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1.
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
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1787-1790, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018345

RESUMO

Medical Microwave Imaging (MWI) has been studied as a technique to aid breast cancer diagnosis. Several different prototypes have been proposed but most of them require the use of a coupling medium between the antennas and the breast, in order to reduce skin backscattering and avoid refraction effects. The use of dry setups has been addressed and recent publications show promising results. In this paper, we assess the importance of considering refraction effects in the image reconstruction algorithms. To this end, we consider a simplified homogeneous spherical model of the breast and analytically compute the propagating rays through the air-body interface. The comparison of results considering only direct ray propagation or refracted rays shows negligible impact on the accuracy of the images for moderately high permittivity media. Thus, we may avoid the computational burden of calculating the refracted rays in convex shapes.


Assuntos
Neoplasias da Mama , Micro-Ondas , Algoritmos , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1919-1922, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018377

RESUMO

Photoacoustic imaging which combines high contrast of optical imaging and high resolution of ultrasound imaging, can provide functional information, potentially playing a crucial role in the study of breast cancer diagnostics. However, open source dataset for PA imaging research is insufficient on account of lacking clinical data. To tackle this problem, we propose a method to automatically generate breast numerical model for photoacoustic imaging. The different type of tissues is automatically extracted first by employing deep learning and other methods from mammography. And then the tissues are combined by mathematical set operation to generate a new breast image after being assigned optical and acoustic parameters. Finally, breast numerical model with proper optical and acoustic properties are generated, which are specifically suitable for PA imaging studies, and the experiment results indicate that our method is feasible with high efficiency.


Assuntos
Técnicas Fotoacústicas , Mama/diagnóstico por imagem , Aprendizado Profundo , Humanos , Análise Espectral , Ultrassonografia
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2003-2006, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018396

RESUMO

Breast-conserving surgery, also known as lumpectomy, is an early stage breast cancer treatment that aims to spare as much healthy breast tissue as possible. A risk associated with lumpectomy is the presence of cancer positive margins post operation. Surgical navigation has been shown to reduce cancer positive margins but requires manual segmentation of the tumor intraoperatively. In this paper, we propose an end-to-end solution for automatic contouring of breast tumor from intraoperative ultrasound images using two convolutional neural network architectures, the U-Net and residual U-Net. The networks are trained on annotated intraoperative breast ultrasound images and evaluated on the quality of predicted segmentations. This work brings us one step closer to providing surgeons with an automated surgical navigation system that helps reduce cancer-positive margins during lumpectomy.


Assuntos
Neoplasias da Mama , Mastectomia Segmentar , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Redes Neurais de Computação , Ultrassonografia Mamária
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2047-2050, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018407

RESUMO

Ultrasound images are potentially invaluable for imaging internal organs and diseases. However, due to noise, they are still difficult to interpret. We apply and compare supervised machine learning approaches to train a model of lesions using features with unsupervised machine learning approaches to segment and detect tumours in breasts. Two synthetic and one real datasets are used in our experiments. The best system performance is achieved by Frost Filter with Quick Shift.


Assuntos
Neoplasias da Mama , Mama , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Humanos , Aprendizado de Máquina Supervisionado , Ultrassonografia , Aprendizado de Máquina não Supervisionado
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2178-2181, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018438

RESUMO

Cancer has affected the human community to a large extent due to its low survival rate towards the end stage of the disease. It is asymptomatic in many cases during the initial stage. Thus the dependency on early diagnosis and regular check up increases manifold. Computer Aided Diagnostic Model is the need of the hour which will increase the diagnostic efficiency. A total of 400 images acquired from the Digital Database for Screening Mammography have been used here for analysis. This paper proposes a novel technique to differentiate benign and malignant breast lesions in mammograms using multiresolution analysis and Schmid Filter Bank, which were not reported earlier. A three level Haar wavelet decomposed image(L1, L2, L3) is obtained for each Region of Interest. In each level Texton based analysis is further investigated through Schmid filter bank. Statistical features and Haralick's Features are obtained from filter response and Gray Level Cooccurence Matrix respectively. Partition Membership Filter is further applied to the feature matrix for feature partitioning. The method shows maximum accuracy of 98.63% and Area under Curve of 0.981 using Random Forest Classifier and ten fold cross validation.


Assuntos
Neoplasias da Mama , Análise de Ondaletas , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer , Humanos , Mamografia
7.
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
8.
Medicine (Baltimore) ; 99(30): e20797, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791669

RESUMO

To evaluate the value of a breast computed tomography (CT) (B-CT) in assessing breast density, pathologies and implant integrity in women with breast implants.This retrospective study was approved by the local ethics committee. B-CT images of 21 women with implants (silicone/saline; 20 bilateral, 1 unilateral) who underwent opportunistic screening or diagnostic bilateral B-CT were included. Breast density, implant integrity, extensive capsular fibrosis, soft tissue lesions and micro-/macrocalcifications were rated. In 18 of the 21 women, an additional ultrasound and in two patients breast magnetic resonance imaging was available for comparison. The average dose was calculated for each breast using verified Monte Carlo simulations on 3D image data sets.Breast density was nearly completely fatty (ACR a) in two patients, scattered fibroglandular (ACR b) in five, heterogeneously dense (ACR c) in ten and very dense (ACR d) in four women. In three women showed a unilateral positive Linguine sign indicative of an inner capsule rupture. Extensive capsular fibrosis was found in three women. In three women, soft tissue lesions were depicted, which revealed to be cysts (n = 2) and lymph nodes (n = 1) on subsequent sonography. Diffuse, non-clustered microcalcifications were found in nine women. Eleven women showed cutaneous or intramammary macrocalcifications. Average dose was 6.45 mGy (range 5.81-7.28 mGy).In women with implants, B-CT presents a promising modality for evaluating breast density, implant integrity, extensive capsular fibrosis, soft tissue lesions and micro-/macrocalcifications without the need of breast compression utilizing a lower dose compared to doses reported for conventional four-view mammography.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Implantes de Mama , Mama/diagnóstico por imagem , Tomografia Computadorizada Espiral , Adulto , Idoso , Mama/patologia , Feminino , Fibrose , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
9.
Adv Exp Med Biol ; 1252: 17-25, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816258

RESUMO

All breast disorders found during pregnancy and lactation should be carefully evaluated. Most of them are benign, but it is essential to exclude pregnancy-associated breast cancer (PABC), which is too often diagnosed late. The first-line imaging technique is ultrasound (US), which must be completed by mammography if there is any clinical or US suspicious sign . In lactating patients with PABC , breast magnetic resonance imaging (MRI) can be useful for local assessment.Management depends on the precise analysis and BI-RADS classification of the lesion. During pregnancy and lactation, there is an overlap in imaging: many benign lesions can grow, infarct, become heterogeneous and thus suspicious, and on the other hand, PABC does not always present with typical malignant features. That is why biopsy must be performed if after the clinical and radiological evaluation the doubt persists, i.e. for all BI-RADS 4 and 5 lesions, and for some BI-RADS 3 lesions.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Mama/diagnóstico por imagem , Lactação , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Mamografia , Gravidez
10.
Lancet Oncol ; 21(9): 1165-1172, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32800099

RESUMO

BACKGROUND: The appropriate age range for breast cancer screening remains a matter of debate. We aimed to estimate the effect of mammographic screening at ages 40-48 years on breast cancer mortality. METHODS: We did a randomised, controlled trial involving 23 breast screening units across Great Britain. We randomly assigned women aged 39-41 years, using individual randomisation, stratified by general practice, in a 1:2 ratio, to yearly mammographic screening from the year of inclusion in the trial up to and including the calendar year that they reached age 48 years (intervention group), or to standard care of no screening until the invitation to their first National Health Service Breast Screening Programme (NHSBSP) screen at approximately age 50 years (control group). Women in the intervention group were recruited by postal invitation. Women in the control group were unaware of the study. The primary endpoint was mortality from breast cancers (with breast cancer coded as the underlying cause of death) diagnosed during the intervention period, before the participant's first NHSBSP screen. To study the timing of the mortality effect, we analysed the results in different follow-up periods. Women were included in the primary comparison regardless of compliance with randomisation status (intention-to-treat analysis). This Article reports on long-term follow-up analysis. The trial is registered with the ISRCTN registry, ISRCTN24647151. FINDINGS: 160 921 women were recruited between Oct 14, 1990, and Sept 24, 1997. 53 883 women (33·5%) were randomly assigned to the intervention group and 106 953 (66·5%) to the control group. Between randomisation and Feb 28, 2017, women were followed up for a median of 22·8 years (IQR 21·8-24·0). We observed a significant reduction in breast cancer mortality at 10 years of follow-up, with 83 breast cancer deaths in the intervention group versus 219 in the control group (relative rate [RR] 0·75 [95% CI 0·58-0·97]; p=0·029). No significant reduction was observed thereafter, with 126 deaths versus 255 deaths occurring after more than 10 years of follow-up (RR 0·98 [0·79-1·22]; p=0·86). INTERPRETATION: Yearly mammography before age 50 years, commencing at age 40 or 41 years, was associated with a relative reduction in breast cancer mortality, which was attenuated after 10 years, although the absolute reduction remained constant. Reducing the lower age limit for screening from 50 to 40 years could potentially reduce breast cancer mortality. FUNDING: National Institute for Health Research Health Technology Assessment programme.


Assuntos
Fatores Etários , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/normas , Mamografia/normas , Adulto , Idoso , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Feminino , Humanos , Mamoplastia , Pessoa de Meia-Idade , Sistema de Registros , Reino Unido
11.
PLoS One ; 15(8): e0237674, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790772

RESUMO

Breast cancer is the most common cancer in women and poses a great threat to women's life and health. Mammography is an effective method for the diagnosis of breast cancer, but the results are largely limited by the clinical experience of radiologists. Therefore, the main purpose of this study is to perform two-stage classification (Normal/Abnormal and Benign/Malignancy) of two- view mammograms through convolutional neural network. In this study, we constructed a multi-view feature fusion network model for classification of mammograms from two views, and we proposed a multi-scale attention DenseNet as the backbone network for feature extraction. The model consists of two independent branches, which are used to extract the features of two mammograms from different views. Our work mainly focuses on the construction of multi-scale convolution module and attention module. The final experimental results show that the model has achieved good performance in both classification tasks. We used the DDSM database to evaluate the proposed method. The accuracy, sensitivity and AUC values of normal and abnormal mammograms classification were 94.92%, 96.52% and 94.72%, respectively. And the accuracy, sensitivity and AUC values of benign and malignant mammograms classification were 95.24%, 96.11% and 95.03%, respectively.


Assuntos
Neoplasias da Mama/diagnóstico , Aprendizado Profundo , Detecção Precoce de Câncer/métodos , Mamografia/métodos , Programas de Rastreamento/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Mama/diagnóstico por imagem , Bases de Dados Factuais , Conjuntos de Dados como Assunto , Feminino , Humanos
12.
Ann R Coll Surg Engl ; 102(8): 577-580, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32777930

RESUMO

INTRODUCTION: An increasing quantity of data is required to guide precision medicine and advance future healthcare practices, but current analytical methods often become overwhelmed. Artificial intelligence (AI) provides a promising solution. Plastic surgery is an innovative surgical specialty expected to implement AI into current and future practices. It is important for all plastic surgeons to understand how AI may affect current and future practice, and to recognise its potential limitations. METHODS: Peer-reviewed published literature and online content were comprehensively reviewed. We report current applications of AI in plastic surgery and possible future applications based on published literature and continuing scientific studies, and detail its potential limitations and ethical considerations. FINDINGS: Current machine learning models using convolutional neural networks can evaluate breast mammography and differentiate benign and malignant tumours as accurately as specialist doctors, and motion sensor surgical instruments can collate real-time data to advise intraoperative technical adjustments. Centralised big data portals are expected to collate large datasets to accelerate understanding of disease pathogeneses and best practices. Information obtained using computer vision could guide intraoperative surgical decisions in unprecedented detail and semi-autonomous surgical systems guided by AI algorithms may enable improved surgical outcomes in low- and middle-income countries. Surgeons must collaborate with computer scientists to ensure that AI algorithms inform clinically relevant health objectives and are interpretable. Ethical concerns such as systematic biases causing non-representative conclusions for under-represented patient groups, patient confidentiality and the limitations of AI based on the quality of data input suggests that AI will accompany the plastic surgeon, rather than replace them.


Assuntos
Inteligência Artificial , Interpretação de Imagem Assistida por Computador , Procedimentos Cirúrgicos Reconstrutivos , Big Data , Mama/diagnóstico por imagem , Mama/cirurgia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mamografia
13.
Anticancer Res ; 40(7): 3633-3643, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620602

RESUMO

BACKGROUND/AIM: With the increase in detection of non-palpable breast lesions through screening, wire-guided localisation (WGL) has long been the favoured method for preoperative localisation. However, this technique comes with several limitations. New methods have been developed, including several non-radioactive, wireless options. We aimed to assess the effectiveness of Savi Scout® localisation (SSL) through this pooled analysis and systematic review. MATERIALS AND METHODS: A number of databases were searched for records reporting data on localisation and retrieval of SSL reflectors, as well as re-excision rate. We included our own data from 20 patients (22 reflectors) at our institution. RESULTS: A total of 842 reflectors were inserted across eleven studies and our own data. Pooled analysis revealed an overall successful deployment rate of 99.64% and a successful retrieval rate of 99.64% using SSL. A statistically significant difference in re-excision rate was found in a smaller pooled analysis conducted across four studies comparing SSL and WGL (12.9% and 21.1% respectively, p<0.01). CONCLUSION: The Savi Scout® localisation system is a safe and effective alternative to WGL. It facilitates flexible scheduling by decoupling radiology and surgery interventions and may reduce the need for re-excision procedures for positive surgical margins.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Mama/diagnóstico por imagem , Mama/patologia , Radiografia/métodos , Feminino , Humanos , Margens de Excisão , Radar
14.
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
15.
Am Surg ; 86(8): 1029-1031, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32721172

RESUMO

BACKGROUND: Breast cancer is the most commonly diagnosed noncutaneous malignancy and remains the second leading cause of cancer deaths in women. The Savi Scout (Cianna Medical, Merit Medical Systems, Inc. South Jordan, UT) is a wireless, nonradioactive, wave reflection implant system that enables surgeons to remove targeted breast lesions. Our study aims to be the largest comparison of wire and Savi Scout localization techniques for positive margin, complication, and reoperation rates. METHODS: Single-institution retrospective review of 512 patients that had Savi Scout Surgical Guidance System breast lesion biopsy or wire localized breast biopsy from May 2017 to December 2018. A RedCaps database was created and reviewed for outcomes. RESULTS: For 320 Savi scout patients, margins were positive or less than 1 mm in 18 cases (5.6%). 17 (5.3%) patients required reoperation. Surgical site occurrence was found in 7 (2.1%) patients, and 2 patients required intervention (0.6%). For 175 wire localization patients, margins were positive or less than 1 mm in 24 patients, and all required reoperation (13.7%). A surgical site occurrence was found in 13 (7.4%) patients and 5 patients required intervention (2.8%). DISCUSSION: In our series, the Savi Scout localization system resulted in a lower rate of positive margins, reoperation, and surgical site occurrence. These data suggest that Savi Scout localization is a reasonable replacement to wire localization for breast lesions and might produce superior results.


Assuntos
Neoplasias da Mama/cirurgia , Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Marcadores Fiduciais , Mastectomia Segmentar/métodos , Radar , Cirurgia Assistida por Computador/instrumentação , Adulto , Idoso , Biópsia , Mama/diagnóstico por imagem , Mama/cirurgia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/patologia , Feminino , Humanos , Margens de Excisão , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Cirurgia Assistida por Computador/métodos
16.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(2): 69-71, abr.-jun. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-193713

RESUMO

La mastopatía diabética es una entidad infrecuente. La presentación más común suele ser en forma de nódulo único o múltiple. Sus características clínicas y radiológicas pueden simular un cáncer de mama, por lo que debe tenerse en cuenta este diagnóstico diferencial en las pacientes jóvenes y con antecedentes de diabetes mellitus. Un correcto diagnóstico puede evitar tratamientos quirúrgicos innecesarios. Presentamos 2 casos que hemos diagnosticado en nuestra área sanitaria así como la revisión de la bibliografía al respecto


Diabetic mastopathy is an uncommon disorder, in which the most frequent presentation is as a single or multiple nodules. It can imitate breast cancer both clinically and radiologically. A differential diagnosis should be done in young patients with a personal history of diabetes, in order to avoid unnecessary surgical interventions. Two cases are presented that were diagnosed in our health area, as well as a review of the literature on this pathology


Assuntos
Humanos , Feminino , Adulto , Doença da Mama Fibrocística/diagnóstico por imagem , Doença da Mama Fibrocística/cirurgia , Doença da Mama Fibrocística/complicações , Diagnóstico Diferencial , Fibroadenoma/complicações , Mama/diagnóstico por imagem , Mama/patologia , Biópsia por Agulha Fina/métodos , Diabetes Mellitus/diagnóstico
17.
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
18.
Clin Imaging ; 65: 143-146, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32505103

RESUMO

PURPOSE: The aim of the study was to evaluate the effect of a one-hour lecture based communication curriculum on breast imaging trainees' confidence in communicating with patients in a challenging communication setting such as delivering bad news or radiologic error disclosure. METHODS: 12 breast imaging trainees from an academic fellowship program completed questionnaires before and after a communication tutorial. A four breast imaging specific scenario questionnaire assessed confidence by asking the trainees to rank agreement with statements related to their attitude in those specific settings. 12-month follow-up questionnaire was sent to the graduating fellows assessing their -overall confidence in patient communication, the contribution of the curriculum to their self-perceived communication skill and their likelihood in disclosing a radiologic error to a patient. RESULTS: All trainees completed the pre and post lecture questionnaire. After the communication tutorial, all trainees reported increased confidence in communicating with patients in a variety of challenging settings with pre lecture survey mean confidence score of 38/98 and post lecture survey mean score of 85.3/98, P = 0.003. Three of eight trainees who completed the 12-month follow up questionnaire reported confidence in their communication skills and reported that the tutorial significantly contributed to their communication skill development. All three agreed that they would be likely to disclose a medical error should they encounter it in their future career. CONCLUSIONS: A limited resource one-hour lecture communication tutorial provides effective communication training for breast imaging fellows and is a promising part of a breast imaging curriculum.


Assuntos
Mama/diagnóstico por imagem , Relações Médico-Paciente , Radiologia/educação , Competência Clínica , Comunicação , Currículo , Bolsas de Estudo , Feminino , Humanos , Inquéritos e Questionários , Revelação da Verdade
20.
Eur J Cancer ; 135: 101-102, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32563013
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