The Accuracy of Breast Cancer Diagnostic Tools.

Background Breast cancer (BC) remains a significant health concern, leading to illness and death among women globally. It is essential to detect BC early using imaging techniques that accurately reflect the final pathology, guiding suitable intervention strategies. Objectives This study aimed to evaluate the agreement between radiological findings and histopathological results in BC cases. Methods We conducted a retrospective review of breast core needle biopsies (CNBs) in women over a six-year period (2017-2022) at Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. The pathological diagnoses were compared with the findings from preceding radiological investigations. We also compared the tumour sizes in the resection specimens with their radiological counterparts. Results A total of 641 cases were included in the study. Ultrasound (US), mammography, and magnetic resonance imaging (MRI) yielded diagnostic accuracies of 85%, 77.9%, and 86.9%, respectively. MRI had the highest sensitivity at 72.2%, while US had the lowest at 61%. MRI provided the best agreement with the final resected tumor size. By contrast, mammography tended to overestimate the size (41.9%), and US most frequently underestimated it (67.7%). The connection between basal-like molecular subtypes and the Breast Imaging Reporting and Data System (BIRADS)-5 classifications was only statistically significant for MRI (p = 0.04). The luminal subtype was more likely to show speculation in mammography. Meanwhile, BIRADS-4 revealed a considerable number of benign pathologies across all the three modalities. Conclusions MRI demonstrated the highest accuracy, sensitivity, specificity, and positive predictive value (PPV) for diagnosing and estimating the tumor size. Mammography outperformed US in terms of sensitivity and yielded the highest negative predictive value (NPV). US, meanwhile, offered superior specificity, PPV, and accuracy. Therefore, combining these diagnostic methods could yield significant benefits.

Myopia progression in school children with prolonged screen time during the coronavirus disease confinement.

Background: Myopia, the most common refractive error, is a global public health problem with substantial visual impairment if left untreated. Several studies have investigated the association between increased near-work and restricted outdoor activities in children with myopia; however, such studies in children without myopia are scarce. We aimed to monitor the effect of the coronavirus disease-2019 (COVID-19) home confinement and mandatory virtual learning on myopic progression among myopic and non-myopic school-aged children. Methods: We conducted a retrospective chart review of children aged 6 - 12 years attending regular visits to the pediatric ophthalmology clinic in a tertiary eye hospital in Eastern Province, Saudi Arabia. Cycloplegic refraction was determined from three visits at least six months apart: two visits before the start of the COVID-19 pandemic and one during the COVID-19 home confinement. Parents were asked about the time spent in near-work and outdoor activities, the devices used during virtual learning, and the demographic characteristics of the children. Statistical analyses were conducted to compare myopia progression before and during the COVID-19 home confinement. Results: A total of 160 eyes of 80 children were analyzed. The boy (n = 46) to girl (n = 34) ratio was 1.4:1. The hyperopia (n = 131 eyes) to myopia (n = 29 eyes) ratio was 4.5:1. Most eyes exhibited a hyperopic shift before the confinement; however, all eyes displayed a myopic shift during the confinement. When comparing both eyes of the same individual, the more myopic or less hyperopic eye in the same child had a significantly greater myopic shift than the fellow eye (both P < 0.05). Children who used tablets showed a significant myopic shift (P < 0.05). Likewise, children in both age categories ( ≤ 8 and > 8 years), boys, those living in an apartment, and those having parents with bachelor's degrees experienced a significant myopic shift during COVID-19 home confinement compared to before (all P < 0.05). The mean myopic shift was greater in children aged > 8 years than in those aged ≤ 8 years. Children with and without a family history of myopia had a myopic shift in the mean spherical equivalent during COVID-19 home confinement; however, that of children with no family history was statistically significant (P < 0.05). Conclusions: Progression of myopia accelerated in children during the COVID-19 pandemic. Excessive time spent on digital screen devices at near distances is considered a substantial environmental contributor to myopic shift in children. Further multicenter studies with extended follow-up periods are needed to assess the factors contributing to myopic progression in our population.