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1.
Zhonghua Bing Li Xue Za Zhi ; 50(4): 344-348, 2021 Apr 08.
Artículo en Chino | MEDLINE | ID: mdl-33831992

RESUMEN

Objective: To study the association between histopathological features and HER2 overexpression/amplification in breast cancers using deep learning algorithms. Methods: A total of 345 HE-stained slides of breast cancer from 2012 to 2018 were collected at the China-Japan Friendship Hospital, Beijing, China. All samples had accurate diagnosis results of HER2 which were classified into one of the 4 HER2 expression levels (0, 1+, 2+, 3+). After digitalization, 204 slides were used for weakly supervised model training, and 141 used for model testing. In the training process, the regions of interest were extracted through cancer detected model and then input to the weakly supervised classification model to tune the model parameters. In the testing phase, we compared performance of the single- and double-threshold strategies to assess the role of the double-threshold strategy in clinical practice. Results: Under the single-threshold strategy, the deep learning model had a sensitivity of 81.6% and a specificity of 42.1%, with the AUC of 0.67 [95% confidence intervals (0.560,0.778)]. Using the double-threshold strategy, the model achieved a sensitivity of 96.3% and a specificity of 89.5%. Conclusions: Using HE-stained histopathological slides alone, the deep learning technology could predict the HER2 status using breast cancer slides, with a satisfactory accuracy. Based on the double-threshold strategy, a large number of samples could be screened with high sensitivity and specificity.


Asunto(s)
Neoplasias de la Mama , Aprendizaje Profundo , Mama , Neoplasias de la Mama/diagnóstico , China , Humanos
2.
Adv Exp Med Biol ; 1310: 385-399, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33834443

RESUMEN

Using the Raman spectroscopic analysis system that gives the chemical information of the biomaterials, classification is performed through the acquisition of fingerprint signals for each cell line, and the basis of the diagnosis is provided. The origin of diagnosis can be clarified by precise analysis through comparison of local signals and morphology in cells, including measurement at tissue level. In this result, normal breast cell line (MCF-10A) and breast cancer cell lines (MDA-MB-231, MDA-MB-453) were characterized using Raman spectroscopy, atomic force microscopy (AFM), and optical microscopy. These three modalities were combined in order to not only separate cancerous and noncancerous cell lines but to analyze their morphological and optical properties. From the results, the inherent optical properties of cancer cells separated from normal cells in terms of local variation were observed. Bright-field (BF) transmission imaging is also compared to the morphological height difference obtained from AFM and is correlated with surface Raman spectra.


Asunto(s)
Neoplasias , Espectrometría Raman , Mama , Línea Celular Tumoral , Humanos , Células MCF-7 , Microscopía de Fuerza Atómica
3.
Gan To Kagaku Ryoho ; 48(3): 437-439, 2021 Mar.
Artículo en Japonés | MEDLINE | ID: mdl-33790180

RESUMEN

A 52-year-old woman experienced right breast pain and detected a mammary tumor 6 months ago. She then noticed rapid enlargement of the tumor, which was suspected to be a borderline malignant phyllodes tumor. The tumor size was approximately 15 cm and presented with skin congestion but without infiltration. The tumor showed internal heterogeneous echo and rich blood flow signals on breast ultrasonography. Ultrasonography also showed swelling of the axillary lymph node. Lymph node cytology revealed the presence of atypical cells in the lymph node, and CT scan showed lymph node metastasis in the right axilla and no distant metastases. We performed mastectomy with lymph node sampling. Pathological examination of the specimens confirmed a malignant phyllodes tumor and a metastatic lymph node. One month later, a subcutaneous mass and multiple pulmonary nodules were identified on a chest CT scan. Chest wall irradiation(45 Gy)and chemotherapy were performed, but the number of pulmonary nodules, pleural effusion, and size of the subcutaneous mass continued to increase. Although she underwent another chemotherapeutic treatment, she died 5 months after the surgery. Thus, we report a case of a malignant phyllodes tumor with an extremely rare lymph node metastasis, which rapidly progressed even though multimodal therapy was performed.


Asunto(s)
Neoplasias de la Mama , Tumor Filoide , Axila , Mama , Neoplasias de la Mama/cirugía , Femenino , Humanos , Ganglios Linfáticos , Metástasis Linfática , Mastectomía , Persona de Mediana Edad , Tumor Filoide/cirugía
4.
Medicine (Baltimore) ; 100(12): e25259, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761723

RESUMEN

RATIONALE: Although single organ vasculitis (SOV) is a rare occurrence and it is difficult to diagnose, its possibility as a cause of fever of unknown origin (FUO) must be considered. Recently, the usefulness of 18F-fluorodeoxyglucose positron emission tomography computed tomography (FDG PET/CT) in the diagnosis of unknown fevers due to vasculitis, especially in cases of small and medium-sized vasculitis, has begun to be pointed out. PATIENT CONCERNS: We report the case of an 84-year-old woman with persisting fever for more than 2 weeks. She had no accompanying symptoms, other than fever, and the physical examination, echocardiography, and contrast-enhanced CT did not reveal any diagnostic clue. DIAGNOSES: The FDG PET/CT revealed positive uptakes of FDG in the left breast, with a standardized uptake value (SUV) of 2.9. The biopsy specimen of the left breast lesion revealed rupture of the elastic plate and evidence of fibrinoid necrosis of arteries, leading to the diagnosis of polyarteritis (PAN). Further angiographic examination and additional imaging did not reveal the presence of other lesions. Therefore, the diagnosis was established as a PAN-SOV of the left breast. INTERVENTIONS: This patient has improved with follow-up only. OUTCOMES: There has been no evidence of a relapse of PAN over a 5-year follow-up period. LESSONS: SOV presenting with unspecific local symptoms is difficult to diagnose based on the medical history and clinical examination. Our findings show that early "Combination of PET-CT and biopsy" can be a powerful diagnostic tool in patients with FUO for whom diagnosis of the underlying cause is difficult despite appropriate clinical examination.


Asunto(s)
Biopsia/métodos , Mama , Arterias Mamarias , Poliarteritis Nudosa , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Anciano de 80 o más Años , Mama/irrigación sanguínea , Mama/diagnóstico por imagen , Diagnóstico Diferencial , Femenino , Fiebre/diagnóstico , Fiebre/etiología , Fluorodesoxiglucosa F18/farmacología , Humanos , Arterias Mamarias/diagnóstico por imagen , Arterias Mamarias/patología , Poliarteritis Nudosa/diagnóstico , Poliarteritis Nudosa/fisiopatología , Radiofármacos/farmacología
5.
Ann Afr Med ; 20(1): 52-58, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33727513

RESUMEN

Background: Early detection of breast cancer is important in reducing mortality, morbidity, and high socioeconomic burden associated with it. Mammography is currently the primary imaging modality used as a screening tool to detect early breast cancer in women experiencing no symptoms as they are most curable in the early stage with availability of breast conservative therapies. Objective: This study aimed at determining the mammographic breast density patterns and outcome in asymptomatic women who presented for mammographic examination in Abuja. Materials and Methods: This descriptive cross-sectional study comprises of 113 asymptomatic women who presented for mammographic examination at the Radiology Department of University of Abuja Teaching Hospital, Gwagwalada from March 2015 to December 2018. Two basic views (craniocaudal and mediolateral views) of the breast were obtained using EXR-650 mammographic machine. Results: The mean age of study population was 40.72 ± 10.45 years with age range of 35 and 65 years. Base on mammographic breast density, breast imaging, reporting, and data system 1 and 2 were the most prevalent. There was a positive correlation between mammographic breast density and age of respondents. This relationship was statistically significant (Pearson correlation = 0.56, P = 0.000). The mammographic outcome among asymptomatic women who had mammographic examination was negative in 69 (61.1%) women and positive in 44 (38.9%). The positive outcome noted in mammograms of women examined was: benign mass in 18 (15.9%) women; 9 (8.0%) had benign calcification; 7 (6.2%) showed architectural distortion; 5 (4.4%) was inconclusive; focal asymmetry in 3 (2.6%); and suspicious mass in 2 (1.8%). Conclusion: In this study, screening of women reveals various benign and malignant breast pathologies which necessitate early interventions.


Asunto(s)
Densidad de la Mama , Neoplasias de la Mama/diagnóstico por imagen , Mama/diagnóstico por imagen , Detección Precoz del Cáncer , Mamografía/métodos , Tamizaje Masivo/métodos , Adulto , Distribución por Edad , Anciano , Neoplasias de la Mama/prevención & control , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Factores Socioeconómicos
6.
JAMA Netw Open ; 4(3): e211974, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33764423

RESUMEN

Importance: Breast cancer screening, surveillance, and diagnostic imaging services were profoundly limited during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic. Objective: To develop a risk-based strategy for triaging mammograms during periods of decreased capacity. Design, Setting, and Participants: This population-based cohort study used data collected prospectively from mammography examinations performed in 2014 to 2019 at 92 radiology facilities in the Breast Cancer Surveillance Consortium. Participants included individuals undergoing mammography. Data were analyzed from August 10 to November 3, 2020. Exposures: Clinical indication for screening, breast symptoms, personal history of breast cancer, age, time since last mammogram/screening interval, family history of breast cancer, breast density, and history of high-risk breast lesion. Main Outcomes and Measures: Combinations of clinical indication, clinical history, and breast cancer risk factors that subdivided mammograms into risk groups according to their cancer detection rate were identified using classification and regression trees. Results: The cohort included 898 415 individuals contributing 1 878 924 mammograms (mean [SD] age at mammogram, 58.6 [11.2] years) interpreted by 448 radiologists, with 1 722 820 mammograms in individuals without a personal history of breast cancer and 156 104 mammograms in individuals with a history of breast cancer. Most individuals were aged 50 to 69 years at imaging (1 113 174 mammograms [59.2%]), and 204 305 (11.2%) were Black, 206 087 (11.3%) were Asian or Pacific Islander, 126 677 (7.0%) were Hispanic or Latina, and 40 021 (2.2%) were another race/ethnicity or mixed race/ethnicity. Cancer detection rates varied widely based on clinical indication, breast symptoms, personal history of breast cancer, and age. The 12% of mammograms with very high (89.6 [95% CI, 82.3-97.5] to 122.3 [95% CI, 108.1-138.0] cancers detected per 1000 mammograms) or high (36.1 [95% CI, 33.1-39.3] to 47.5 [95% CI, 42.4-53.3] cancers detected per 1000 mammograms) cancer detection rates accounted for 55% of all detected cancers and included mammograms to evaluate an abnormal mammogram or breast lump in individuals of all ages regardless of breast cancer history, to evaluate breast symptoms other than lump in individuals with a breast cancer history or without a history but aged 60 years or older, and for short-interval follow-up in individuals aged 60 years or older without a breast cancer history. The 44.2% of mammograms with very low cancer detection rates accounted for 13.1% of detected cancers and included annual screening mammograms in individuals aged 50 to 69 years (3.8 [95% CI, 3.5-4.1] cancers detected per 1000 mammograms) and all screening mammograms in individuals younger than 50 years regardless of screening interval (2.8 [95% CI, 2.6-3.1] cancers detected per 1000 mammograms). Conclusions and Relevance: In this population-based cohort study, clinical indication and individual risk factors were associated with cancer detection and may be useful for prioritizing mammography in times and settings of decreased capacity.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Asignación de Recursos para la Atención de Salud/métodos , Mamografía , Tamizaje Masivo/métodos , Pandemias , Triaje/métodos , Anciano , Mama/diagnóstico por imagen , Mama/patología , Estudios de Cohortes , Detección Precoz del Cáncer , Femenino , Humanos , Anamnesis , Persona de Mediana Edad , Examen Físico , Radiología , Factores de Riesgo
7.
Ann R Coll Surg Engl ; 103(3): e98-e100, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33645284

RESUMEN

Pneumothorax resulting from traumatic thoracic injury is a potentially life-threatening emergency requiring prompt recognition and management with an intercostal drain. A 34-year-old woman was brought into the emergency department after sustaining a stab injury to the right upper outer quadrant of the right breast. She described noticing a jelly-like substance from her wound, on the background of a prior cosmetic breast augmentation. On examination, it was noted that the right breast was significantly swollen. Computed tomography demonstrated a large right sided pneumothorax with associated punctured right breast implant, a 'pneumocapsule' and extensive subcutaneous emphysema of the breast. This case highlights that the fibrous tissue capsule around a breast implant can function as an anatomical space in continuity with the thoracic cavity, masking the diagnosis of pneumothorax in penetrating trauma.


Asunto(s)
Implantes de Mama , Neumotórax/diagnóstico por imagen , Traumatismos Torácicos/diagnóstico por imagen , Heridas Punzantes/diagnóstico por imagen , Adulto , Mama/diagnóstico por imagen , Mama/lesiones , Tubos Torácicos , Femenino , Humanos , Laceraciones , Hígado/diagnóstico por imagen , Hígado/lesiones , Neumotórax/etiología , Neumotórax/terapia , Enfisema Subcutáneo , Traumatismos Torácicos/complicaciones , Toracostomía , Tomografía Computarizada por Rayos X , Heridas Punzantes/complicaciones
8.
Sci Rep ; 11(1): 5282, 2021 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-33674709

RESUMEN

In this study, we evaluated the effectiveness of palliative breast radiation therapy (RT), with single fraction RT compared with fractionated RT. Our study showed that both RT fractionation schemas provide palliation. Single fraction RT allowed for treatment with minimal interference with systemic therapy, whereas fractionated RT provided a more durable palliative response. Due to equivalent palliative response, at our institution we have increasingly been providing single fraction RT palliation during the COVID-19 pandemic.


Asunto(s)
Neoplasias de la Mama/radioterapia , Electrones/uso terapéutico , Recurrencia Local de Neoplasia/radioterapia , Cuidados Paliativos/métodos , Fotones/uso terapéutico , Radiodermatitis/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Mama/patología , Mama/efectos de la radiación , Neoplasias de la Mama/patología , /prevención & control , Fraccionamiento de la Dosis de Radiación , Relación Dosis-Respuesta en la Radiación , Electrones/efectos adversos , Femenino , Estudios de Seguimiento , Humanos , Control de Infecciones/normas , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Pandemias/prevención & control , Fotones/efectos adversos , Oncología por Radiación/normas , Radiodermatitis/etiología , Estudios Retrospectivos , Resultado del Tratamiento
9.
Medicine (Baltimore) ; 100(10): e24023, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725814

RESUMEN

RATIONALE: Fibroadenoma (FA) is a common type of benign breast tumors but ductal carcinoma in situ (DCIS) rarely arises within this tumor type. PATIENT CONCERNS: This case report presents a non-symptomatic 61-year-old woman with FA that was coincidentally found during a breast cancer screening program performed 5 years ago by her city of residence. She had subsequently been followed-up with mammography and breast ultrasound (US). US showed a slightly enlarged tumor and dynamic magnetic resonance imaging (MRI) indicated malignancy within the FA. DIAGNOSIS: The pathological examination revealed low-grade DCIS within the FA. INTERVENTIONS: The patient underwent a core needle biopsy followed by breast-conserving therapy with sentinel lymph node biopsy and then postoperative radiation therapy. OUTCOMES: Currently, she has been followed-up for 2 years without no signs of recurrence. LESSONS: Careful observation with US followed by dynamic MRI is essential in the early diagnosis of DCIS originating in a FA.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Carcinoma Intraductal no Infiltrante/diagnóstico , Fibroadenoma/diagnóstico , Neoplasias Primarias Secundarias/diagnóstico , Enfermedades Asintomáticas/terapia , Biopsia con Aguja , Mama/diagnóstico por imagen , Mama/patología , Mama/cirugía , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Carcinoma Intraductal no Infiltrante/patología , Carcinoma Intraductal no Infiltrante/terapia , Femenino , Fibroadenoma/patología , Fibroadenoma/terapia , Estudios de Seguimiento , Humanos , Hallazgos Incidentales , Mamografía , Mastectomía Segmentaria , Persona de Mediana Edad , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/terapia , Radioterapia Ayuvante , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
10.
Medicine (Baltimore) ; 100(10): e24995, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725875

RESUMEN

BACKGROUND: Adjuvant trastuzumab improves survival outcomes of human epidermal receptor 2 positive early breast cancer patients. Currently, administration of 12 months adjuvant trastuzumab is the standard therapy. However, whether 6 months treatment is non-inferior to the standard 12 months treatment remains controversial. METHODS: Relevant records were searched in PubMed, Cochrane Library, Web of Science, and EMBASE through Jan 14, 2020. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) for disease-free survival (DFS) and overall survival (OS) were meta-analyzed. The primary endpoint was DFS with a non-inferiority hazard margin of 1.2 and the second was OS with 1.43. RESULTS: Three randomized clinical studies met the inclusion criteria, including 3974 patients in 6 months group and 3976 in 12 months group. HR for DFS was 1.18 (95% CI 0.97-1.44, P = .09), with the non-inferiority margin comprised in the 95% CI. HR for OS was 1.14 (95% CI 0.98-1.32, P= .08), whereas the upper limit of 95% CI did not exceed the non-inferiority hazard margin. CONCLUSION: Our analysis failed to show that 6 months treatment was non-inferior to 12 months treatment in improving the DFS. Although the non-inferiority of the 6-month adjuvant trastuzumab treatment was found for OS, considering that breast cancer patients should receive additional systematic therapies when disease progression or relapse happens, we suggest that 12 months adjuvant trastuzumab treatment should remain the standard therapeutic strategy for patients with early human epidermal receptor 2 positive breast cancer.


Asunto(s)
Antineoplásicos Inmunológicos/administración & dosificación , Neoplasias de la Mama/terapia , Recurrencia Local de Neoplasia/epidemiología , Receptor ErbB-2/antagonistas & inhibidores , Trastuzumab/administración & dosificación , Mama/inmunología , Mama/patología , Mama/cirugía , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/inmunología , Neoplasias de la Mama/mortalidad , Quimioterapia Adyuvante/métodos , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Esquema de Medicación , Femenino , Humanos , Mastectomía , Recurrencia Local de Neoplasia/inmunología , Recurrencia Local de Neoplasia/prevención & control , Estadificación de Neoplasias , Receptor ErbB-2/metabolismo , Factores de Tiempo
11.
Medicine (Baltimore) ; 100(10): e25124, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725911

RESUMEN

ABSTRACT: Although some studies have reported the expression and clinical significance of phosphorylated signal transducer and activator of transcription 3 (p-STAT3) in breast cancer tissues, it is still controversial whether p-STAT3 play a role in promoting or suppressing cancer. Here, we used immunohistochemistry analysis to explore expression of p-STAT3 in 407 cases of breast cancer, and analyzed the relationship between p-STAT3 expression and the clinicopathological characteristics and prognosis of breast cancer patients. Positive p-STAT3 expression was seen in 112 cases (27.5%) of breast cancer. p-STAT3 expression was negatively correlated with tumor size, tumor stage and human epidermal growth factor receptor 2 (HER2) status, and the positive rate of p-STAT3 was lowest in HER2-enriched subtype breast cancer (15.3%), while other subtypes were luminal B (23.0%), luminal A (30.2%), and triple-negative breast cancer (TNBC) (37.5%). Logistic regression model multivariate analysis showed that the independent correlation factor of p-STAT3 expression in breast cancer was tumor size (OR = 0.187, 95% CI = 0.042-0.839, P = .029) and HER2 status (OR = 0.392, 95% CI = 0.216-0.710, P = .002). In this study, no clear relationship was observed between patients' prognosis and expression of p-STAT3. Therefore, we suggest that p-STAT3 expression in breast cancer is negatively correlated with tumor size and HER2 status, but appears to have no effect on survival.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/patología , Receptor ErbB-2/metabolismo , Factor de Transcripción STAT3/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/análisis , Mama/patología , Mama/cirugía , Neoplasias de la Mama/mortalidad , China/epidemiología , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Mastectomía , Persona de Mediana Edad , Fosforilación , Pronóstico , Receptor ErbB-2/análisis , Factor de Transcripción STAT3/análisis , Análisis de Matrices Tisulares , Carga Tumoral
13.
Artículo en Inglés | MEDLINE | ID: mdl-33530640

RESUMEN

Thermography is widely used in the medical field, including in the detection of breast disorders. The aim of the research was to characterize the range of breast surface temperature values, taking into account the entire area of the mammary gland and, independently, the nipple, in healthy women. An additional aim was to assess the symmetry of the breast temperature distribution (using an IR camera) and the correlation of temperatures with the content of adipose tissue. Thermograms were made for the right and left breasts, each time delineating the area of the entire breast and a separate area of the nipple, chest, and abdomen. Analyzing the intergroup differences in temperature of selected body areas (Tmean), it was shown that, in all cases, they were significantly higher in younger women. Statistical analysis showed no significant differences between breast and nipple temperatures in relation to the body sides. The highest temperatures within the mammary gland were recorded for the nipple area. The use of the high-resolution digital infrared thermal imaging method in early and screening preventive diagnoses of changes in the mammary gland requires individual interpretation of the results, taking into account the assessment of the physiological pattern of temperature distribution in both breasts.


Asunto(s)
Neoplasias de la Mama , Termografía , Temperatura Corporal , Mama , Femenino , Humanos , Temperatura
14.
J Surg Oncol ; 123(5): 1215-1231, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33621375

RESUMEN

As the sophistication of microsurgical breast reconstruction continues to evolve, plastic surgeons are focusing on techniques to improve functional and psychosocial outcomes for patients, including breast sensation. Interest in neurotization of breast flaps, among both patients and surgeons, has grown significantly in recent years. This study aimed to review the outcomes of neurotization across autologous flap reconstructions, to provide a comprehensive analysis of the efficacy of this technique in improving postoperative sensory recovery.


Asunto(s)
Neoplasias de la Mama/cirugía , Mama/inervación , Mamoplastia/métodos , Regeneración Nerviosa , Transferencia de Nervios/métodos , Sensación/fisiología , Femenino , Humanos , Trasplante Autólogo
15.
Br J Radiol ; 94(1120): 20200880, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33560894

RESUMEN

OBJECTIVES: To assess the value of contrast-enhanced ultrasound (CEUS) for diagnosing malignant non-mass breast lesions (NMLs) and to explore the CEUS diagnostic criteria. METHODS: A total of 116 patients with 119 NMLs detected by conventional US were enrolled. Histopathological results were used as the reference standard. The enhancement characteristics of NMLs in CEUS were compared between malignant and benign NMLs. The CEUS diagnostic criteria for malignant NMLs were established using independent diagnostic indicators identified by binary logistic regression analysis. The diagnostic performance of Breast Imaging Reporting and Data System-US (BI-RADS-US), CEUS, and BI-RADS-US combined with CEUS was evaluated and compared. RESULTS: Histopathological results showed 63 and 56 benign and malignant NMLs. Enhancement degree (OR = 5.75, p = 0.003), enhancement area (OR = 4.25, p = 0.005), and radial or penetrating vessels (OR = 7.54, p = 0.003) were independent diagnostic indicators included to establish the CEUS diagnostic criteria. The sensitivity and specificity of BI-RADS-US, CEUS, and BI-RADS-US combined with CEUS were 100 and 30.2%, 80.4 and 74.6%, and 94.6 and 77.8%, respectively; the corresponding areas under the receiver operating characteristic curve (AUC) were 0.819, 0.775, and 0.885, respectively. CONCLUSIONS: CEUS has a high specificity in malignant NML diagnosis based on the diagnostic criteria including enhancement degree, enhancement area, and radial or penetrating vessels, but with lower sensitivity than BI-RADS-US. The combination of CEUS and BI-RADS-US is an effective diagnostic tool with both high sensitivity and specificity for the diagnosis of malignant NMLs. ADVANCES IN KNOWLEDGE: In this study, we assessed the diagnostic value of CEUS for malignant NMLs and constructed a feasible diagnostic criterion. We further revealed that the combination of CEUS and BI-RADS-US has a high diagnostic value for malignant NMLs.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Medios de Contraste , Aumento de la Imagen/métodos , Ultrasonografía Mamaria/métodos , Adulto , Anciano , Anciano de 80 o más Años , Mama/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto Joven
16.
Ann Intern Med ; 174(2): JC18, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33524283

RESUMEN

SOURCE CITATION: Duffy SW, Vulkan D, Cuckle H, et al. Effect of mammographic screening from age 40 years on breast cancer mortality (UK Age trial): final results of a randomised, controlled trial. Lancet Oncol. 2020;21:1165-72. 32800099.


Asunto(s)
Neoplasias de la Mama , Adulto , Mama , Neoplasias de la Mama/diagnóstico por imagen , Detección Precoz del Cáncer , Femenino , Humanos , Mamografía , Persona de Mediana Edad , Reino Unido
19.
mBio ; 12(1)2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33563823

RESUMEN

Whether mother-to-infant SARS-CoV-2 transmission can occur during breastfeeding and, if so, whether the benefits of breastfeeding outweigh this risk during maternal COVID-19 illness remain important questions. Using RT-qPCR, we did not detect SARS-CoV-2 RNA in any milk sample (n = 37) collected from 18 women following COVID-19 diagnosis. Although we detected evidence of viral RNA on 8 out of 70 breast skin swabs, only one was considered a conclusive positive result. In contrast, 76% of the milk samples collected from women with COVID-19 contained SARS-CoV-2-specific IgA, and 80% had SARS-CoV-2-specific IgG. In addition, 62% of the milk samples were able to neutralize SARS-CoV-2 infectivity in vitro, whereas milk samples collected prior to the COVID-19 pandemic were unable to do so. Taken together, our data do not support mother-to-infant transmission of SARS-CoV-2 via milk. Importantly, milk produced by infected mothers is a beneficial source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness.IMPORTANCE Results from prior studies assaying human milk for the presence of SARS-CoV-2, the causative virus of COVID-19, have suggested milk may act as a potential vehicle for mother-to-child transmission. Most previous studies are limited because they followed only a few participants, were cross-sectional, and/or failed to report how milk was collected and/or analyzed. As such, considerable uncertainty remains regarding whether human milk is capable of transmitting SARS-CoV-2 from mother to child. Here, we report that repeated milk samples collected from 18 women following COVID-19 diagnosis did not contain SARS-CoV-2 RNA; however, risk of transmission via breast skin should be further evaluated. Importantly, we found that milk produced by infected mothers is a source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness as milk likely provides specific immunologic benefits to infants.


Asunto(s)
Anticuerpos Neutralizantes/metabolismo , Anticuerpos Antivirales/metabolismo , Leche Humana/inmunología , Complicaciones Infecciosas del Embarazo/inmunología , /inmunología , Adulto , Mama/virología , Lactancia Materna , /virología , Femenino , Humanos , Lactante , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Leche Humana/virología , Madres , Embarazo , Complicaciones Infecciosas del Embarazo/virología , ARN Viral/aislamiento & purificación , /aislamiento & purificación
20.
Nat Commun ; 12(1): 882, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33563996

RESUMEN

Photoacoustic computed tomography (PACT) has generated increasing interest for uses in preclinical research and clinical translation. However, the imaging depth, speed, and quality of existing PACT systems have previously limited the potential applications of this technology. To overcome these issues, we developed a three-dimensional photoacoustic computed tomography (3D-PACT) system that features large imaging depth, scalable field of view with isotropic spatial resolution, high imaging speed, and superior image quality. 3D-PACT allows for multipurpose imaging to reveal detailed angiographic information in biological tissues ranging from the rodent brain to the human breast. In the rat brain, we visualize whole brain vasculatures and hemodynamics. In the human breast, an in vivo imaging depth of 4 cm is achieved by scanning the breast within a single breath hold of 10 s. Here, we introduce the 3D-PACT system to provide a unique tool for preclinical research and an appealing prototype for clinical translation.


Asunto(s)
Imagenología Tridimensional/métodos , Técnicas Fotoacústicas/métodos , Tomografía Computarizada por Rayos X/métodos , Angiografía , Animales , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Mama/irrigación sanguínea , Mama/diagnóstico por imagen , Diseño de Equipo , Femenino , Neuroimagen Funcional , Humanos , Imagenología Tridimensional/instrumentación , Técnicas Fotoacústicas/instrumentación , Ratas , Tomografía Computarizada por Rayos X/instrumentación
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