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1.
Ann Afr Med ; 20(1): 52-58, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33727513

RESUMO

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.


Assuntos
Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Mamografia/métodos , Programas de Rastreamento/métodos , Adulto , Distribuição por Idade , Idoso , Neoplasias da Mama/prevenção & controle , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Fatores Socioeconômicos
2.
Cancer Epidemiol ; 70: 101879, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33373798

RESUMO

INTRODUCTION: Inconclusive data exist on the association between breast density and breast cancer characteristics. MATERIALS AND METHODS: We conducted a case-only study on 667 invasive breast cancers, using data from the Piedmont Cancer Registry. We applied a multivariate logistic regression model to estimate odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of high breast density (Breast Imaging Reporting and Data System, BI-RADS 3-4) versus low (BI-RADS 1-2) in relation to histologic grade, pathological tumour size and lymph node status, histotype, estrogen and progesterone receptor, HER2 and Ki67 status. Histopathological data were assessed according to the American Joint Committee on Cancer (AJCC) Staging Manual guidelines. The model includes terms for age at diagnosis, education level, body mass index, reproductive factors, family history of breast cancer, smoking and diabetes. RESULTS: As regards histologic grade, compared to well differentiated tumours, the OR of high (versus low) breast density cases was 0.61 (95% CI 0.38-0.98) for moderately-poorly differentiated tumours. No other associations with hormonal and histopathological characteristics were observed. DISCUSSION: Our results indicate that low breast density is associated with moderately-poorly differentiated breast tumours.


Assuntos
Densidade da Mama/fisiologia , Neoplasias da Mama/diagnóstico , Idoso , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade
3.
Clin Imaging ; 69: 115-119, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32717538

RESUMO

PURPOSE: The aim of this study was to assess the accuracy of digital mammography (DM), digital breast tomosynthesis (DBT) and synthetic mammography (SM) in tumor size measurements compared with histological tumor sizes. MATERIALS AND METHODS: 71 breast cancer patients who underwent DM and DBT acquisitions simultaneously were included in this study. One radiologist with 8 years of experience in breast imaging measured tumor sizes independently in three separate sessions which include DM, DBT and SM images, respectively. The correlations between the measured tumor sizes on each imaging technique and histological sizes were analyzed using Spearman correlation test. The patients were categorized into two subgroups according to assigned breast density categories (dense and non-dense), and histological tumor sizes (≤2 cm and > 2 cm). To assess the agreement levels between the measured tumor sizes and histological sizes Bland-Altman analyses were performed for each imaging technique. RESULTS: The mean of histological size of tumors was 23.85 ±â€¯16.57 mm (median: 20). The means of measured tumor sizes were 21.21 ±â€¯13.59 mm (median: 19), 21.52 ±â€¯13.42 mm (median: 19) and 18.97 ±â€¯11.21 mm (median: 17) in DM, DBT and SM, respectively. The Spearman correlation values with histologic sizes were 0.814 (P < 0.001), 0.887 (P < 0.001), and 0.852 (P < 0.001) for DM, DBT and SM, respectively. In subgroup analyses, the correlation values showed decrement for tumors >2 cm in size compared to tumors ≤2 cm in size. CONCLUSION: DBT provides the most accurate tumor size measurements among mammographic imaging techniques and if mammography will be used in tumor size measurements, DBT should be preferred.


Assuntos
Neoplasias da Mama , Mamografia , Mama/diagnóstico por imagem , Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Humanos
4.
Medicine (Baltimore) ; 99(52): e23857, 2020 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-33350778

RESUMO

ABSTRACT: To compare the relationship between background parenchymal enhancement (BPE) on contrast-enhanced spectral mammography (CESM), mammographic breast density (MBD), age, in the group with benign vs malignant breast lesions.Four hundred thirty three non-high-risk patients from January 2018 to May 2019 were retrospectively analyzed. Patients were assigned into 4 groups: premenopausal benign lesions, premenopausal malignant lesions, postmenopausal benign lesions, and postmenopausal malignant lesions. The differences in CESM BPE and MBD between premenopausal benign lesions and premenopausal malignant lesions, between postmenopausal benign lesions and postmenopausal malignant lesions, between premenopausal and postmenopausal benign lesions, and between premenopausal and postmenopausal malignant lesions were evaluated. Pearson Chi-Squared test was used to analyze the differences between the above groups. Spearman rank correlation analysis was used to evaluate the correlations between BPE, MBD, and age. Multiple logistic regression was used to analyze the influencing factors of breast cancer. P < .05 was considered statistically significant.There was no significant difference in CESM BPE or MBD of benign and malignant lesions regardless of premenopausal or postmenopausal status, but there was a significant difference in CESM BPE and MBD of premenopausal and postmenopausal patients regardless of the presence of benign or malignant lesions. The intensity of CESM BPE was positively correlated with MBD, and the intensity of CESM BPE and MBD were negatively correlated with age. Multiple logistic regression analysis showed that age was an influencing factor for breast cancer in both premenopausal and postmenopausal patients.For non-high-risk women, CESM BPE and MBD were not correlated with benign or malignant breast lesions, and age was an influencing factor for breast cancer.


Assuntos
Fatores Etários , Densidade da Mama , Neoplasias da Mama/diagnóstico , Mama , Mamografia/métodos , Neoplasias/diagnóstico , Adulto , Idoso , Mama/diagnóstico por imagem , Mama/patologia , Meios de Contraste/farmacologia , Correlação de Dados , Feminino , Humanos , Aumento da Imagem/métodos , Pessoa de Meia-Idade , Pós-Menopausa , Dados Preliminares , Pré-Menopausa
5.
J Cancer Res Ther ; 16(6): 1258-1264, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33342781

RESUMO

Purpose: The study aimed to assess breast density as a risk factor for breast malignancy using automated volumetric breast density software and to study the relationship of breast density with tumor histopathological characteristics. Materials and Methods: One hundred and thirty-four women with unilateral core biopsy-proven breast cancer were taken in the "case group." Two hundred and one women with normal bilateral screening mammograms were enrolled in the "control group." The cases and controls were further divided into pre- and post-menopausal subgroups. The mammograms of the contralateral breast of the cases and bilateral breasts of the controls were evaluated by automated volumetric breast density software and classified into four density grades. The tumor histopathological characteristics in the various density grades were also evaluated. Results: In premenopausal women, the odds of having breast cancer was significantly higher for Grade 3 breasts (odds ratio [OR] 3.03; 95% confidence interval [CI]: [1.19-7.71]) versus Grade 1 and 2 breasts. Grade 4 premenopausal breasts also had greater odds (OR 3.09; 95% CI [0.89-10.78]) of developing breast cancer. No such relationship was established for postmenopausal women. No significant difference was seen in the histopathology of breast cancer among various breast density groups. Conclusion: Increased breast density can be considered as an inherent, independent risk factor for breast cancer in premenopausal women.


Assuntos
Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Mama/diagnóstico por imagem , Mama/patologia , Adulto , Idoso , Estudos de Casos e Controles , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Mamografia/métodos , Pessoa de Meia-Idade , Razão de Chances , Pré-Menopausa , Fatores de Risco , Software
7.
Medicine (Baltimore) ; 99(46): e23112, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181680

RESUMO

To determine the association between mammographic density (MD) and the risk of breast cancer (BC) in Chinese women and to investigate the role of fertility risk factors in regulating the relationship between MD and BC.We used Quantra software and the BI-RADS classification to assess MD in 466 patients and 932 controls. Conditional matched logistic multiple regression analysis was used to determine the relationship between MD and BC, and risk was evaluated with the odds ratio (OR) and 95% confidence interval (CI).The ORs for category 4 versus category 2 were 1.95 (95% confidence interval [95% CI] (1.42∼2.66)) and 1.76 (95% CI (1.28∼2.42)) for the BI-RADS and Quantra classifications, respectively. The ORs for category 5 volumetric breast density (VBD) versus category 2 VBD and 5 fibroglandular tissue volume (FGV) versus category 2 FGV were 1.63 (95% CI (1.20∼2.23)) and 1.92 (95% CI (1.40∼2.63)), respectively. Females with category 5 VBD whose age at menarche was ≤13 years had the highest risk of BC (OR = 2.16, 95% CI (1.24∼3.79)), and females with category 5 FGV whose age at menarche was = 15 years had the lowest risk of BC (OR = 1.65, 95% CI (1.05∼2.62)). Females with categories 3-5 VBD and categories 3-5 FGV had reduced risks of BC with increasing number of births. Females with category 5 VBD had an increased risk of BC with increasing age at first childbirth (the OR increased from 1.49 to 1.95). Those with category 5 VBD had a reduced risk of BC with increasing breastfeeding duration (the OR decreased from 2.08 to 1.55). Females with category 5 FGV had a reduced risk of BC with increasing breastfeeding duration (the OR decreased from 4.12 to 1.62).Both the BI-RADS density classification and Quantra measures indicated that MD is positively associated with the risk of BC in Chinese women and that associations between MD and BC risk differ by age at menarche, parity, age at first childbirth and breastfeeding duration.


Assuntos
Densidade da Mama , Neoplasias da Mama/diagnóstico , Mama , Mamografia/métodos , Medição de Risco/métodos , Fatores Etários , Mama/diagnóstico por imagem , Mama/patologia , Aleitamento Materno/estatística & dados numéricos , Neoplasias da Mama/epidemiologia , China/epidemiologia , Detecção Precoce de Câncer , Feminino , Humanos , Menarca , Pessoa de Meia-Idade , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , História Reprodutiva , Software
8.
Nat Commun ; 11(1): 5116, 2020 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-33037222

RESUMO

Mammographic density (MD) phenotypes are strongly associated with breast cancer risk and highly heritable. In this GWAS meta-analysis of 24,192 women, we identify 31 MD loci at P < 5 × 10-8, tripling the number known to 46. Seventeen identified MD loci also are associated with breast cancer risk in an independent meta-analysis (P < 0.05). Mendelian randomization analyses show that genetic estimates of dense area (DA), nondense area (NDA), and percent density (PD) are all significantly associated with breast cancer risk (P < 0.05). Pathway analyses reveal distinct biological processes involving DA, NDA and PD loci. These findings provide additional insights into the genetic basis of MD phenotypes and their associations with breast cancer risk.


Assuntos
Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/genética , Predisposição Genética para Doença , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Estudo de Associação Genômica Ampla , Humanos , Mamografia , Análise da Randomização Mendeliana , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1140-1143, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018188

RESUMO

We have developed a deep learning architecture, DualViewNet, for mammogram density classification as well as a novel metric for quantifying network preference of mediolateral oblique (MLO) versus craniocaudal (CC) views in density classification. Also, we have provided thorough analysis and visualization to better understand the behavior of deep neural networks in density classification. Our proposed architecture, DualViewNet, simultaneously examines and classifies both MLO and CC views corresponding to the same breast, and shows best performance with a macro average AUC of 0.8970 and macro average 95% confidence interval of 0.8239-0.9450 obtained via bootstrapping 1000 test sets. By leveraging DualViewNet we provide a novel algorithm and quantitative comparison of MLO versus CC views for classification and find that MLO provides stronger influence in 1,187 out of 1,323 breasts.


Assuntos
Densidade da Mama , Neoplasias da Mama , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Humanos , Mamografia , Redes Neurais de Computação
10.
Medicine (Baltimore) ; 99(39): e22405, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991467

RESUMO

This study aims to compare Quantra, as an automated volumetric breast density (Vbd) tool, with visual assessment according to ACR BI-RADS density categories and to determine its potential usage in clinical practice.Five hundred randomly selected screening and diagnostic mammograms were included in this retrospective study. Three radiologists independently assigned qualitative ACR BI-RADS density categories to the mammograms. Quantra automatically calculates the volumetric density data into the system. The readers were blinded to the Quantra and other readers assessment. Inter-reader agreement and agreement between Quantra and each reader were tested. Region under the curve (ROC) analysis was performed to obtain the cut-off value to separate dense from a non-dense breast. Results with P value <.05 was taken as significant.There were 40.4% Chinese, 27% Malays, 19% Indian and 3.6% represent other ethnicities. The mean age of the patients was 57. 15%, 45.6%, 30.4%, and 9% of patients fall under BI-RADS A, B, C and D density category respectively. Fair agreement with Kappa (κ) value: 0.49, 0.38, and 0.30 were seen for Reader 1, 2 and 3 versus Quantra. Moderate agreement with κ value: 0.63, 0.64, 0.51 was seen when the data were dichotomized (density A and B to "non-dense", C and D to "dense"). The cut-off Vbd value was 13.5% to stratify dense from non-dense breasts with a sensitivity of 86.2% and specificity of 83.1% (AUC 91.4%; confidence interval: 88.8, 94.1).Quantra showed moderate agreement with radiologists visual assessment. Hence, this study adds to the available evidence to support the potential use of Quantra as an adjunct tool for breast density assessment in routine clinical practice in the Asian population. We found 13.5% is the best cut-off value to stratify dense to non-dense breasts in our study population. Its application will provide an objective, consistent and reproducible results as well as aiding clinical decision-making on the need for supplementary breast ultrasound in our screening population.


Assuntos
Densidade da Mama , Mama/diagnóstico por imagem , Mamografia/métodos , Software , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
11.
Rev. colomb. cancerol ; 24(3): 124-129, jul.-set. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1144331

RESUMO

Resumen Objetivo: Establecer la prevalencia de mujeres mayores de 50 años con mamas densas estudiadas por mamografía en el área de Bucaramanga. Métodos: Se realizó un estudio descriptivo retrospectivo durante el periodo comprendido entre enero de 2014 y agosto de 2015, en el que se revisaron 10.110 mamografías de pacientes mayores de 50 años. Posteriormente, se hizo una revisión de la literatura en las principales bases de datos. Resultados: De las 10.110 mamografías realizadas, 4.448 fueron encontradas como positivas para mama densa. De estas, el 39,69% correspondió a tejido mamario heterogéneamente denso y el 4,29%, a tejido mamario extremadamente denso, para un total de 43,9% de los casos estudiados. Conclusión: La densidad mamaria es un factor de riesgo independiente de cáncer de mama, considerado de mediana importancia frente a otros factores. A medida que incrementa la densidad mamaria, se genera la superposición del tejido mamario radio-opaco que puede ocultar y llegar a retardar el diagnóstico de un cáncer subyacente. Dada la alta prevalencia de tejido mamario denso encontrado en la población estudiada, se sugiere complementar el tamizaje con otros métodos de imágenes.


Abstract Objective: To establish the prevalence of dense breast tissue in a group of women aged over 50 years, who were studied with mammography in the city of Bucaramanga (Colombia). Methods: A retrospective descriptive study was conducted from January 2014 to August 2015; 10.110 mammograms of patients aged over 50 years were reviewed. Subsequently, a review of the literature in the main databases was made. Results: From 10.110 mammograms that were performed, 4.448 were found to be positive for dense breast tissue. 39,69% had heterogeneously dense breast tissue, and 4,29% extremely dense breast tissue, for a total result of 43,9% patients with positive dense breast tissue. Conclusion: Breast density is an independent risk factor for breast cancer, being of medium importance compared with other factors. As the breast density increases, the overlap of the radiopaque breast tissue that can hide and delay the diagnosis of an underlying cancer is generated. The high prevalence of dense breast tissue that we found in this population suggests the need of complementing screening with other imaging methods.


Assuntos
Humanos , Feminino , Mamografia , Programas de Rastreamento , Fatores de Risco , Densidade da Mama , Mulheres , Neoplasias da Mama
12.
AJR Am J Roentgenol ; 215(3): 760-764, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32755154

RESUMO

OBJECTIVE. The objective of our study was to compare the performance of digital breast tomosynthesis (DBT)-guided prone and upright breast biopsies. MATERIALS AND METHODS. In this retrospective study, we reviewed all consecutive DBT-guided breast biopsies performed at our institution from May 1, 2018, to July 31, 2019. We recorded patient age, breast density, biopsy indications and technique, number of samples obtained, number of exposures performed, procedure times, percentage of calcifications removed, biopsy complications, histopathologic diagnosis, and radiology-pathology concordance. These characteristics were then compared between biopsy methods using the chi-square test or Wilcoxon rank sum test. RESULTS. There were 282 patients in our study: 215 patients (76.2%) underwent prone DBT-guided biopsy, and 67 (23.8%) underwent upright DBT-guided biopsy. All patients (100%) had technically successfully biopsies. The mean number of exposures for upright biopsies was significantly lower than the mean number of exposures for prone biopsies (p < 0.001). Otherwise, there was no significant difference between the two biopsy methods in the mean number of samples acquired (p = 0.26), mean procedure time (p = 0.67), percentage of calcifications removed (p = 0.31), or biopsy complications (p = 0.56). CONCLUSION. Besides the mean number of exposures acquired, prone and upright DBT-guided biopsies have similar clinical performance. Other factors, such as room utilization and patient comfort, should be considered when deciding between prone and upright DBT-guided biopsies.


Assuntos
Neoplasias da Mama/patologia , Biópsia Guiada por Imagem , Mamografia/métodos , Posicionamento do Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Densidade da Mama , Feminino , Humanos , Pessoa de Meia-Idade , Decúbito Ventral , Estudos Retrospectivos
13.
AJR Am J Roentgenol ; 215(3): 765-769, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32755224

RESUMO

OBJECTIVE. Patients with dense breast tissue are seeking supplemental screening because of the limited sensitivity of mammography. Abbreviated protocol (AP) breast MRI is attractive because it offers a higher cancer detection rate, shorter scan time, and lower cost than full MRI. This article explores the issues of balancing the benefits of AP MRI with safety concerns about gadolinium-based contrast agents, lack of standardization of protocols and field strengths, potential decrease in performance metrics, and potential for overdiagnosis. CONCLUSION. Important questions need to be addressed before AP MRI can be used routinely for breast cancer screening. Evidence is lacking from well-designed prospective trials that can confirm the accuracy and efficacy of AP MRI are comparable with those of other breast imaging modalities. Determining which patients benefit most from AP MRI will help shape future screening guidelines.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Densidade da Mama , Meios de Contraste , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Seleção de Pacientes , Sensibilidade e Especificidade
15.
Croat Med J ; 61(3): 223-229, 2020 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-32643338

RESUMO

AIM: To determine the relationship between breast stiffness assessed with sonoelastography (elasticity) and breast tissue density assessed with mammography (MG) and ultrasound (US). METHODS: This cross-sectional study involved 100 women who underwent MG, gray-scale US, and shear-wave sonoelastography during 2013. Mammographic density was categorized into four groups and sonographic density into three groups according to Breast Imaging-Reporting and Data System criteria. The stiffness of breast parenchymal and adipose tissue in all breast quadrants was quantified by shear-wave sonoelastography. Mean elastographic estimates were compared with MG- and US-derived density estimates. RESULTS: Parenchymal and adipose tissue elasticity positively correlated with MG- and US-derived breast density (for parenchyma: for MG Kendall's tau b 0.522; Jonckheere-Terpstra test P<0.001 and for US Kendall's tau b 0.533; Jonckheere-Terpstra test P<0.001); the higher was the breast density on MG and US, the higher was the elastographic stiffness. CONCLUSION: Sonoelastographic breast stiffness strongly positively correlated with breast density. Thus, sonoelastography may have a potential for estimating the breast cancer risk, which allows a novel application of this technique in routine clinical practice.


Assuntos
Tecido Adiposo/fisiologia , Densidade da Mama/fisiologia , Mama/diagnóstico por imagem , Mama/fisiologia , Técnicas de Imagem por Elasticidade/métodos , Tecido Parenquimatoso/fisiologia , Ultrassonografia Mamária/métodos , Adulto , Idoso , Estudos Transversais , Elasticidade/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Ultrassonografia
16.
AJR Am J Roentgenol ; 215(2): 277-284, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32551908

RESUMO

OBJECTIVE. The purpose of this article is to review clinical uses and image interpretation of molecular breast imaging (MBI) and clarify radiation risks. CONCLUSION. MBI detects additional cancers compared with conventional imaging in women with dense breasts and those with elevated risk of breast cancer. Its role as an imaging biomarker of cancer risk and in assessing neoadjuvant chemotherapy response is growing. Radiation risk is minimal; benefit-to-risk ratio is similar to that of mammography. MBI is low cost, well tolerated, and easily adapted into clinical practice.


Assuntos
Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Imagem Molecular , Feminino , Humanos , Lesões por Radiação/epidemiologia , Medição de Risco
17.
Br J Radiol ; 93(1112): 20200154, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32525693

RESUMO

OBJECTIVES: To assess the associations between automated volumetric estimates of mammographic asymmetry and breast cancers detected at the same ("contemporaneous") screen, at subsequent screens, or in between (interval cancers). METHODS: Automated measurements from mammographic images (N = 79,731) were used to estimate absolute asymmetry in breast volume (BV) and dense volume (DV) in a large ethnically diverse population of attendees of a UK breast screening programme. Logistic regression models were fitted to assess asymmetry associations with the odds of a breast cancer detected at contemporaneous screen (767 cases), adjusted for relevant confounders.Nested case-control investigations were designed to examine associations between asymmetry and the odds of: (a) interval cancer (numbers of cases/age-matched controls: 153/646) and (b) subsequent screen-detected cancer (345/1438), via conditional logistic regression. RESULTS: DV, but not BV, asymmetry was positively associated with the odds of contemporaneous breast cancer (P-for-linear-trend (Pt) = 0.018). This association was stronger for first (prevalent) screens (Pt = 0.012). Both DV and BV asymmetry were positively associated with the odds of an interval cancer diagnosis (Pt = 0.060 and 0.030, respectively). Neither BV nor DV asymmetry were associated with the odds of having a subsequent screen-detected cancer. CONCLUSIONS: Increased DV asymmetry was associated with the risk of a breast cancer diagnosis at a contemporaneous screen or as an interval cancer. BV asymmetry was positively associated with the risk of an interval cancer diagnosis. ADVANCES IN KNOWLEDGE: The findings suggest that DV and BV asymmetry may provide additional signals for detecting contemporaneous cancers and assessing the likelihood of interval cancers in population-based screening programmes.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Mamografia , Interpretação de Imagem Radiográfica Assistida por Computador , Idoso , Mama/patologia , Densidade da Mama , Neoplasias da Mama/patologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Mamografia/efeitos adversos , Pessoa de Meia-Idade , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Fatores de Risco , Fatores de Tempo , Reino Unido
18.
Cancer Causes Control ; 31(9): 827-837, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32476101

RESUMO

PURPOSE: We investigated the associations of aspirin and other non-steroid anti-inflammatory drugs with mammographic breast density (MBD) and their interactions in relation to breast cancer risk. METHODS: This study included 3,675 cancer-free women within the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII) cohorts. Percent breast density (PD), absolute dense area (DA), and non-dense area (NDA) were measured from digitized film mammograms using a computer-assisted thresholding technique; all measures were square root-transformed. Information on medication use was collected in 1980 (NHS) and 1989 (NHSII) and updated biennially. Medication use was defined as none, past or current; average cumulative dose and frequency were calculated for all past or current users from all bi-annual questionnaires preceding the mammogram date. We used generalized linear regression to quantify associations of medications with MBD. Two-way interactions were examined in logistic regression models. RESULTS: In multivariate analysis, none of the anti-inflammatory medications were associated with PD, DA, and NDA. We found no interactions of any of the medications with PD with respect to breast cancer risk (all p-interactions > 0.05). However, some of the aspirin variables appeared to have positive associations with breast cancer risk limited only to women with PD 10-24% (past aspirin OR 1.56, 95% CI 1.03-2.35; current aspirin with < 5 years of use OR 1.82, 95% CI 1.01-3.28; current aspirin with ≥ 5 years of use OR 1.89, 95% CI 1.26-2.82). CONCLUSIONS: Aspirin and NSAIDs are not associated with breast density measures. We found no interactions of aspirin with MBD in relation to breast cancer risk.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Aspirina/administração & dosagem , Densidade da Mama/efeitos dos fármacos , Neoplasias da Mama/epidemiologia , Mama/diagnóstico por imagem , Adulto , Mama/citologia , Mama/efeitos dos fármacos , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Estudos de Coortes , Feminino , Humanos , Modelos Lineares , Mamografia , Pessoa de Meia-Idade , Análise Multivariada , Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia
19.
PLoS One ; 15(5): e0233369, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32433664

RESUMO

INTRODUCTION: Cadmium (Cd) is a heavy metal, which is widespread in the environment and has been hypothesized to be a metalloestrogen and a breast cancer risk factor. Mammographic density (MD) reflects the composition of the breast and was proposed to be used as a surrogate marker for breast cancer. The aim of our study was to investigate association between cadmium concentration in urine and mammographic density. METHODS: A cross-sectional study included 517 women aged 40-60 years who underwent screening mammography in Lódz, Poland. Data were collected through personal interviews and anthropometric measurements. Spot morning urine samples were obtained. The examination of the breasts included both craniocaudal and mediolateral oblique views. Raw data ("for processing") generated by the digital mammography system were analysed using Volpara Imaging Software, The volumetric breast density(%) and fibrograndular tissue volume(cm3) were determined. Cadmium concentration in urine was analysed using the standard ICP-MS method. RESULTS: After adjusting for key confounders including age, BMI, family breast cancer, mammographic device, season of the year of mammography, and age at menarche, an inverse association of Cd and volumetric breast density was found, which was attenuated after further adjustment for smoking. Associations of Cd with dense volume were null. CONCLUSIONS: These findings suggest that Cd is not positively associated with breast density, a strong marker of breast cancer risk, when examined in a cross-sectional fashion.


Assuntos
Densidade da Mama/efeitos dos fármacos , Neoplasias da Mama/etiologia , Cádmio/urina , Mamografia/métodos , Adulto , Neoplasias da Mama/diagnóstico , Cádmio/toxicidade , Estudos Transversais , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Polônia/epidemiologia , Medição de Risco , Fatores de Risco , Software
20.
Sci Rep ; 10(1): 8608, 2020 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-32451404

RESUMO

To evaluate the relationship of the extent and quantitative intensity of background parenchymal enhancement (BPE) on contrast-enhanced spectral mammography (CESM) with age, breast density, menstruation status, and menstrual cycle timing. This retrospective study included women who underwent CESM from July 2017 to March 2019 and who had menstruation status records. BPE category assessment was performed subjectively. BPE intensity was quantitatively measured using regions-of-interest. 208 subjects were included (150 were regular menstrual cycle and 58 were postmenopausal). The breast density was classified as category B in 11 subjects, category C in 231 subjects, and category D in 23 subjects. Subjects based on menstrual cycle timing, 24 at days 1-7, 55 at days 8-14, 48 at days 15-21, and 23 at days 22-28. Both quantitative and categorical analyses show a weak negative correlation between BPE and age in all subjects, but there was no significant correlation in premenopausal patients. Both the BPE pixel intensity value and BPE category was significantly lower in postmenopausal patients than in premenopausal patients, and there was no significant difference in breast density according to BPE. The minimum and maximum pixel values of BPE on days 8-14 of the menstrual cycle was significantly lower than those on days 15-21. There was no correlation between BPE level and menstrual cycle timing. Breast density with category D was more likely to have a lower BPE level than category C. We show here that BPE level is affected by menstruation status and menstrual cycle timing. We suggest that CESM should not be performed on days 15-21 of the menstrual cycle, but on days 8-14.


Assuntos
Mama/diagnóstico por imagem , Meios de Contraste/química , Aumento da Imagem/métodos , Mamografia , Menstruação/fisiologia , Adolescente , Adulto , Fatores Etários , Idoso , Mama/fisiologia , Densidade da Mama , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Estudos Retrospectivos , Adulto Jovem
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