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Choridah L, Icanervilia AV, Rengganis AA, At Thobari J, Postma MJ, D I van Asselt A. Comparing the performance of three modalities of breast cancer screening within a combined programme targeting at-risk women in Indonesia: An implementation study. Glob Public Health 2023; 18:2284370. [PMID: 38015726 DOI: 10.1080/17441692.2023.2284370] [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: 12/30/2022] [Accepted: 11/10/2023] [Indexed: 11/30/2023]
Abstract
ABSTRACTAlthough mammography is the gold standard for breast cancer screening, the World Health Organization recommends clinical breast examination (CBE) as the preferred early detection method in countries with limited resources. However, its effectiveness as a 'stand-alone' screening modality compared with other techniques remains unclear. Therefore, we evaluated a risk-based opportunistic breast cancer screening programme using three modalities. Between June and December 2018, we conducted a cross-sectional study in Yogyakarta, Indonesia, of women aged >40 years with at least one risk factor for breast cancer. Subjects underwent CBE, mammography, and ultrasonography. We calculated the proportion of breast lesions detected through each modality and compared their mass size. A total of 503 eligible subjects were screened. Five cases of potential malignant lesions were detected; pathological tests conducted for 4 of them confirmed breast cancer diagnoses. A combined assessment of mammography and ultrasonography examinations revealed 343 breast lesions (68.2%), whereas CBE screening detected only 76 breast lesions (15.1%). The mean lesion sizes detected by mammography or ultrasonography, but not through CBE, were significantly smaller (p-values of 0.037 and 0.007 for mammography and ultrasonography, respectively). In conclusion, mammography and ultrasonography produced higher detection rates for benign and malignant breast lesions compared with CBE.
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Affiliation(s)
- Lina Choridah
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ajeng Viska Icanervilia
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Clinical Epidemiology and Biostatistics Unit (CEBU), Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Anggraeni Ayu Rengganis
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Clinical Epidemiology and Biostatistics Unit (CEBU), Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Jarir At Thobari
- Clinical Epidemiology and Biostatistics Unit (CEBU), Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Maarten J Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Antoinette D I van Asselt
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Longitudinal Serum Protein Analysis of Women with a High Risk of Developing Breast Cancer Reveals Large Interpatient Versus Small Intrapatient Variations: First Results from the TESTBREAST Study. Int J Mol Sci 2022; 23:ijms232012399. [PMID: 36293255 PMCID: PMC9604317 DOI: 10.3390/ijms232012399] [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: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022] Open
Abstract
The prospective, multicenter TESTBREAST study was initiated with the aim of identifying a novel panel of blood-based protein biomarkers to enable early breast cancer detection for moderate-to-high-risk women. Serum samples were collected every (half) year up until diagnosis. Protein levels were longitudinally measured to determine intrapatient and interpatient variabilities. To this end, protein cluster patterns were evaluated to form a conceptual basis for further clinical analyses. Using a mass spectrometry-based bottom-up proteomics strategy, the protein abundance of 30 samples was analyzed: five sequential serum samples from six high-risk women; three who developed a breast malignancy (cases) and three who did not (controls). Serum samples were chromatographically fractionated and an in-depth serum proteome was acquired. Cluster analyses were applied to indicate differences between and within protein levels in serum samples of individuals. Statistical analyses were performed using ANOVA to select proteins with a high level of clustering. Cluster analyses on 30 serum samples revealed unique patterns of protein clustering for each patient, indicating a greater interpatient than intrapatient variability in protein levels of the longitudinally acquired samples. Moreover, the most distinctive proteins in the cluster analysis were identified. Strong clustering patterns within longitudinal intrapatient samples have demonstrated the importance of identifying small changes in protein levels for individuals over time. This underlines the significance of longitudinal serum measurements, that patients can serve as their own controls, and the relevance of the current study set-up for early detection. The TESTBREAST study will continue its pursuit toward establishing a protein panel for early breast cancer detection.
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Basurto-Hurtado JA, Cruz-Albarran IA, Toledano-Ayala M, Ibarra-Manzano MA, Morales-Hernandez LA, Perez-Ramirez CA. Diagnostic Strategies for Breast Cancer Detection: From Image Generation to Classification Strategies Using Artificial Intelligence Algorithms. Cancers (Basel) 2022; 14:3442. [PMID: 35884503 PMCID: PMC9322973 DOI: 10.3390/cancers14143442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/02/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
Breast cancer is one the main death causes for women worldwide, as 16% of the diagnosed malignant lesions worldwide are its consequence. In this sense, it is of paramount importance to diagnose these lesions in the earliest stage possible, in order to have the highest chances of survival. While there are several works that present selected topics in this area, none of them present a complete panorama, that is, from the image generation to its interpretation. This work presents a comprehensive state-of-the-art review of the image generation and processing techniques to detect Breast Cancer, where potential candidates for the image generation and processing are presented and discussed. Novel methodologies should consider the adroit integration of artificial intelligence-concepts and the categorical data to generate modern alternatives that can have the accuracy, precision and reliability expected to mitigate the misclassifications.
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Affiliation(s)
- Jesus A. Basurto-Hurtado
- C.A. Mecatrónica, Facultad de Ingeniería, Campus San Juan del Río, Universidad Autónoma de Querétaro, Rio Moctezuma 249, San Cayetano, San Juan del Rio 76807, Mexico; (J.A.B.-H.); (I.A.C.-A.)
- Laboratorio de Dispositivos Médicos, Facultad de Ingeniería, Universidad Autónoma de Querétaro, Carretera a Chichimequillas S/N, Ejido Bolaños, Santiago de Querétaro 76140, Mexico
| | - Irving A. Cruz-Albarran
- C.A. Mecatrónica, Facultad de Ingeniería, Campus San Juan del Río, Universidad Autónoma de Querétaro, Rio Moctezuma 249, San Cayetano, San Juan del Rio 76807, Mexico; (J.A.B.-H.); (I.A.C.-A.)
- Laboratorio de Dispositivos Médicos, Facultad de Ingeniería, Universidad Autónoma de Querétaro, Carretera a Chichimequillas S/N, Ejido Bolaños, Santiago de Querétaro 76140, Mexico
| | - Manuel Toledano-Ayala
- División de Investigación y Posgrado de la Facultad de Ingeniería (DIPFI), Universidad Autónoma de Querétaro, Cerro de las Campanas S/N Las Campanas, Santiago de Querétaro 76010, Mexico;
| | - Mario Alberto Ibarra-Manzano
- Laboratorio de Procesamiento Digital de Señales, Departamento de Ingeniería Electrónica, Division de Ingenierias Campus Irapuato-Salamanca (DICIS), Universidad de Guanajuato, Carretera Salamanca-Valle de Santiago KM. 3.5 + 1.8 Km., Salamanca 36885, Mexico;
| | - Luis A. Morales-Hernandez
- C.A. Mecatrónica, Facultad de Ingeniería, Campus San Juan del Río, Universidad Autónoma de Querétaro, Rio Moctezuma 249, San Cayetano, San Juan del Rio 76807, Mexico; (J.A.B.-H.); (I.A.C.-A.)
| | - Carlos A. Perez-Ramirez
- Laboratorio de Dispositivos Médicos, Facultad de Ingeniería, Universidad Autónoma de Querétaro, Carretera a Chichimequillas S/N, Ejido Bolaños, Santiago de Querétaro 76140, Mexico
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de Freitas RM, Guerra MR, Fayer VA, Campos AAL, Cintra JRD, Warren J, Ervilha RR, de Paula CD, Bustamante-Teixeira MT. Histological and Immunohistochemical Characteristics for Hereditary Breast Cancer Risk in a Cohort of Brazilian Women. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:761-770. [PMID: 35468643 PMCID: PMC9948274 DOI: 10.1055/s-0042-1743103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The study aimed to characterize the clinical, histological, and immunohistochemical profile of women with invasive breast cancer, according to the risk for Hereditary Predisposition Breast and Ovarian Cancer Syndrome in a Brazilian population. METHODS This is a retrospective study performed from a hospital-based cohort of 522 women, diagnosed with breast cancer treated at an oncology referral center in the Southeast region of Brazil, between 2014 and 2016. RESULTS Among the 430 women diagnosed with invasive breast cancer who composed the study population, 127 (29.5%) were classified as at increased risk for hereditary predisposition to breast and ovarian cancer syndrome. There was a lower level of education in patients at increased risk (34.6%) when compared with those at usual risk (46.0%). Regarding tumor characteristics, women at increased risk had higher percentages of the disease diagnosed at an advanced stage (32.3%), and with tumors > 2cm (63.0%), with increased prevalence for both characteristics, when compared with those at usual risk. Furthermore, we found higher percentages of HG3 (43.3%) and Ki-67 ≥ 25% (64.6%) in women at increased risk, with prevalence being about twice as high in this group. The presence of triple-negative tumors was observed as 25.2% in women at increased risk and 6.0% in women at usual risk, with the prevalence of absence of biomarkers being 2.5 times higher among women in the increased risk group. CONCLUSION From the clinical criteria routinely used in the diagnosis of breast cancer, the care practice of genetic counseling for patients at increased risk of hereditary breast cancer in contexts such as Brazil is still scarce.
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Affiliation(s)
- Renata Mendes de Freitas
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.,Epidemiology of Congenital Malformations Laboratory, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Maximiliano Ribeiro Guerra
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Vívian Assis Fayer
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | | | - Joan Warren
- Independent Researcher, Washington, United States
| | - Rafaela Russi Ervilha
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Camila Damasceno de Paula
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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Chokoev A, Akhunbaev S, Kudaibergenova I, Soodonbekov E, Nurtazinova G, Telmanova Z, Makimbetov E, Igissinov N. Evaluation of the Dynamics of Breast Cancer Incidence in Kyrgyzstan: Component Analysis. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: In 2020, 19.2 million cases of all types of cancer were registered worldwide, of which 11.7%, that is, 2.3 million, related to breast cancer (BC). The global burden of cancer is increasing worldwide, with the majority of new cancer cases and related deaths occurring in low- and middle-income countries.
OBJECTIVE: The study is to conduct a component analysis of the dynamics of the incidence of BC in Kyrgyzstan.
METHODS: Primary data were for registered patients with BC (International Classification of Diseases – C50) in the whole country during the period of 2003–2017. Evaluation of changes in BC incidence in the population of Kyrgyzstan was performed using component analysis according to the methodological recommendations.
RESULTS: The study period, 7850 new cases of BC were recorded. The incidence rate increased from 17.70°/0000 (2003) to 19.03°/0000 in 2017 and the overall growth was 1.34°/0000, including due to the age structure – ΣΔA=2.08°/0000, due to the risk of acquiring illness – ΣΔR=−0.55°/0000 and their combined effect – ΣΔRA=−0.19°/0000. The component analysis revealed that the increase in the number of patients with BC was mainly due to the growth of the population (ΔP=+71.8%), changes in its age structure (ΔA=+35.5%), and changes associated with the risk of acquiring illness (ΔR=+8.4%). The increase and, in some cases, the decrease in the number of patients in the regions of the republic is due to the influence of demographic factors and risk factors for getting sick.
CONCLUSION: The component analysis assessed the role of the influence of demographic factors and the risk of acquiring the disease on the formation of the number of patients and the incidence of BC, while geographical variability was established. The implementation of the results of this study is recommended in the management of anticancer measures for BC.
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Bicchierai G, Busoni S, Tortoli P, Bettarini S, Naro FD, De Benedetto D, Savi E, Bellini C, Miele V, Nori J. Single Center Evaluation of Comparative Breast Radiation dose of Contrast Enhanced Digital Mammography (CEDM), Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT). Acad Radiol 2022; 29:1342-1349. [PMID: 35065889 DOI: 10.1016/j.acra.2021.12.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this retrospective study is to compare the radiation dose received during CEDM, short and long protocol (CEDM SP and CEDM LP), with dose received during DM and DBT on patients with varying breast thickness, age and density. MATERIALS AND METHODS Between January 2019 and December 2019, patients having 6214 DM, 3662 DBT and 173 CEDM examinations in our department were analyzed. Protocol total single breast AGD has been evaluated for all clinical imaging protocols, extracting AGD values and exposure data from the dose DICOM Structured Report (SR) information stored in the hospital PACS system. Protocol AGD was calculated as the sum of single projection AGDs carried out in every exam for each clinical protocol. A total amount of 23,383 exams for each breast were analyzed. Protocol AGDs, stratified as a function of patient breast compression thickness, age, and breast density were assessed. RESULTS The total protocol AGD median values for each protocol are: 2.8 mGy for DM, 3.2 mGy for DBT, 6.0 mGy for DM+DBT, 4.5 mGy for CEDM SP, 7.4 mGy for CEDM SP_DBT (CEDM SP protocol with DBT), 8.4 mGy for CEDM LP and 11.6 mGy for CEDM LP_DBT (CEDM LP protocol with DBT). CEDM SP AGD median value is 59% higher than DM AGD median value and 40% lesser than DM+DBT AGD median; this last difference was statistically confirmed with a p-value <0.001. AGD value for each standard breast CEDM SP projection results to be below 3-mGy limit. AGD value for each standard breast CEDM SP projection results to be below 3 mGy, as required by international legislation. For dense breasts, the AGD median value is 4.2 mGy, with the first and third quartile of 3.3 mGy and 6.0 mGy respectively; for non-dense breasts, the AGD median value is 4.7 mGy, with first and third quartile of 3.5 mGy and 6.3 mGy respectively. The difference between the two groups was statistically tested and confirmed, with a p-value of 0.039. CONCLUSION CEDM SP results in higher radiation exposure compared with conventional DM and DBT but lower than the Combo mode. The dose administered during the CEDM SP is lower in patients with dense breasts regardless of their size. An interesting outcome, considering the ongoing studies on CEDM screening in patients with dense breasts.
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Zhu Y, O'Connell AM, Ma Y, Liu A, Li H, Zhang Y, Zhang X, Ye Z. Dedicated breast CT: state of the art-Part II. Clinical application and future outlook. Eur Radiol 2021; 32:2286-2300. [PMID: 34476564 DOI: 10.1007/s00330-021-08178-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 06/19/2021] [Accepted: 06/29/2021] [Indexed: 12/17/2022]
Abstract
Dedicated breast CT is being increasingly used for breast imaging. This technique provides images with no compression, removal of tissue overlap, rapid acquisition, and available simultaneous assessment of microcalcifications and contrast enhancement. In this second installment in a 2-part review, the current status of clinical applications and ongoing efforts to develop new imaging systems are discussed, with particular emphasis on how to achieve optimized practice including lesion detection and characterization, response to therapy monitoring, density assessment, intervention, and implant evaluation. The potential for future screening with breast CT is also addressed. KEY POINTS: • Dedicated breast CT is an emerging modality with enormous potential in the future of breast imaging by addressing numerous clinical needs from diagnosis to treatment. • Breast CT shows either noninferiority or superiority with mammography and numerical comparability to MRI after contrast administration in diagnostic statistics, demonstrates excellent performance in lesion characterization, density assessment, and intervention, and exhibits promise in implant evaluation, while potential application to breast cancer screening is still controversial. • New imaging modalities such as phase-contrast breast CT, spectral breast CT, and hybrid imaging are in the progress of R & D.
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Affiliation(s)
- Yueqiang Zhu
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Huan-Hu-Xi Road, Ti-Yuan-Bei, Hexi District, 300060, Tianjin, China
| | - Avice M O'Connell
- Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY, 14642, USA
| | - Yue Ma
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Huan-Hu-Xi Road, Ti-Yuan-Bei, Hexi District, 300060, Tianjin, China
| | - Aidi Liu
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Huan-Hu-Xi Road, Ti-Yuan-Bei, Hexi District, 300060, Tianjin, China
| | - Haijie Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Huan-Hu-Xi Road, Ti-Yuan-Bei, Hexi District, 300060, Tianjin, China
| | - Yuwei Zhang
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Huan-Hu-Xi Road, Ti-Yuan-Bei, Hexi District, 300060, Tianjin, China
| | - Xiaohua Zhang
- Koning Corporation, Lennox Tech Enterprise Center, 150 Lucius Gordon Drive, Suite 112, West Henrietta, NY, 14586, USA
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Huan-Hu-Xi Road, Ti-Yuan-Bei, Hexi District, 300060, Tianjin, China.
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D'Antonio KB, McGuire M, Rupert K. Managing patients with high-risk breast lesions, precursors on the breast neoplasia pathway. JAAPA 2021; 34:35-39. [PMID: 33870927 DOI: 10.1097/01.jaa.0000742948.34484.aa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Breast cancer remains the most commonly diagnosed cancer among women. Imaging abnormalities may be noted on routine breast cancer screenings and require biopsy for further evaluation. Atypia and carcinoma in situ are nonmalignant lesions identified via breast biopsy and are associated with an increased risk of invasive carcinoma. Because of the lack of specialized breast cancer prevention and risk reduction programs, patients may not be able to access optimal management of the various subtypes of atypia and carcinoma in situ. By understanding the pathology of high-risk breast lesions and the resulting elevated cancer risk, healthcare providers, specifically primary care providers, can better counsel, manage, and treat patients to provide comprehensive quality care.
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Affiliation(s)
- Katherine B D'Antonio
- In the Womens Cancer Center at UPMC Magee Womens Hospital in Pittsburgh, Pa., Katherine B. D'Antonio is a senior PA, Meaghan McGuire is an NP, and Karlyn Rupert is a senior PA. The authors have disclosed no potential conflicts of interest, financial or otherwise
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Martaindale S. Breast cancer screening: Helping patients navigate recommendations. Breast J 2021; 27:421-422. [PMID: 33880890 DOI: 10.1111/tbj.14236] [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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