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Goździk M, Żelaźniewicz A, Nowak-Kornicka J, Pawłowska-Seredyńska K, Umławska W, Pawłowski B. Autoimmune Hashimoto's Disease and Feminization Level-Testing the Immunocompetence Hypothesis. EVOLUTIONARY PSYCHOLOGY 2024; 22:14747049241259187. [PMID: 39238450 PMCID: PMC11378202 DOI: 10.1177/14747049241259187] [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: 09/07/2024] Open
Abstract
Morphological femininity depends mainly on estrogen levels at puberty and is perceived as a cue of a woman's biological condition. Due to the immunostimulant properties of estradiol, estradiol-dependent feminine traits are expected to be positively related to immunity. However, heightened immunity in women may increase the risk of autoimmune disease, thus the relationship between femininity and immune quality may be complex. This study aimed to assess the relationship between morphological femininity and both the occurrence and severity of Hashimoto thyroiditis (HT) in women of reproductive age. Moreover, 95 women with HT and 84 without HT (all between 20 and 37 years) participated in the study. Morphological femininity was assessed based on somatic measurements of sexually dimorphic traits (2D:4D ratio, WHR, breast size, facial sexual dimorphism). The occurrence and severity of HT were assessed by serum TPOAb levels. The results showed that only the 2D:4D ratio of the right hand was higher in the HT group, indicating higher femininity in these women. However, there was also a positive relationship between facial femininity and TPOAb level in women with HT, indicating a higher severity of the disease. The results suggest that prenatal and pubertal exposure to estrogens may increase the probability or severity of autoimmune diseases in adulthood, but the relationship is tentative.
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Affiliation(s)
- Malwina Goździk
- Department of Human Biology, University of Wrocław, Wroclaw, Poland
| | | | | | | | - Wioleta Umławska
- Department of Human Biology, University of Wrocław, Wroclaw, Poland
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Stahl S, Dannehl D, Daigeler A, Jorge C, Brendlin A, Hagen F, Santos Stahl A, Feng YS, Nikolaou K, Estler A. Definitions of Abnormal Breast Size and Asymmetry: A Cohort Study of 400 Women. Aesthetic Plast Surg 2023; 47:2242-2252. [PMID: 37253846 DOI: 10.1007/s00266-023-03400-4] [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: 03/08/2023] [Accepted: 04/23/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Macromastia, micromastia and breast asymmetry have an impact on health and quality of life. However, there is scarce information addressing breast size and asymmetry frequency distribution in reference populations. OBJECTIVE The current study aims to identify factors that influence breast size and symmetry and classifies abnormal breast sizes and breast asymmetries in an adult German population. METHODS Breast base dimensions, breast volume, symmetry, and other breast anthropometric parameters of 400 German female patients were determined in a retrospective review of the MRI archives at our institution. Professional medical MRI-segmentation software was used for volume measurement. RESULTS A total of 400 Patients were retrospectively enrolled. The patients had a mean age of 50 ± 12 years (min: 24; max: 82), mean BMI of 25.0 ± 5.0 (min: 14.7, max: 45.6), and a mean total breast volume of 976 ml (right: 973 ml, min: 64, max: 4777; left: 979 ml, min: 55, max: 4670). The strongest correlation of breast volume was observed with BMI (r = 0.834, p < 0.001), followed by breast base width (r = 0.799, p < 0.001). Smaller breasts have higher breast volume asymmetry ratios (r = - 0.124, p < 0.014). For a BMI between 18.5 and 24.9 kg/m2, micromastia is defined by breast volumes below 250 ml (5th percentile) and macromastia by volumes above 1250 ml (95th percentile). Abnormal breast volume asymmetry (< 5th and > 95th percentile) is equivalent to an absolute difference of approximately 25% relative to the smallest side (bidirectional asymmetry ratio 5th percentile - 19%; 95th percentile 26%). CONCLUSION This study provides normative data of German women, as well as selected size-for-BMI percentiles and asymmetry ratio percentiles. The normative data may help to establish transparent and objective coverage criteria for health insurances. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Stéphane Stahl
- CenterPlast Private Practice, Bahnhofstr. 36, 66111, Saarbrücken, Germany
| | - Dominik Dannehl
- Department of Women's Health, University Hospital Tübingen, Calwerstr 7/6, 72076, Tübingen, Germany
| | - Adrien Daigeler
- Department of Plastic Hand and Reconstructive Surgery, BG Trauma Center Tübingen, Schnarrenbergstr 95, 72076, Tübingen, Germany
| | - Cristina Jorge
- Department of General-, Visceral-, Vascular-, and Pediatric Surgery, Saarland University Medical Center, Kirrberger Straße, 66421, Homburg, Saar, Germany
| | - Andreas Brendlin
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Florian Hagen
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | | | - You-Shan Feng
- Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Arne Estler
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
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Hudson SM, Wilkinson LS, De Stavola BL, Dos-Santos-Silva I. Left-right breast asymmetry and risk of screen-detected and interval cancers in a large population-based screening population. Br J Radiol 2020; 93:20200154. [PMID: 32525693 DOI: 10.1259/bjr.20200154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To assess the associations between automated volumetric estimates of mammographic asymmetry and breast cancers detected at the same ("contemporaneous") screen, at subsequent screens, or in between (interval cancers). METHODS Automated measurements from mammographic images (N = 79,731) were used to estimate absolute asymmetry in breast volume (BV) and dense volume (DV) in a large ethnically diverse population of attendees of a UK breast screening programme. Logistic regression models were fitted to assess asymmetry associations with the odds of a breast cancer detected at contemporaneous screen (767 cases), adjusted for relevant confounders.Nested case-control investigations were designed to examine associations between asymmetry and the odds of: (a) interval cancer (numbers of cases/age-matched controls: 153/646) and (b) subsequent screen-detected cancer (345/1438), via conditional logistic regression. RESULTS DV, but not BV, asymmetry was positively associated with the odds of contemporaneous breast cancer (P-for-linear-trend (Pt) = 0.018). This association was stronger for first (prevalent) screens (Pt = 0.012). Both DV and BV asymmetry were positively associated with the odds of an interval cancer diagnosis (Pt = 0.060 and 0.030, respectively). Neither BV nor DV asymmetry were associated with the odds of having a subsequent screen-detected cancer. CONCLUSIONS Increased DV asymmetry was associated with the risk of a breast cancer diagnosis at a contemporaneous screen or as an interval cancer. BV asymmetry was positively associated with the risk of an interval cancer diagnosis. ADVANCES IN KNOWLEDGE The findings suggest that DV and BV asymmetry may provide additional signals for detecting contemporaneous cancers and assessing the likelihood of interval cancers in population-based screening programmes.
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Affiliation(s)
- Sue M Hudson
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Louise S Wilkinson
- Oxford Breast Imaging Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Bianca L De Stavola
- Faculty of Pop Health Sciences, Institute of Child Health, University College London, London, UK
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Hudson SM, Wilkinson LS, Denholm R, De Stavola BL, Dos-Santos-Silva I. Ethnic and age differences in right-left breast asymmetry in a large population-based screening population. Br J Radiol 2019; 93:20190328. [PMID: 31661305 DOI: 10.1259/bjr.20190328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Exposure to sex hormones is important in the pathogenesis of breast cancer and inability to tolerate such exposure may be reflected in increased asymmetrical growth of the breasts. This study aims to characterize, for the first time, asymmetry in breast volume (BV) and radiodense volume (DV) in a large ethnically diverse population. METHODS Automated measurements from digital raw mammographic images of 54,591 cancer-free participants (aged 47-73) in a UK breast screening programme were used to calculate absolute (cm3) and relative asymmetry in BV and DV. Logistic regression models were fitted to assess asymmetry associations with age and ethnicity. RESULTS BV and DV absolute asymmetry were positively correlated with the corresponding volumetric dimension (BV or DV). BV absolute asymmetry increased, whilst DV absolute asymmetry decreased, with increasing age (P-for-linear-trend <0.001 for both). Relative to Whites, Blacks had statistically significantly higher, and Chinese lower, BV and DV absolute asymmetries. However, after adjustment for the corresponding underlying volumetric dimension the age and ethnic differences were greatly attenuated. Median relative (fluctuating) BV and DV asymmetry were 2.34 and 3.28% respectively. CONCLUSION After adjusting for the relevant volumetric dimension (BV or DV), age and ethnic differences in absolute breast asymmetry were largely resolved. ADVANCES IN KNOWLEDGE Previous small studies have reported breast asymmetry-breast cancer associations. Automated measurements of asymmetry allow the conduct of large-scale studies to further investigate these associations.
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Affiliation(s)
- Sue M Hudson
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Louise S Wilkinson
- Oxford Breast Imaging Centre, University of Oxford Hospitals NHS Foundation Trust, Oxford, UK
| | - Rachel Denholm
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Bianca L De Stavola
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, UK
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Natural Breast Symmetry in Preoperative Breast Cancer Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2297. [PMID: 31942335 PMCID: PMC6952140 DOI: 10.1097/gox.0000000000002297] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/17/2019] [Indexed: 11/25/2022]
Abstract
Plastic surgeons aim to achieve breast symmetry during cosmetic and reconstructive breast surgery. They rely on measures of breast size, position, and projection to determine and achieve breast symmetry, but normative data on symmetry in preoperative breast reconstruction patients are scarce.
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Robichaux JP, Fuseler JW, Patel SS, Kubalak SW, Hartstone-Rose A, Ramsdell AF. Left-right analysis of mammary gland development in retinoid X receptor-α+/- mice. Philos Trans R Soc Lond B Biol Sci 2017; 371:rstb.2015.0416. [PMID: 27821527 DOI: 10.1098/rstb.2015.0416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2016] [Indexed: 12/31/2022] Open
Abstract
Left-right (L-R) differences in mammographic parenchymal patterns are an early predictor of breast cancer risk; however, the basis for this asymmetry is unknown. Here, we use retinoid X receptor alpha heterozygous null (RXRα+/-) mice to propose a developmental origin: perturbation of coordinated anterior-posterior (A-P) and L-R axial body patterning. We hypothesized that by analogy to somitogenesis-in which retinoic acid (RA) attenuation causes anterior somite pairs to develop L-R asynchronously-that RA pathway perturbation would likewise result in asymmetric mammary development. To test this, mammary glands of RXRα+/- mice were quantitatively assessed to compare left- versus right-side ductal epithelial networks. Unlike wild-type controls, half of the RXRα+/- thoracic mammary gland (TMG) pairs exhibited significant L-R asymmetry, with left-side reduction in network size. In RXRα+/- TMGs in which symmetry was maintained, networks had bilaterally increased size, with left networks showing greater variability in area and pattern. Reminiscent of posterior somites, whose bilateral symmetry is refractory to RA attenuation, inguinal mammary glands (IMGs) also had bilaterally increased network size, but no loss of symmetry. Together, these results demonstrate that mammary glands exhibit differential A-P sensitivity to RXRα heterozygosity, with ductal network symmetry markedly compromised in anterior but not posterior glands. As TMGs more closely model human breast development than IMGs, these findings raise the possibility that for some women, breast cancer risk may initiate with subtle axial patterning defects that result in L-R asymmetric growth and pattern of the mammary ductal epithelium.This article is part of the themed issue 'Provocative questions in left-right asymmetry'.
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Affiliation(s)
- Jacqulyne P Robichaux
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - John W Fuseler
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC 29208, USA
| | - Shrusti S Patel
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC 29208, USA
| | - Steven W Kubalak
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Adam Hartstone-Rose
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC 29208, USA
| | - Ann F Ramsdell
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA .,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA.,Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC 29208, USA.,Program in Women's and Gender Studies, College of Arts and Sciences, University of South Carolina, Columbia, SC 29208, USA
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