in the study. Participants were asked to write down all the questions and subjects they would like to be explained in a breast cancer educational program. The questions were reviewed and categorized after every fifteen consecutive forms were filled until there was not even one new question. Afterwards, all the questions were reviewed and matched based on their similarity and repeated items were eliminated. Finally, questions were organized according to their common topics and the range of details they comprised. RESULTS Sixty patients were included in the study, and 194 questions were gathered and categorized according to common scientific terms, resulting in 63 questions in 5 categories. CONCLUSIONS Many studies have been conducted on breast cancer education, but none have addressed healthy women's personal queries. This study outlines the questions of unaffected women about breast cancer that need to be addressed in educational programs. The results can be used for development of educational material at community level. TRIAL REGISTRATION This study was conducted as the preliminary phase of a study approved in Tehran University of Medical Sciences (Approval Code 99-1-101-46,455) and by the Ethics Committee of the University (Ethical Code IR.TUMS.MEDICINE.REC.1399.105).
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Affiliation(s)
- Sadaf Alipour
- Breast Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Orouji
- Nursing Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yas Eskandari
- Faculty of Psychology and Education, University of Tehran, Tehran, Iran
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The relationship between diet quality indices and odds of breast cancer in women: a case-control study. BMC Womens Health 2023; 23:90. [PMID: 36879242 PMCID: PMC9990286 DOI: 10.1186/s12905-023-02242-1] [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: 09/16/2022] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
Dietary quality is an important factor in the etiology of breast cancer (BrCa), but further studies are required to better elucidate this relationship. Accordingly, we sought to analyze if diet quality, assessed using the Diet Quality Index-International (DQI-I), Mean Adequacy Ratio (MAR), and Dietary Energy Density (DED), was related to BrCa. In this Hospital-based case-control study, 253 patients with BrCa and 267 non BrCa controls were enrolled. Individual food consumption data from a food frequency questionnaire was used to calculate the Diet Quality Indices (DQI). Employing a case-control design, odds ratios (ORs) and 95% confidence intervals (CIs) were obtained, and a dose-response analysis investigated. After adjusting for potential confounders, those in the highest quartile of the MAR index had significantly lower odds of BrCa than those in the lowest (OR = 0.42, 95% CI 0.23-0.78; P for trend = 0.007). Although there was no association between individual quartiles of the DQI-I and BrCa, there was evidence of a significant trend across all the quartile categories (P for trend = 0.030).There was no significant association was found between DED index and the odds of BrCa in the crude and fully adjusted models. We found that higher MAR indices were associated with decreased odds of BrCa, Therefore, the dietary patterns reflected by these scores may serve as a possible guide to preventing BrCa in Iranian women.
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Ahmadinejad N, Azhdeh S, Arian A, Eslami B, Mehrabinejad MM. Implementation of abbreviated breast MRI in diagnostic and screening settings. Acta Radiol 2023; 64:987-992. [PMID: 35938611 DOI: 10.1177/02841851221114434] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Abbreviated magnetic resonance imaging (MRI) includes fewer sequences than standard MRI, which could be utilized for breast cancer detection. PURPOSE To evaluate the diagnostic accuracy of abbreviated MRI protocol in screening and diagnostic settings. MATERIAL AND METHODS All women with screening and diagnostic (problem-solving and preoperative staging) MRI examination were recruited from 2017 to 2020. Two expert radiologists assessed designed abbreviated protocol (fat-saturated T1-weighted [T1W] pre-contrast and two first fat-saturated T1W post-contrast series with reconstruction of their subtraction) including maximum intensity projection (MIP) and then evaluated standard protocol of breast MRI. Associated findings, including axillary lymphadenopathy and invasion to nipple, skin, or pectoralis muscle were also evaluated. The concordance rate of abbreviated with standard protocol in screening and diagnostic settings were also compared, based on BI-RADS classification. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value were calculated. RESULTS A total of 108 (26.5%) of 408 patients (mean age = 43 ± 9 years) were classified as BI-RADS 4-5 and considered positive findings based on suspicious enhancement (mass or non-mass enhancement). Compared to standard protocol, abbreviated protocol revealed >98% accuracy in the diagnostic setting as well as 100% accuracy in the screening setting. Concordance rates in screening and diagnostic settings were 99.6% and 98.1%, respectively. There was no discordance between abbreviated and standard protocol in the evaluation of associated findings. CONCLUSION Abbreviated MRI protocol possesses substantial diagnostic accuracy in both screening and diagnostic settings. Additional information provided by standard protocol might not require for cancer detection.
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Affiliation(s)
- Nasrin Ahmadinejad
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Shilan Azhdeh
- Department of Radiology, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Arvin Arian
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, 48439Tehran University of Medical Sciences, Tehran, Iran
- Breast Disease Research Center, Cancer Institute, Tehran University of Medical Science, Tehran, Iran
| | - Bita Eslami
- Breast Disease Research Center, Cancer Institute, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad-Mehdi Mehrabinejad
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, 48439Tehran University of Medical Sciences, Tehran, Iran
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Cancer Screening Differences Among Muslims and Non-Muslims: Insights from the Chicago Multiethnic Prevention and Surveillance Study. J Racial Ethn Health Disparities 2023; 10:176-182. [PMID: 35028902 DOI: 10.1007/s40615-021-01208-z] [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: 09/15/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND While cancer screening disparities along socioeconomic and racial/ethnic lines are well studied, differences based on religious affiliation are under-researched. Though diverse in terms of race/ethnicity, Muslim Americans appear to share values and beliefs that similarly inform their health and healthcare seeking behaviors. Cancer screening disparities among Muslim Americans are also understudied. METHODS To examine differences in cancer screening behaviors based on Muslim affiliation, we analyzed data from a longitudinal cohort study examining lifestyle, healthcare access, environmental, and genetic factors on the health of Chicagoans. RESULTS Of 7552 participants, 132 (1.7%) were Muslim. Between Muslim and non-Muslims, there were no significant differences in prostate, cervical, and breast cancer screening rates, but Muslims were less likely to undergo colorectal cancer screening. When differences in obesity and insurance status were accounted for in a multivariate regression model, religious affiliation was no longer significantly associated with screening rates. DISCUSSION Religious values can influence cancer screening behaviors; hence, tracking cancer screening along religious lines may illuminate previously unknown disparities. Our analysis of a predominately African American cohort of Chicagoans, however, did not reveal religious affiliation to predict cancer screening disparities.
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Ayana G, Dese K, Dereje Y, Kebede Y, Barki H, Amdissa D, Husen N, Mulugeta F, Habtamu B, Choe SW. Vision-Transformer-Based Transfer Learning for Mammogram Classification. Diagnostics (Basel) 2023; 13:diagnostics13020178. [PMID: 36672988 PMCID: PMC9857963 DOI: 10.3390/diagnostics13020178] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
Breast mass identification is a crucial procedure during mammogram-based early breast cancer diagnosis. However, it is difficult to determine whether a breast lump is benign or cancerous at early stages. Convolutional neural networks (CNNs) have been used to solve this problem and have provided useful advancements. However, CNNs focus only on a certain portion of the mammogram while ignoring the remaining and present computational complexity because of multiple convolutions. Recently, vision transformers have been developed as a technique to overcome such limitations of CNNs, ensuring better or comparable performance in natural image classification. However, the utility of this technique has not been thoroughly investigated in the medical image domain. In this study, we developed a transfer learning technique based on vision transformers to classify breast mass mammograms. The area under the receiver operating curve of the new model was estimated as 1 ± 0, thus outperforming the CNN-based transfer-learning models and vision transformer models trained from scratch. The technique can, hence, be applied in a clinical setting, to improve the early diagnosis of breast cancer.
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Affiliation(s)
- Gelan Ayana
- Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Republic of Korea
- School of Biomedical Engineering, Jimma University, Jimma 378, Ethiopia
| | - Kokeb Dese
- School of Biomedical Engineering, Jimma University, Jimma 378, Ethiopia
| | - Yisak Dereje
- Department of Information Engineering, Marche Polytechnic University, 60121 Ancona, Italy
| | - Yonas Kebede
- Biomedical Engineering Unit, Black Lion Hospital, Addis Ababa University, Addis Ababa 1000, Ethiopia
| | - Hika Barki
- Department of Artificial Intelligence Convergence, Pukyong National University, Busan 48513, Republic of Korea
| | - Dechassa Amdissa
- Department of Basic and Applied Science for Engineering, Sapienza University of Rome, 00161 Roma, Italy
| | - Nahimiya Husen
- Department of Bioengineering and Robotics, Campus Bio-Medico University of Rome, 00128 Roma, Italy
| | - Fikadu Mulugeta
- Center of Biomedical Engineering, Addis Ababa Institute of Technology, Addis Ababa University, Addis Ababa 1000, Ethiopia
| | - Bontu Habtamu
- School of Biomedical Engineering, Jimma University, Jimma 378, Ethiopia
| | - Se-Woon Choe
- Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Republic of Korea
- Department of IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Republic of Korea
- Correspondence: ; Tel.: +82-54-478-7781; Fax: +82-54-462-1049
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Berliere M, Coche M, Lacroix C, Riggi J, Coyette M, Coulie J, Galant C, Fellah L, Leconte I, Maiter D, Duhoux FP, François A. Effects of Hormones on Breast Development and Breast Cancer Risk in Transgender Women. Cancers (Basel) 2022; 15:cancers15010245. [PMID: 36612241 PMCID: PMC9818520 DOI: 10.3390/cancers15010245] [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: 11/06/2022] [Revised: 12/05/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Transgender women experience gender dysphoria due to a gender assignment at birth that is incongruent with their gender identity. Transgender people undergo different surgical procedures and receive sex steroids hormones to reduce psychological distress and to induce and maintain desired physical changes. These persons on feminizing hormones represent a unique population to study the hormonal effects on breast development, to evaluate the risk of breast cancer and perhaps to better understand the precise role played by different hormonal components. In MTF (male to female) patients, hormonal treatment usually consists of antiandrogens and estrogens. Exogenous hormones induce breast development with the formation of ducts and lobules and an increase in the deposition of fat. A search of the existing literature dedicated to hormone regimens for MTF patients, their impact on breast tissue (incidence and type of breast lesions) and breast cancer risk provided the available information for this review. The evaluation of breast cancer risk is currently complicated by the heterogeneity of administered treatments and a lack of long-term follow-up in the great majority of studies. Large studies with longer follow-up are required to better evaluate the breast cancer risk and to understand the precise mechanisms on breast development of each exogenous hormone.
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Affiliation(s)
- Martine Berliere
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Gynecology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Correspondence: (M.B.); (M.C.)
| | - Maximilienne Coche
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Gynecology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Correspondence: (M.B.); (M.C.)
| | - Camille Lacroix
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Gynecology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Julia Riggi
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Gynecology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Maude Coyette
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Plastic Surgery, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Julien Coulie
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Plastic Surgery, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Christine Galant
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Pathology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Latifa Fellah
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Radiology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Isabelle Leconte
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Radiology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Dominique Maiter
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Francois P. Duhoux
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Medical Oncology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Aline François
- Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
- Department of Pathology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
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Dabi Y, Bendifallah S, Suisse S, Haury J, Touboul C, Puchar A, Favier A, Daraï E. Overview of non-coding RNAs in breast cancers. Transl Oncol 2022; 25:101512. [PMID: 35961269 PMCID: PMC9382556 DOI: 10.1016/j.tranon.2022.101512] [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: 06/20/2022] [Revised: 07/18/2022] [Accepted: 08/02/2022] [Indexed: 12/24/2022] Open
Abstract
Breast cancer in women is the second most common cancer and the fifth leading cause of cancer death worldwide. Although earlier diagnosis and detection of breast cancer has resulted in lower mortality rates, further advances in prevention, detection, and treatment are needed to improve outcomes and survival for women with breast cancer as well as to offer a personalized therapeutic approach. It is now well-established that non-coding RNAs (ncRNAs) represent 98% of the transcriptome but in-depth knowledge about their involvement in the regulation of gene expression is lacking. A growing body of research indicates that ncRNAs are essential for tumorigenesis by regulating the expression of tumour-related genes. In this review, we focus on their implication in breast cancer genesis but also report the latest knowledge of their theragnostic and therapeutic role. We highlight the need for accurate quantification of circulating ncRNAs which is determinant to develop reliable biomarkers. Further studies are mandatory to finally enter the era of personalized medicine for women with breast cancer.
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Affiliation(s)
- Yohann Dabi
- Sorbonne University - Department of Obstetrics and Reproductive Medicine, Hôpital Tenon, 4 rue de la Chine, 75020 Paris; Clinical Research Group (GRC) Paris 6: Centre Expert Endométriose (C3E), Sorbonne University (GRC6 C3E SU); INSERM UMR_S_938, Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris 75020, France.
| | - Sofiane Bendifallah
- Sorbonne University - Department of Obstetrics and Reproductive Medicine, Hôpital Tenon, 4 rue de la Chine, 75020 Paris; Clinical Research Group (GRC) Paris 6: Centre Expert Endométriose (C3E), Sorbonne University (GRC6 C3E SU); INSERM UMR_S_938, Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris 75020, France
| | | | - Julie Haury
- Sorbonne University - Department of Obstetrics and Reproductive Medicine, Hôpital Tenon, 4 rue de la Chine, 75020 Paris
| | - Cyril Touboul
- Sorbonne University - Department of Obstetrics and Reproductive Medicine, Hôpital Tenon, 4 rue de la Chine, 75020 Paris; Clinical Research Group (GRC) Paris 6: Centre Expert Endométriose (C3E), Sorbonne University (GRC6 C3E SU); INSERM UMR_S_938, Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris 75020, France
| | - Anne Puchar
- Sorbonne University - Department of Obstetrics and Reproductive Medicine, Hôpital Tenon, 4 rue de la Chine, 75020 Paris
| | - Amélia Favier
- Sorbonne University - Department of Obstetrics and Reproductive Medicine, Hôpital Tenon, 4 rue de la Chine, 75020 Paris
| | - Emile Daraï
- Sorbonne University - Department of Obstetrics and Reproductive Medicine, Hôpital Tenon, 4 rue de la Chine, 75020 Paris; Clinical Research Group (GRC) Paris 6: Centre Expert Endométriose (C3E), Sorbonne University (GRC6 C3E SU); INSERM UMR_S_938, Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris 75020, France
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Ayana G, Choe SW. BUViTNet: Breast Ultrasound Detection via Vision Transformers. Diagnostics (Basel) 2022; 12:diagnostics12112654. [PMID: 36359497 PMCID: PMC9689470 DOI: 10.3390/diagnostics12112654] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Convolutional neural networks (CNNs) have enhanced ultrasound image-based early breast cancer detection. Vision transformers (ViTs) have recently surpassed CNNs as the most effective method for natural image analysis. ViTs have proven their capability of incorporating more global information than CNNs at lower layers, and their skip connections are more powerful than those of CNNs, which endows ViTs with superior performance. However, the effectiveness of ViTs in breast ultrasound imaging has not yet been investigated. Here, we present BUViTNet breast ultrasound detection via ViTs, where ViT-based multistage transfer learning is performed using ImageNet and cancer cell image datasets prior to transfer learning for classifying breast ultrasound images. We utilized two publicly available ultrasound breast image datasets, Mendeley and breast ultrasound images (BUSI), to train and evaluate our algorithm. The proposed method achieved the highest area under the receiver operating characteristics curve (AUC) of 1 ± 0, Matthew’s correlation coefficient (MCC) of 1 ± 0, and kappa score of 1 ± 0 on the Mendeley dataset. Furthermore, BUViTNet achieved the highest AUC of 0.968 ± 0.02, MCC of 0.961 ± 0.01, and kappa score of 0.959 ± 0.02 on the BUSI dataset. BUViTNet outperformed ViT trained from scratch, ViT-based conventional transfer learning, and CNN-based transfer learning in classifying breast ultrasound images (p < 0.01 in all cases). Our findings indicate that improved transformers are effective in analyzing breast images and can provide an improved diagnosis if used in clinical settings. Future work will consider the use of a wide range of datasets and parameters for optimized performance.
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Affiliation(s)
- Gelan Ayana
- Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Korea
| | - Se-woon Choe
- Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Korea
- Department of IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Korea
- Correspondence: ; Tel.: +82-54-478-7781; Fax: +82-54-462-1049
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Deep Learning Models for Automated Assessment of Breast Density Using Multiple Mammographic Image Types. Cancers (Basel) 2022; 14:cancers14205003. [PMID: 36291787 PMCID: PMC9599904 DOI: 10.3390/cancers14205003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Abstract
Simple Summary The DL model predictions in automated breast density assessment were independent of the imaging technologies, moderately or substantially agreed with the clinical reader density values, and had improved performance as compared to inclusion of commercial software values. Abstract Recently, convolutional neural network (CNN) models have been proposed to automate the assessment of breast density, breast cancer detection or risk stratification using single image modality. However, analysis of breast density using multiple mammographic types using clinical data has not been reported in the literature. In this study, we investigate pre-trained EfficientNetB0 deep learning (DL) models for automated assessment of breast density using multiple mammographic types with and without clinical information to improve reliability and versatility of reporting. 120,000 for-processing and for-presentation full-field digital mammograms (FFDM), digital breast tomosynthesis (DBT), and synthesized 2D images from 5032 women were retrospectively analyzed. Each participant underwent up to 3 screening examinations and completed a questionnaire at each screening encounter. Pre-trained EfficientNetB0 DL models with or without clinical history were optimized. The DL models were evaluated using BI-RADS (fatty, scattered fibroglandular densities, heterogeneously dense, or extremely dense) versus binary (non-dense or dense) density classification. Pre-trained EfficientNetB0 model performances were compared using inter-observer and commercial software (Volpara) variabilities. Results show that the average Fleiss’ Kappa score between-observers ranged from 0.31–0.50 and 0.55–0.69 for the BI-RADS and binary classifications, respectively, showing higher uncertainty among experts. Volpara-observer agreement was 0.33 and 0.54 for BI-RADS and binary classifications, respectively, showing fair to moderate agreement. However, our proposed pre-trained EfficientNetB0 DL models-observer agreement was 0.61–0.66 and 0.70–0.75 for BI-RADS and binary classifications, respectively, showing moderate to substantial agreement. Overall results show that the best breast density estimation was achieved using for-presentation FFDM and DBT images without added clinical information. Pre-trained EfficientNetB0 model can automatically assess breast density from any images modality type, with the best results obtained from for-presentation FFDM and DBT, which are the most common image archived in clinical practice.
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Hawkins R, McWilliams L, Ulph F, Evans DG, French DP. Healthcare professionals' views following implementation of risk stratification into a national breast cancer screening programme. BMC Cancer 2022; 22:1058. [PMID: 36224549 PMCID: PMC9555254 DOI: 10.1186/s12885-022-10134-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background It is crucial to determine feasibility of risk-stratified screening to facilitate successful implementation. We introduced risk-stratification (BC-Predict) into the NHS Breast Screening Programme (NHSBSP) at three screening sites in north-west England from 2019 to 2021. The present study investigated the views of healthcare professionals (HCPs) on acceptability, barriers, and facilitators of the BC-Predict intervention and on the wider implementation of risk-based screening after BC-Predict was implemented in their screening site. Methods Fourteen semi-structured interviews were conducted with HCPs working across the breast screening pathway at three NHSBSP sites that implemented BC-Predict. Thematic analysis interpreted the data. Results Three pre-decided themes were produced. (1) Acceptability of risk-based screening: risk-stratification was perceived as a beneficial step for both services and women. HCPs across the pathway reported low burden of running the BC-Predict trial on routine tasks, but with some residual concerns; (2) Barriers to implementation: comprised capacity constraints of services including the inadequacy of current IT systems to manage women with different risk profiles and, (3) Facilitators to implementation: included the continuation of stakeholder consultation across the pathway to inform implementation and need for dedicated risk screening admin staff, a push for mammography staff recruitment and guidance for screening services. Telephone helplines, integrating primary care, and supporting access for all language needs was emphasised. Conclusion Risk-stratified breast screening was viewed as a progressive step providing it does not worsen inequalities for women. Implementation of risk-stratified breast screening requires staff to be reassured that there will be systems in place to support implementation and that it will not further burden their workload. Next steps require a comprehensive assessment of the resource needed for risk-stratification versus current resource availability, upgrades to screening IT and building screening infrastructure. The role of primary care needs to be determined. Simplification and clarification of risk-based screening pathways is needed to support HCPs agency and facilitate implementation. Forthcoming evidence from ongoing randomised controlled trials assessing effectiveness of breast cancer risk-stratification will also determine implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10134-0.
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Affiliation(s)
- Rachel Hawkins
- The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK. .,NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, England.
| | - Lorna McWilliams
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, England
| | - Fiona Ulph
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - D Gareth Evans
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, England.,Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust, Southmoor Road, M23 9LT, Wythenshawe, Manchester, UK.,Department of Genomic Medicine, Division of Evolution and Genomic Science, Manchester Academic Health Science Centre, University of Manchester, Manchester University NHS Foundation Trust, Oxford Road, M13 9WL, Manchester, UK
| | - David P French
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, England
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The Impact of Race–Ethnicity and Diagnosis of Alzheimer’s Disease and Related Dementias on Mammography Use. Cancers (Basel) 2022; 14:cancers14194726. [PMID: 36230648 PMCID: PMC9561983 DOI: 10.3390/cancers14194726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Analyzing real-world data from the OneFlorida+ Clinical Research Network, we examined the impact of ADRD diagnosis and race–ethnicity on mammography use in breast cancer screening (BCS)-eligible women. We found that BCS-eligible women with Alzheimer’s disease (AD) and AD-related dementias (ADRD) were more likely to undergo a mammography than the BCS-eligible women without ADRD. Stratified by race–ethnicity, BCS-eligible Hispanic women with ADRD were more likely to undergo a mammography, whereas BCS-eligible non-Hispanic black and non-Hispanic other women with ADRD were less likely to undergo a mammography. Abstract Breast cancer screening (BCS) with mammography is a crucial method for improving cancer survival. In this study, we examined the association of Alzheimer’s disease (AD) and AD-related dementias (ADRD) diagnosis and race–ethnicity with mammography use in BCS-eligible women. In the real-world data from the OneFlorida+ Clinical Research Network, we extracted a cohort of 21,715 BCS-eligible women with ADRD and a matching comparison cohort of 65,145 BCS-eligible women without ADRD. In multivariable regression analysis, BCS-eligible women with ADRD were more likely to undergo a mammography than the BCS-eligible women without ADRD (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.13–1.26). Stratified by race–ethnicity, BCS-eligible Hispanic women with ADRD were more likely to undergo a mammography (OR = 1.56, 95% CI = 1.39–1.75), whereas BCS-eligible non-Hispanic black (OR = 0.72, 95% CI = 0.62–0.83) and non-Hispanic other (OR = 0.65, 95% CI = 0.45–0.93) women with ADRD were less likely to undergo a mammography. This study was the first to report the impact of ADRD diagnosis and race–ethnicity on mammography use in BCS-eligible women using real-world data. Our results suggest ADRD patients might be undergoing BCS without detailed guidelines to maximize benefits and avoid harms.
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Rangarajan K, Gupta A, Dasgupta S, Marri U, Gupta AK, Hari S, Banerjee S, Arora C. Ultra-high resolution, multi-scale, context-aware approach for detection of small cancers on mammography. Sci Rep 2022; 12:11622. [PMID: 35803985 PMCID: PMC9270480 DOI: 10.1038/s41598-022-15259-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/21/2022] [Indexed: 12/28/2022] Open
Abstract
While detection of malignancies on mammography has received a boost with the use of Convolutional Neural Networks (CNN), detection of cancers of very small size remains challenging. This is however clinically significant as the purpose of mammography is early detection of cancer, making it imperative to pick them up when they are still very small. Mammography has the highest spatial resolution (image sizes as high as 3328 × 4096 pixels) out of all imaging modalities, a requirement that stems from the need to detect fine features of the smallest cancers on screening. However due to computational constraints, most state of the art CNNs work on reduced resolution images. Those that work on higher resolutions, compromise on global context and work at single scale. In this work, we show that resolution, scale and image-context are all important independent factors in detection of small masses. We thereby use a fully convolutional network, with the ability to take any input size. In addition, we incorporate a systematic multi-scale, multi-resolution approach, and encode image context, which we show are critical factors to detection of small masses. We show that this approach improves the detection of cancer, particularly for small masses in comparison to the baseline model. We perform a single institution multicentre study, and show the performance of the model on a diagnostic mammography dataset, a screening mammography dataset, as well as a curated dataset of small cancers < 1 cm in size. We show that our approach improves the sensitivity from 61.53 to 87.18% at 0.3 False Positives per Image (FPI) on this small cancer dataset. Model and code are available from https://github.com/amangupt01/Small_Cancer_Detection.
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Affiliation(s)
- Krithika Rangarajan
- School of Information Technology, Indian Institute of Technology, Delhi, India.
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Aman Gupta
- Department of Computer Science and Engineering, Indian Institute of Technology, Delhi, India
| | - Saptarshi Dasgupta
- Department of Computer Science and Engineering, Indian Institute of Technology, Delhi, India
| | - Uday Marri
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arun Kumar Gupta
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Hari
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Subhashis Banerjee
- Department of Computer Science and Engineering, Indian Institute of Technology, Delhi, India
- Department of Computer Science, Ashoka University, Sonepat, Harayana, India
| | - Chetan Arora
- Department of Computer Science and Engineering, Indian Institute of Technology, Delhi, India
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Mask Branch Network: Weakly Supervised Branch Network with a Template Mask for Classifying Masses in 3D Automated Breast Ultrasound. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Automated breast ultrasound (ABUS) is being rapidly utilized for screening and diagnosing breast cancer. Breast masses, including cancers shown in ABUS scans, often appear as irregular hypoechoic areas that are hard to distinguish from background shadings. We propose a novel branch network architecture incorporating segmentation information of masses in the training process. The branch network is integrated into neural network, providing the spatial attention effect. The branch network boosts the performance of existing classifiers, helping to learn meaningful features around the target breast mass. For the segmentation information, we leverage the existing radiology reports without additional labeling efforts. The reports, which is generated in medical image reading process, should include the characteristics of breast masses, such as shape and orientation, and a template mask can be created in a rule-based manner. Experimental results show that the proposed branch network with a template mask significantly improves the performance of existing classifiers. We also provide qualitative interpretation of the proposed method by visualizing the attention effect on target objects.
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Alnefaie A, Albogami S, Asiri Y, Ahmad T, Alotaibi SS, Al-Sanea MM, Althobaiti H. Chimeric Antigen Receptor T-Cells: An Overview of Concepts, Applications, Limitations, and Proposed Solutions. Front Bioeng Biotechnol 2022; 10:797440. [PMID: 35814023 PMCID: PMC9256991 DOI: 10.3389/fbioe.2022.797440] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
Adaptive immunity, orchestrated by B-cells and T-cells, plays a crucial role in protecting the body from pathogenic invaders and can be used as tools to enhance the body's defense mechanisms against cancer by genetically engineering these immune cells. Several strategies have been identified for cancer treatment and evaluated for their efficacy against other diseases such as autoimmune and infectious diseases. One of the most advanced technologies is chimeric antigen receptor (CAR) T-cell therapy, a pioneering therapy in the oncology field. Successful clinical trials have resulted in the approval of six CAR-T cell products by the Food and Drug Administration for the treatment of hematological malignancies. However, there have been various obstacles that limit the use of CAR T-cell therapy as the first line of defense mechanism against cancer. Various innovative CAR-T cell therapeutic designs have been evaluated in preclinical and clinical trial settings and have demonstrated much potential for development. Such trials testing the suitability of CARs against solid tumors and HIV are showing promising results. In addition, new solutions have been proposed to overcome the limitations of this therapy. This review provides an overview of the current knowledge regarding this novel technology, including CAR T-cell structure, different applications, limitations, and proposed solutions.
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Affiliation(s)
- Alaa Alnefaie
- Department of Medical Services, King Faisal Medical Complex, Taif, Saudi Arabia
| | - Sarah Albogami
- Department of Biotechnology, College of Science, Taif University, Taif, Saudi Arabia
| | - Yousif Asiri
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Tanveer Ahmad
- Multidisciplinary Centre for Advanced Research and Studies, Jamia Millia Islamia, New Delhi, India
| | - Saqer S. Alotaibi
- Department of Biotechnology, College of Science, Taif University, Taif, Saudi Arabia
| | - Mohammad M. Al-Sanea
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Hisham Althobaiti
- Chief of Medical Department, King Faisal Medical Complex (KFMC), Taif, Saudi Arabia
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Brega C, Raviola E, Zucchetta F, Tripodi A, Albertini A. Periareolar approach in female patients undergoing mitral and tricuspid valve surgery: An almost invisible surgical access. J Card Surg 2022; 37:2581-2585. [PMID: 35726656 DOI: 10.1111/jocs.16693] [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: 04/13/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM OF THE STUDY Periareolar minithoracotomy represents an interesting option in minimally invasive cardiac surgery and it is our preferred approach for women. Our aim is to assess the results in female patients, in terms of nipple postoperative pain, local sensitivity, and eventual alterations in mammography after surgery. METHODS Fifty-seven female patients underwent periareolar incision, as minithoracotomy approach, from December 2018 to December 2021. Their mean age was 56 ± 12 years, their body mass index was 22.5 ± 4.8; their surgery was elective in 93%, with mean Euroscore II about 2 ± 1.3. RESULTS Of 57 patients, 87.7% (50 patients) underwent mitral valve repair, whose six with associated procedures; 8.8% (five patients) underwent mitral valve replacement whose two with tricuspid annuloplasty associated and 3.5% (two patients) had isolated tricuspid surgery. The cardiopulmonary bypass and aortic cross-clamp time were 123.2 ± 30.2 and 101.3 ± min respectively. There were no conversions to either full sternotomy or larger thoracotomy approach. There were no in-hospital and follow-up deaths. No strokes or wound infections were observed. Mean follow-up was 16± 9 months. Within the investigated follow-up, 100% of the patients were satisfied with the esthetic result, no remarkable postoperative pain was reported, two patients had slight hyposensitivity in the nipple area. About 50% IThad mammography as prevention screening after surgery and no abnormalities were found. CONCLUSIONS Periareolar minithoracotomy is a feasible surgical option in female patients, with excellent healing and cosmetic results and preserving the tissues of the mammary gland.
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Affiliation(s)
- Carlotta Brega
- Department of Cardiovascular, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy
| | - Eliana Raviola
- Department of Cardiovascular, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy
| | - Fabio Zucchetta
- Department of Cardiovascular, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy
| | - Alberto Tripodi
- Department of Cardiovascular, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy
| | - Alberto Albertini
- Department of Cardiovascular, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy
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Liu C, Zhou X, Jin J, Zhu Q, Li L, Yin Q, Xu T, Gu W, Ma F, Yang R. The Association Between Breast Cancer and Blood-Based Methylation of CD160, ISYNA1 and RAD51B in the Chinese Population. Front Genet 2022; 13:927519. [PMID: 35812748 PMCID: PMC9261985 DOI: 10.3389/fgene.2022.927519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/23/2022] [Indexed: 12/25/2022] Open
Abstract
Recent studies have identified DNA methylation signatures in the white blood cells as potential biomarkers for breast cancer (BC) in the European population. Here, we investigated the association between BC and blood-based methylation of cluster of differentiation 160 (CD160), inositol-3-phosphate synthase 1 (ISYNA1) and RAD51 paralog B (RAD51B) genes in the Chinese population. Peripheral blood samples were collected from two independent case-control studies with a total of 272 sporadic early-stage BC cases (76.5% at stage I&II) and 272 cancer-free female controls. Mass spectrometry was applied to quantitatively measure the levels of DNA methylation. The logistic regression and non-parametric tests were used for the statistical analyses. In contrast to the protective effects reported in European women, we reported the blood-based hypomethylation in CD160, ISYNA1 and RAD51B as risk factors for BC in the Chinese population (CD160_CpG_3, CD160_CpG_4/cg20975414, ISYNA1_CpG_2, RAD51B_CpG_3 and RAD51B_CpG_4; odds ratios (ORs) per -10% methylation ranging from 1.08 to 1.67, p < 0.05 for all). Moreover, hypomethylation of CD160, ISYNA1 and RAD51B was significantly correlated with age, BC subtypes including estrogen receptor (ER)-negative BC tumors, triple negative tumors, BC cases with larger size, advanced stages and more lymph node involvement. Our results supported the report in European women that BC is associated with altered methylation of CD160, ISYNA1 and RAD51B in the peripheral blood, although the effects are opposite in the Chinese population. The difference between the two populations may be due to variant genetic background or life styles, implicating that the validations of epigenetic biomarkers in variant ethnic groups are warranted.
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Affiliation(s)
- Chunlan Liu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiajie Zhou
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jialie Jin
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qiang Zhu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Lixi Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qiming Yin
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Tian Xu
- Department of Clinical Laboratory, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Wanjian Gu
- Department of Clinical Laboratory, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Rongxi Yang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- *Correspondence: Rongxi Yang,
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Bioinformatic investigation and functional analysis of 214 hereditary genes identified non-coding RNAs as therapeautic tool for breast cancer management. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dale J, Di Tomaso M, Gay V. Marrying Story with Science: The Impact of Outdated and Inconsistent Breast Cancer Screening Practices in Canada. Curr Oncol 2022; 29:3540-3551. [PMID: 35621676 PMCID: PMC9139242 DOI: 10.3390/curroncol29050286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022] Open
Abstract
Behind the science of breast cancer in Canada, as well as globally, are the stories of thousands of women, their families, and their communities. These include stories from those who have died or those suffering from the realities of stage III and stage IV breast cancer due to late detection, misinformation, and dismissal. The reality for these women is that, whilst grateful for the latest developments in cancer research, much of this knowledge is not reflected in policy and practice. Canadian guidelines do not reflect the recommended screening by experts within the field and inequities in screening practices and practitioner knowledge exist in different areas within Canada. Told through the stories of women with lived experiences of late-stage breast cancer and supported by scientific evidence, this paper explores the impact of outdated breast cancer screening practices on the lives of women. Recent patient advocacy is driving changes, such as notifying women of their breast density in a few jurisdictions in Canada, but we call for the whole medical community to take responsibility and ensure breast screening is optimised to save more lives.
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Affiliation(s)
| | | | - Victoria Gay
- Independent Researcher, Vancouver, BC, Canada; (M.D.T.); (V.G.)
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Paran M, Shulman K, Kessel B, Dagan J. Synchronous Malignancies Identified by PET-CT Scan in Breast Cancer Patients. Rambam Maimonides Med J 2022; 13:RMMJ.10472. [PMID: 35482458 PMCID: PMC9049150 DOI: 10.5041/rmmj.10472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Breast cancer is a common malignancy and a common cause of cancer-related mortality in women. Pre-treatment workup of breast cancer does not routinely include positron emission tomography scans. We aimed to review cases of women with breast cancer and a synchronous second primary malignancy. We present three cases of women with non-metastatic cancer in whom a synchronous second primary malignancy was found. Synchronous, second primary malignancies which were identified included rectal cancer, gastrointestinal stromal tumor, and non-small cell lung cancer. All second primary malignancies were identified by a PET-CT scan. In conclusion, PET-CT may be used for detection of secondary primary malignancies in select breast cancer patients.
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Affiliation(s)
- Maya Paran
- Division of General Surgery, Hillel Yaffe Medical Center, Hadera, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- To whom correspondence should be addressed. E-mail:
| | - Katerina Shulman
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Oncology Service, Clalit Health Services, Lady Davis Carmel Hospital, Haifa, Israel
| | - Boris Kessel
- Division of General Surgery, Hillel Yaffe Medical Center, Hadera, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
| | - Jasmin Dagan
- Division of General Surgery, Hillel Yaffe Medical Center, Hadera, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
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MicroRNA 21 and microRNA 10b: early diagnostic biomarkers of breast cancer in Egyptian females. J Egypt Natl Canc Inst 2022; 34:16. [PMID: 35399150 DOI: 10.1186/s43046-022-00115-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is one of the most prevalent cancers in developing and developed countries among women worldwide. Mammography is one of the superior methods for BC detection, but it carries up to 20% false-negative results, especially in early cases. Histological examination of tissue biopsies and fine-needle aspiration cytology are invasive techniques. Hence, minimally invasive markers are needed for the improved detection of BC. microRNAs, small, noncoding, single-stranded RNAs functioning as tumor suppressor genes or oncogenes, are attractive biomarkers for early detection. This study aimed to examine the serum levels of miR21 and miR10b in patients with BC especially in the early stages compared to healthy controls to evaluate their potential use as BC biomarkers. METHODS This study included 90 females who were divided into two groups. Group I included 70 patients with BC and was subdivided into group Ia with 40 nonmetastatic BC patients and group Ib with 30 metastatic BC patients. Group II included 20 apparently healthy females as a control group. Serum miR21 and miR10b as biomarkers and miR16 as a housekeeping gene were evaluated using real-time polymerase chain reaction. RESULTS The median levels of miR10b and miR21 were statistically significantly upregulated in the sera of patients with BC compared to healthy controls (P = 0.001). Receiver operating characteristic curve analyses demonstrated that serum levels of miR10b and miR21 were useful biomarkers for distinguishing between patients with BC and the control group, with an area under the curve (AUC) of 0.991 with 97.1% sensitivity and 100% specificity at a cutoff of 3.1 for miR10b and an AUC of 0.965 with 95.7% sensitivity and 85% specificity at a cutoff of 1.7 for miR21. Regarding the early stages of BC, the median levels of the fold change of serum miR21 and miR10b were statistically significantly higher in patients with BC (stages I and IIa) than in the control group (P < 0.001). CONCLUSIONS Both miR21 and miR10b have valuable diagnostic roles in detecting the early stages of BC.
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Wang Q, Aktary ML, Spinelli JJ, Shack L, Robson PJ, Kopciuk KA. Pre-diagnosis lifestyle, health history and psychosocial factors associated with stage at breast cancer diagnosis - Potential targets to shift stage earlier. Cancer Epidemiol 2022; 78:102152. [PMID: 35390584 DOI: 10.1016/j.canep.2022.102152] [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: 07/31/2021] [Revised: 02/19/2022] [Accepted: 03/26/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Early detection of breast cancer improves survival, so identifying factors associated with stage at diagnosis may help formulate cancer prevention messages tailored for higher risk women. The goal of this study was to evaluate associations between multiple potential risk factors, including novel ones, measured before a breast cancer diagnosis and stage at diagnosis in women from Alberta, Canada. METHODS Women enrolled in Alberta's Tomorrow Project completed health and lifestyle questionnaires on average 7 years before their breast cancer diagnosis. The association of previously identified and novel predictors with stage (I, II and III + IV) at diagnosis were simultaneously evaluated in partial proportional odds ordinal (PPO) regression models. RESULTS The 492 women in this study were predominantly diagnosed in Stage 1 (51.4%), had college or university education (75.4%), were married or had a partner (74.6%), had been pregnant (90.2%), had taken birth control pills for any reason (86.8%), and had an average body mass index of 26.6. Most had at least one mammogram (83%) with five mammograms the average number. Nearly all reported previously having a breast health examination from a medical practitioner (92.5%). Statistically significant factors identified in the PPO model included protective ones (older age at diagnosis, high household income, parity, smoking, spending time in the sun during high ultraviolet times, having a mammogram and high daily protein intake) and ones that increased risk of later stage at diagnosis (a comorbidity, current stressful situations and high daily caloric intake). CONCLUSION Shifting breast cancer stage at diagnosis downwards may potentially be achieved through cancer prevention programs that target higher risk groups such as women with co-morbidities, non-smokers and younger women who may be eligible for breast cancer screening.
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Affiliation(s)
- Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.
| | - Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
| | - John J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Population Oncology, BC Centre, Vancouver, BC, Canada.
| | - Lorraine Shack
- Cancer Surveillance and Reporting, Alberta Health Services, Calgary, Alberta, Canada.
| | - Paula J Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Cancer Care Alberta, Alberta Health Services, Edmonton, Alberta, Canada.
| | - Karen A Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada; Departments of Oncology, Community Health Sciences and Mathematics and Statistics, University of Calgary, Calgary, Alberta, Canada.
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Mirabi S, Chaurasia A, Oremus M. The association between religiosity, spirituality, and breast cancer screening: A cross-sectional analysis of Alberta’s Tomorrow Project. Prev Med Rep 2022; 26:101726. [PMID: 35198361 PMCID: PMC8844898 DOI: 10.1016/j.pmedr.2022.101726] [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: 08/23/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 12/24/2022] Open
Abstract
Religion and spirituality provide a foundation for regulating health behaviors such as cancer screening. However, religion and spirituality were not associated with mammography in a population-level sample of women from Alberta, Canada. Religion and spirituality may be associated with mammography in population subgroups. Future research should employ longitudinal analyses.
Breast cancer is the leading cause of cancer-related mortality among women. Screening permits the early detection and treatment of malignancies, thereby reducing mortality. A woman’s religiosity and spirituality (R/S) may facilitate screening through encouragement of healthy behaviors. Population-level data from Alberta’s Tomorrow Project (ATP) were used to explore the cross-sectional association between R/S and breast cancer screening among women aged 50 to 69 years who did not have a history of breast cancer. Two variables were used to measure R/S: (1) R/S Salience was defined as the importance of religion and spirituality in one’s life; (2) R/S Attendance was defined as the frequency of attendance at religious or spiritual services. We regressed breast cancer screening (mammogram: yes/no) on each R/S variable in separate multivariable logistic regression models. At baseline (n = 2569), 94% of women reported receiving a mammogram. Greater R/S Salience was not associated with receipt of mammogram: the adjusted odds ratio (aOR) was 1.04 (95% confidence interval [CI]: 0.71–1.51. R/S Attendance also showed no association with mammogram: attending at least once monthly versus never attending (aOR: 1.10; 95% CI: 0.71–1.69); attending one to four times yearly versus never attending (aOR: 0.95, 95% CI: 0.57–1.58). Further research could examine specific subgroups of the population, e.g., whether use of R/S to promote breast cancer screening may be more effective among females with strong pre-existing connections to faith.
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A Critique of the Theory of Planned Behavior in the Cancer Screening Domain. ANS Adv Nurs Sci 2022; 45:179-193. [PMID: 35502990 DOI: 10.1097/ans.0000000000000395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The theory of planned behavior (TPB) has been widely used to guide research in cancer screening-related behavior, but no critique of the TPB's application in this domain has been published. We used Fawcett and DeSanto-Madeya's 2013 framework to analyze and evaluate the theory. The theory was developed on the basis of antecedent knowledge regarding human behavior, and its concepts and propositions are comprehensively delineated. The TPB shows adequate internal consistency and impressive social and theoretical significance. Methodologically sound studies are called for to further test some theory propositions and to evaluate its pragmatic adequacy for promoting cancer screening in nursing practice.
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