Patients' Perceptions and Attitudes to the Use of Artificial Intelligence in Breast Cancer Diagnosis: A Narrative Review.

Breast cancer remains the most prevalent cancer among women worldwide, necessitating advancements in diagnostic methods. The integration of artificial intelligence (AI) into mammography has shown promise in enhancing diagnostic accuracy. However, understanding patient perspectives, particularly considering the psychological impact of breast cancer diagnoses, is crucial. This narrative review synthesizes literature from 2000 to 2023 to examine breast cancer patients' attitudes towards AI in breast imaging, focusing on trust, acceptance, and demographic influences on these views. Methodologically, we employed a systematic literature search across databases such as PubMed, Embase, Medline, and Scopus, selecting studies that provided insights into patients' perceptions of AI in diagnostics. Our review included a sample of seven key studies after rigorous screening, reflecting varied patient trust and acceptance levels towards AI. Overall, we found a clear preference among patients for AI to augment rather than replace the diagnostic process, emphasizing the necessity of radiologists' expertise in conjunction with AI to enhance decision-making accuracy. This paper highlights the importance of aligning AI implementation in clinical settings with patient needs and expectations, emphasizing the need for human interaction in healthcare. Our findings advocate for a model where AI augments the diagnostic process, underlining the necessity for educational efforts to mitigate concerns and enhance patient trust in AI-enhanced diagnostics.

Advancements in Standardizing Radiological Reports: A Comprehensive Review.

Standardized radiological reports stimulate debate in the medical imaging field. This review paper explores the advantages and challenges of standardized reporting. Standardized reporting can offer improved clarity and efficiency of communication among radiologists and the multidisciplinary team. However, challenges include limited flexibility, initially increased time and effort, and potential user experience issues. The efforts toward standardization are examined, encompassing the establishment of reporting templates, use of common imaging lexicons, and integration of clinical decision support tools. Recent technological advancements, including multimedia-enhanced reporting and AI-driven solutions, are discussed for their potential to improve the standardization process. Organizations such as the ACR, ESUR, RSNA, and ESR have developed standardized reporting systems, templates, and platforms to promote uniformity and collaboration. However, challenges remain in terms of workflow adjustments, language and format variability, and the need for validation. The review concludes by presenting a set of ten essential rules for creating standardized radiology reports, emphasizing clarity, consistency, and adherence to structured formats.

Safety of autologous fat grafting in breast cancer: a multicenter Italian study among 17 senonetwork breast units autologous fat grafting safety: a multicenter Italian retrospective study.

BACKGROUND: Autologous fat grafting (AFG), defined as the re-implant to the breast of fat tissue from different body areas, has been firstly applied to esthetic plastic surgery and then has moved to reconstructive surgery, mainly used for scar correction and opposite breast altering. Nevertheless, due to the potentially unsafe stem-like properties of adipocytes at the tumoral bed level, no clear evidence of the procedure's oncological safety has been clearly documented at present. PATIENTS AND METHODS: We retrospectively collected data of early breast cancer (BC) patients from 17 Italian Breast Units and assessed differences in terms of locoregional recurrence rate (LRR) and locoregional recurrence-free survival (LRFS) between patients who underwent AFG and patients who did not. Differences were analyzed in the entire cohort of invasive tumors and in different subgroups, according to prognostic biological subtypes. RESULTS: With a median follow-up time of 60 months, LRR was 5.3% (n = 71) in the matched population, 3.9% (n = 18) in the AFG group, and 6.1% (n = 53) in the non-AFG group, suggesting non-inferiority of AFG (p = 0.084). Building Kaplan-Meier curves confirmed non-inferiority of the AFG procedure for LRFS (aHR 0.73, 95% CI 0.41-1.30, p = 0.291). The same effect, in terms of LRFS, was also documented among different biological subtypes (luminal-like group, aHR 0.76, 95% CI 0.34-1.68, p = 0.493; HER2 enriched-like, aHR 0.89, 95% CI 0.19-4.22, p = 0.882; and TNBC, aHR 0.61, 95% CI 0.12-2.98, p = 0.543). CONCLUSIONS: Our study confirms in a very large, multicenter cohort of early BC patients that, aside the well-known benefits on the esthetic result, AFG do not interfere negatively with cancer prognosis.

The P.I.N.K. Study Approach for Supporting Personalized Risk Assessment and Early Diagnosis of Breast Cancer.

Breast cancer is a clear example of excellent survival when it is detected and properly treated in the early stage. Currently, screening of this cancer relies on mammography, which may be integrated by new imaging techniques for more exhaustive evaluation. The Personalized, Integrated, Network, Knowledge (P.I.N.K.) study is a longitudinal multicentric study involving several diagnostic centres across Italy, co-ordinated by the Italian National Research Council and co-funded by the Umberto Veronesi Foundation. Aim of the study is to evaluate the increased diagnostic accuracy in detecting cancers obtained with different combinations of imaging technologies, and find the most effective diagnostic pathway matching the characteristics of an individual patient. The study foresees the enrolment of 50,000 women over the age of 40 years presenting for breast examination and providing informed consent to data handling. So far, the 15 participating centres across Italy have recruited a total of 22,848 patients. Based on the analyses of the first 175 histopathological-proven breast cancers, mammographic sensitivity was estimated to be 61.7% (n = 108 cancers), whereas diagnostic accuracy increased by 35.5% (n = 44 cancers) when mammography was integrated with other imaging modalities (ultrasound and/or digital breast tomosynthesis). Increase was mainly determined by ultrasound alone. Given the ongoing data collection and recruitment, the number of cancers detected is too low to allow any further in-depth analysis to explore links to patient characteristics. Past studies show that the uniform approach of population screening guidelines should be revised in favour of more personalised regimens, where known standards are integrated by imaging techniques most suitable for the individual's characteristics. With the ultimate goal of identifying early breast cancer detection strategies, our preliminary results suggest that integrated diagnostic approach could lead to a paradigm shift from an age-based regimen toward more specific and effective risk-based personalised screening regimens, in order to reduce mortality from breast cancer.