Artificial Intelligence as a Potential Catalyst to a More Equitable Cancer Care.

As we enter the era of digital interdependence, artificial intelligence (AI) emerges as a key instrument to transform health care and address disparities and barriers in access to services. This viewpoint explores AI's potential to reduce inequalities in cancer care by improving diagnostic accuracy, optimizing resource allocation, and expanding access to medical care, especially in underserved communities. Despite persistent barriers, such as socioeconomic and geographical disparities, AI can significantly improve health care delivery. Key applications include AI-driven health equity monitoring, predictive analytics, mental health support, and personalized medicine. This viewpoint highlights the need for inclusive development practices and ethical considerations to ensure diverse data representation and equitable access. Emphasizing the role of AI in cancer care, especially in low- and middle-income countries, we underscore the importance of collaborative and multidisciplinary efforts to integrate AI effectively and ethically into health systems. This call to action highlights the need for further research on user experiences and the unique social, cultural, and political barriers to AI implementation in cancer care.

Granulomatous mastitis with erythema nodosum: A breast cancer mimicking entity.

We present the case of a 42-year-old Hispanic patient who consulted with a left breast mass that showed clinical and imaging signs of breast cancer. During preprocedural examination before needle biopsy, the patient was found to have bilateral, purplish-brown skin lesions on her lower legs, suggestive of erythema nodosum. This clinical finding raised the diagnostic suspicion of granulomatous mastitis, which was later confirmed by histopathology. Granulomatous mastitis is a rare, nonmalignant entity that should be considered in patients of childbearing age who present with a breast mass. The coexistence with erythema nodosum contributes to the clinical suspicion of granulomatous mastitis; the mechanism of this association and the optimal treatment approach remain unknown.

Latin America and the Caribbean Code Against Cancer 1st edition: Building capacity on cancer prevention to primary healthcare professionals.

INTRODUCTION: Every year 1.5 million new cancer cases are diagnosed in Latin America and the Caribbean (LAC). Of these, about 40 % could be prevented. Health illiteracy has been identified as a main barrier for cancer prevention. Primary healthcare professionals (HCP) are key in cancer prevention as they are the first entry point of the population into the healthcare system. The LAC Code Against Cancer 1st edition aims to improve health literacy and awareness of cancer prevention in the LAC population, through building capacity of primary HCP. METHODS: The definition and development of the learning objectives, curriculum, structure, and evaluation of an online learning program for primary HCP was led by a dedicated group of experts from the LAC Code Against Cancer project. A pedagogical guideline and a template to ensure harmonization across topics were produced to guide the program development. Two rounds of internal revisions and an editorial process were performed. RESULTS: An online competency-based microlearning program for primary HCP was produced, taking the LAC Code Against Cancer as a basis. The competences addressed in the curriculum are core knowledge, communication skills, decision-making and applying knowledge to real-world situations. A comprehensive evaluation to assess acquisition of these competences, based on the Miller's Pyramid, was designed with three data collection points: a) immediately before, to assess baseline knowledge and skills; b) immediately after, to determine acquired competences; and c) at 3-6 months follow-up, to assess performance in daily practice. The e-learning will be freely available in the Virtual Campus for Public Health of the Pan American Health Organization in Spanish, English, and Portuguese. CONCLUSION: Primary HCP, perceived as trustworthy sources of information, are key actors to increase the population's awareness and literacy on cancer prevention. Building capacity of these professionals has the potential to increase dissemination and impact of the LAC Code Against Cancer by prompting communication with the public and offering personalized actionable preventive messages through counselling.

Breast pseudoaneurysm after core needle biopsy in a pregnant patient.

Breast pseudoaneurysm is an extremely rare complication of interventional breast procedures. Pregnancy and lactation are associated with increased breast vascularization, which may act as a risk factor. We present the case of a 36-year-old woman in the third trimester of a spontaneous twin pregnancy, who presented with a newly-detected BI-RADS 4 mass in her right breast. The patient requested not to defer a biopsy until after the pregnancy, and an ultrasound-guided breast core biopsy was performed. The patient presented bleeding during the procedure, but no hematomas or other vascular lesions were immediately detected. During follow-up, a breast ultrasound revealed an anechoic circumscribed mass and high-velocity blood flow. The color Doppler showed a spiral blood flow with the Yin-Yang sign, together with a communication channel between the sac and feeding artery. A diagnosis of breast pseudoaneurysm was made. The patient was managed conservatively, and breastfeeding continued normally. This case report highlights the importance of color Doppler in the detection of pseudoaneurysms, and the need to consider deferring invasive breast procedures in pregnant women when possible.

Breast lactating adenoma, an example of the utility of the radiological-pathological correlation.

Lactating adenomas are benign breast tumors, of which etiology, pathogenesis, and management are not yet fully evident in the literature. The primary goal of the radiological evaluation is to make the differential diagnosis with malignant conditions. We present a case of a 34-year-old pregnant woman referred to our service with a progressively increasing mass in the right breast, in whom the histopathology was consistent with a lactating adenoma.

Diagnostic performance of shear wave elastography in discriminating malignant and benign breast lesions : Our experience with QelaXtoTM software.

STUDY AIMS: We sought to evaluate the diagnostic performance of quantitative elastography (shear wave elastography) and to establish the optimal cutoff value to differentiate malignant and benign breast lesions using QelaXtoTM software. METHODS: We conducted a retrospective observational study of adult women with suspicious breast lesions (BIRADS 3, 4 or 5) who underwent programmed ultrasound-guided core biopsies. Breast lesions were assessed using quantitative elastography combined with B-mode ultrasound. Histopathology was used as reference standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated, and a ROC curve analysis was conducted. Three elastography cutoff values were considered: 36, 50 and 80 kPa. RESULTS: We included 143 women (mean age of 56 years) with a total of 145 breast lesions: 68 benign tumors (47.26%) and 77 malignancies (52.74%). Mean elasticity measurements of benign and malignant lesions were significantly different (24.6 kPa, SD 28.47, vs. 101.49 kPa, SD 47.38, [Formula: see text]). Using the 50 kPa cutoff, elastography showed a global sensitivity of 87% to discriminate malignant lesions (AUC = 0.897). Moreover, sensitivity was 90.7% when lesions were located 5-40 mm below the skin surface (optimal elastographic field of view). Our false positive rate was 17.65%, comprised mainly of fibroepithelial neoplasms, fibroadenomas and fibrosis. CONCLUSIONS: Quantitative elastography can differentiate malignant and benign breast lesions with acceptable to excellent performance. In our sample, the QelaXtoTM software showed a lower optimal cutoff than other ultrasound systems.

Inteligencia Artificial como herramienta en el diagnóstico Mamario. ¿Es una tecnología que ha llegado para quedar? / Artificial Intelligence as a tool in breast diagnosis. Is it a technology that has come to stay?

La Inteligencia Artificial (IA), si bien ha generado gran interés en los últimos cinco años en el campo de la Medicina, no podemos aseverar que se trate de un concepto nuevo, ya que, desde la década del 1940 se publican artículos sobre la materia. La primera vez que tuve ocasión de tomar conocimiento sobre el gran potencial que residía en una computadora fue en mayo de 1997, cuando me encontraba cursando el segundo año de la residencia en Ginecología. Fue una sorpresa leer en el periódico que la máquina llamada "Deep Blue", desarrollada por IBM (International Business Machines), había ganado una competencia virtual de ajedrez al entonces campeón mundial de ajedrez, Garry Kasparov

Eficacia de la mamografía como método de screening para el diagnóstico del cáncer de mama: [revisión] / Effectiveness of mammography as a screening method for breast cancer diagnostic: [review]

Las recientes controversias respecto de las recomendaciones para el screening del cáncer de mama han creado incertidumbre en la comunidad médica y en la población general.Este artículo revisa las recomendaciones actuales para detección de cáncer de mama de varias organizaciones y los datos científicos que respaldan estos lineamientos, además de enfatizar algunas de las controversias y las razones que fundamentan los diferentes puntos de vista. Su propósito es ofrecerle al médico recomendaciones basadas en evidencias, para brindar consejo y asesoramiento a las mujeres que se encuentran en un riesgo promedio de cáncer de mama.

Carcinomas mucinosos puros: experiencia del Hospital Italiano de Buenos Aires / Pure mucinous carcinomas: experience of the Italian Hospital of Buenos Aires

Objetivo: Determinar las características clínico-patológicas de las pacientes tratadas por carcinoma mucinoso puro (CMP) de mama en el Hospital Italiano de Buenos Aires. Material y método: Análisis retrospectivo de todas las pacientes tratadas por CMP de mama, desde enero de 2001 a diciembre de 2010. Resultados: Se registraron 56 casos de carcinomas mucinosos de mama, de los cuales 64,5% (36/56) fueron puros. La media de edad al diagnóstico fue de 67 años. En el 86,1% (31/36) de las pacientes se realizó tratamiento quirúrgico conservador. Las características anatomopatológicas más frecuentes fueron: tamaño tumoral medio de 2 cm, bajo grado histológico y estado de receptores hormonales positivo. Con un seguimiento de 41 meses no se observaron recurrencias locales/regionales ni a distancia. Conclusiones: Los CMP de mama son una entidad poco frecuente, donde el compromiso metastásico de los ganglios axilares no es habitual. Se asocian a baja tasa de recurrencia local/regional y a distancia.