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1.
Am J Case Rep ; 22: e929309, 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34226439

RESUMO

BACKGROUND Extranodal non-Hodgkin lymphomas (NHL) are low-grade B-cell lymphomas and the breast is not a common site for this condition. This case report describes a 62-year-old woman with a primary NHL and ductal carcinoma in situ (DCIS) of the left breast diagnosed by a magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy. The simultaneous diagnosis of breast cancer and NHL is rare, with few cases described in the literature. Primary breast lymphomas account only for 0.04% to 0.5% of breast malignancies. CASE REPORT In November 2016, a 62-year-old woman was treated for a peripheral T-cell lymphoma (follicular helper T-cell phenotype) of the left upper central breast; later she underwent periodic breast imaging follow-ups. In October 2018, MRI revealed a focal 33-mm non-mass contrast enhancement (according to the Breast Imaging Reporting and Data System -MRI lexicon of the American College of Radiology) in the lower external quadrant of the left breast. Neither mammography nor ultrasonography demonstrated any suspicious features. The multidisciplinary medical team performed an MRI-guided vacuum-assisted breast biopsy and the histological analysis confirmed the diagnosis of a DCIS. Subsequently, she underwent surgery resulting in eradication of the disease and has had regular follow-ups, including mammography, ultrasonography, and MRI. CONCLUSIONS This is a rare case of both a primary NHL of the breast and DCIS, which was detected only by MRI. It highlights the role of an MRI-guided vacuum-assisted breast biopsy, which allows an accurate and economic diagnosis in case of suspicious findings on MRI. We recommend the use of MRI in follow-ups for patients with previous breast lymphomas (high-risk patients).


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Linfoma de Células T Periférico , Biópsia , Neoplasias da Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Feminino , Humanos , Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética , Mamografia , Pessoa de Meia-Idade
2.
Prev Med ; 151: 106540, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34217424

RESUMO

The COVID-19 pandemic disrupted breast cancer screening and diagnostic imaging in the United States. We sought to evaluate how medical facilities prioritized breast imaging services during periods of reduced capacity or upon re-opening after closures. In fall 2020, we surveyed 77 breast imaging facilities within the Breast Cancer Surveillance Consortium in the United States. The survey ascertained the pandemic's impact on clinical practices during March-September 2020. Nearly all facilities (97%) reported closing or operating at reduced capacity at some point during this period. All facilities were open by August 2020, though 14% were still operating at reduced capacity in September 2020. During periods of re-opening or reduced capacity, 93% of facilities reported prioritizing diagnostic breast imaging over breast cancer screening. For diagnostic imaging, facilities prioritized based on rescheduling canceled appointments (89%), specific indication for diagnostic imaging (89%), patient demand (84%), individual characteristics and risk factors (77%), and time since last imaging examination (72%). For screening mammography, facilities prioritized based on rescheduled cancelations (96%), patient demand (83%), individual characteristics and risk factors (73%), and time since last mammogram (71%). For biopsy services, more than 90% of facilities reported prioritization based on rescheduling of canceled exams, patient demand, patient characteristics and risk factors and level of suspicion on imaging. The observed patterns from this large and geographically diverse sample of facilities in the United States indicate that multiple factors were commonly used to prioritize breast imaging services during periods of reduced capacity.


Assuntos
Neoplasias da Mama , COVID-19 , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Programas de Rastreamento , Pandemias , SARS-CoV-2 , Estados Unidos
3.
Prev Med ; 151: 106602, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34217417

RESUMO

The COVID-19 pandemic forced the Dutch national breast screening program to a halt in week 12, 2020. In week 26, the breast program was resumed at 40% capacity, which increased to 60% in week 34. We examined the impact of the suspension and restart of the screening program on the incidence of screen-detected and non-screen-detected breast cancer. We selected women aged 50-74, diagnosed during weeks 2-35 of 2018 (n = 7250), 2019 (n = 7302), or 2020 (n = 5306), from the Netherlands Cancer Registry. Weeks 2-35 were divided in seven periods, based on events occurring at the start of the COVID-19 pandemic. Incidence of screen-detected and non-screen-detected tumors was calculated overall and by age group, cT-stage, and cTNM-stage for each period in 2020, and compared to the incidence in the same period of 2018/2019 (averaged). The incidence of screen-detected tumors decreased during weeks 12-13, reached almost zero during weeks 14-25, and increased during weeks 26-35. Incidence of non-screen-detected tumors decreased to a lesser extent during weeks 12-16. The decrease in incidence was seen in all age groups and mainly occurred for cTis, cT1, DCIS, and stage I tumors. Due to the suspension of the breast cancer screening program, and the restart at reduced capacity, the incidence of screen-detected breast tumors decreased by 67% during weeks 9-35 2020, which equates to about 2000 potentially delayed breast cancer diagnoses. Up to August 2020 there was no indication of a shift towards higher stage breast cancers after restart of the screening.


Assuntos
Neoplasias da Mama , COVID-19 , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer , Feminino , Humanos , Incidência , Mamografia , Programas de Rastreamento , Países Baixos/epidemiologia , Pandemias , SARS-CoV-2
4.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(6): 898-908, 2021 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-34238743

RESUMO

OBJECTIVE: To assess the imaging performance of digital breast tomography (DBT) based on systematic simulation. OBJECTIVE: The raw measurements of physical phantoms at a variety of radiation dose levels and clinical patients at the normal radiation dose were acquired from a clinical DBT system for low-dose simulation and reconstruction using 3 reconstruction algorithms, namely Feldkamp-Davis-Kress (FDK), simultaneous algebraic reconstruction technique (SART) and adaptive steepest-descent projection onto convex sets with total-variation constraint (ASDPOCS-TV) algorithms. The image quality was compared across different radiation dose levels and reconstruction algorithms in terms of signal-to-noise ratio (SNR), peak signal-to-noise ratio (PSNR), noise-power spectrum (NPS), artifact spread function (ASF) and full width at half maximum (FWHM) of ASF indexes. OBJECTIVE: The reliability of low-dose DBT simulation strategy was verified by the experiment. Within a suitable range of dose levels, increasing the doses resulted in reduced high-frequency noise component and significantly increased SNR (P < 0.05). But when the value of exposure was below 40 mAs, the images acquired at different dose levels had similar representation. The performance of the 3 reconstruction algorithms varied for different anatomical structures, and the image quality of ASDPOCS-TV algorithm was generally superior to SART and FDK algorithms with less through-plane artifacts and noise. OBJECTIVE: The quality of DBT images is significantly affected by both radiation dose and reconstruction algorithms. A tradeoff of the parameters, the overall image quality and the clinical needs for diagnostic purposes should be considered to achieve the optimal imaging performance on a given clinical task.


Assuntos
Artefatos , Mamografia , Algoritmos , Humanos , Processamento de Imagem Assistida por Computador , Imagens de Fantasmas , Reprodutibilidade dos Testes , Razão Sinal-Ruído
5.
Sensors (Basel) ; 21(13)2021 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-34283105

RESUMO

Ultrasound breast imaging is a promising alternative to conventional mammography because it does not expose women to harmful ionising radiation and it can successfully image dense breast tissue. However, conventional ultrasound imaging only provides morphological information with limited diagnostic value. Ultrasound computed tomography (USCT) uses energy in both transmission and reflection when imaging the breast to provide more diagnostically relevant quantitative tissue properties, but it is often based on time-of-flight tomography or similar ray approximations of the wave equation, resulting in reconstructed images with low resolution. Full-waveform inversion (FWI) is based on a more accurate approximation of wave-propagation phenomena and can consequently produce very high resolution images using frequencies below 1 megahertz. These low frequencies, however, are not available in most USCT acquisition systems, as they use transducers with central frequencies well above those required in FWI. To circumvent this problem, we designed, trained, and implemented a two-dimensional convolutional neural network to artificially generate missing low frequencies in USCT data. Our results show that FWI reconstructions using experiment data after the application of the proposed method successfully converged, showing good agreement with X-ray CT and reflection ultrasound-tomography images.


Assuntos
Neoplasias da Mama , Aprendizado Profundo , Densidade da Mama , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Mamografia , Imagens de Fantasmas , Ultrassonografia Mamária
6.
Rev Bras Enferm ; 74(3): e20200995, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34259730

RESUMO

OBJECTIVES: to analyze care strategies for breast cancer screening in Primary Health Care in Brazil. METHODS: this is a systematic review following the Cochrane Collaboration recommendations. RESULTS: among 355 manuscripts, five were eligible. The patient navigation program by Community Health Agent stood out with the best result, among the strategies: flexibility of goals considering viability; community engagement; team training; active search of the target population by Community Health Agent; request for mammography by physicians; actions integrated to women's health; monitoring of mammography results, absent users, and population coverage by physician and nurse; and assessment of criteria for requesting screening mammography by means of an information system. The population coverage rate in the program ranged from 23% to 88%. CONCLUSIONS: Primary Health Care in Brazil presents devices with potential to induce the production of care for breast cancer screening.


Assuntos
Neoplasias da Mama , Brasil , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Atenção Primária à Saúde
7.
Sensors (Basel) ; 21(14)2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34300597

RESUMO

Microcalcification clusters in mammograms are one of the major signs of breast cancer. However, the detection of microcalcifications from mammograms is a challenging task for radiologists due to their tiny size and scattered location inside a denser breast composition. Automatic CAD systems need to predict breast cancer at the early stages to support clinical work. The intercluster gap, noise between individual MCs, and individual object's location can affect the classification performance, which may reduce the true-positive rate. In this study, we propose a computer-vision-based FC-DSCNN CAD system for the detection of microcalcification clusters from mammograms and classification into malignant and benign classes. The computer vision method automatically controls the noise and background color contrast and directly detects the MC object from mammograms, which increases the classification performance of the neural network. The breast cancer classification framework has four steps: image preprocessing and augmentation, RGB to grayscale channel transformation, microcalcification region segmentation, and MC ROI classification using FC-DSCNN to predict malignant and benign cases. The proposed method was evaluated on 3568 DDSM and 2885 PINUM mammogram images with automatic feature extraction, obtaining a score of 0.97 with a 2.35 and 0.99 true-positive ratio with 2.45 false positives per image, respectively. Experimental results demonstrated that the performance of the proposed method remains higher than the traditional and previous approaches.


Assuntos
Neoplasias da Mama , Calcinose , Neoplasias da Mama/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Computadores , Feminino , Humanos , Mamografia , Redes Neurais de Computação
8.
Artigo em Inglês | MEDLINE | ID: mdl-34063854

RESUMO

Breast cancer (BC) is the cancer with the highest incidence in women in the world. In this last period, the COVID-19 pandemic has caused in many cases a drastic reduction of routine breast imaging activity due to the combination of various factors. The survival of BC is directly proportional to the earliness of diagnosis, and especially during this period, it is at least fundamental to remember that a diagnostic delay of even just three months could affect BC outcomes. In this article we will review the state of the art of breast imaging, starting from morphological imaging, i.e., mammography, tomosynthesis, ultrasound and magnetic resonance imaging and contrast-enhanced mammography, and their most recent evolutions; and ending with functional images, i.e., magnetic resonance imaging and contrast enhanced mammography.


Assuntos
Neoplasias da Mama , COVID-19 , Neoplasias da Mama/diagnóstico por imagem , Diagnóstico Tardio , Feminino , Humanos , Imageamento por Ressonância Magnética , Mamografia , Pandemias , SARS-CoV-2
10.
Wiad Lek ; 74(4): 842-848, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34155990

RESUMO

OBJECTIVE: The aim: Comparing sensitivity and specificity of digital breast tomosynthesis and full-field digital mammography in breast cancer detection associated with four different types of asymmetries according to BI-RADS Atlas. PATIENTS AND METHODS: Materials and methods: Study included 201 patients with four types of asymmetries according BI-RADS atlas (asymmetry - 81 (40,3%), focal asymmetry - 82 (40,8%), global asymmetry - 36 (17,9%) and developing asymmetry - 2 (1,0%)) who underwent full-field digital mammography, digital breast tomosynthesis and hand-held full breast ultrasound from January 2017 to June 2018. The general rate of breast cancer for the 201 patients with asymmetries was 8 cases (4,0%) (IBC, n=6 (3,0%); DCIS, n=2 (1,0%) other findings associated with asymmetries were non-malignant, n=10 (5,0%) (sclerosing adenosis, n=5 (2,5%); fibroadenomatosis, n=3 (1,5%); simple cyst, n=1 (0,5%); radial scar associated with papilloma, typical ductal hyperplasia and sclerosing adenosis, n=1 (0,5%). RESULTS: Results: Analysis of the results showed that sensitivity of digital breast tomosynthesis was 75.0% [95% CI, 34.91% to 96.81%] and specificity was 94.8% [95% CI, 90.68% to 97.49%] which was superior to full-field digital mammography sensitivity 50.0% [95% CI, 15.70% to 84.30%] and specificity 91.19% [95% CI, 86.27% to 94.78%] for breast cancer detection associated with different types of asymmetries. CONCLUSION: Conclusions: Using of digital breast tomosynthesis in assessment of breast asymmetries can improve sensitivity and specificity in breast cancer detection and reduce number of unnecessary biopsies and short-interval follow-up examinations.


Assuntos
Neoplasias da Mama , Biópsia , Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Estudos Retrospectivos , Sensibilidade e Especificidade
11.
Artigo em Inglês | MEDLINE | ID: mdl-34069375

RESUMO

Screening mammography is used worldwide for the early detection of breast cancer in women experiencing no symptoms. The Breast Imaging Reporting and Database System (BI-RADS) is used to report mammographic findings. However, little is known about the clinical characteristics of Asian women with BI-RADS category 0, and we aimed to explore such characteristics in the context of Taiwan. This retrospective cross-sectional study was conducted using data from a single tertiary medical center. We examined the association of blood test data and estrogen exposure-related medical histories with BI-RADS reports from screening mammography of 4280 women between 1 January 2010 and 31 July 2019. The data of 4280 participants were evaluated, and they were categorized into BI-RADS category 0 (n = 413; 9.6%) and 1-5 (n = 3867; 90.4%) subgroups. In a multivariate analysis, breast surgery history and premenopausal status had a positive relationship with a category 0 status, with respective risk increases of 64% and 34% (p = 0.010 and 0.013). Hormone contraceptive use for ≥5 years was a negative independent predictor of having a category 0 status. In conclusion, breast surgery history and premenopausal status significantly increased the likelihood of individuals having incomplete mammographic findings, even when they were older than 45 years. Identifying related factors before screening mammography is helpful for clinical physicians to arrange more proper and alternative examination and obtain a definite diagnosis.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico por imagem , Estudos Transversais , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Estudos Retrospectivos , Taiwan/epidemiologia
12.
Rozhl Chir ; 100(4): 166-172, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34182758

RESUMO

INTRODUCTION: Ductal carcinoma in situ (DCIS) is a very heterogenous disease. The incidence of DCIS has been increasing with the adoption of mammography screening. This opened new questions concerning surgical and adjuvant therapy.  Methods: We retrospectively observed the incidence of DCIS amongst the patients that underwent surgical resection in EUC clinic Zlín between 2017 and 2019. We also assessed the extent of breast surgery including interventions in axilla and the adjuvant therapy.  Results: There were 616 breast cancer patients, of whom 44 (7.1%) were diagnosed with DCIS. Breast-conserving surgery was performed in 35 (80%) patients. Lumpectomy alone was performed in 21 (47%) patients. Mastectomy was indicated primarily in 9 cases with additional two mastectomies performed to achieve clear margins. All sentinel nodes were negative.  Conclusion: Results confirmed, that the surgical therapy as well as radiotherapy and hormonal treatment are performed according to guidelines at our department. Proportion of sentinel node biopsy is remarkably higher, therefore an improvement in this area is our next goal.


Assuntos
Neoplasias da Mama , Carcinoma Intraductal não Infiltrante , Neoplasias da Mama/cirurgia , Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Carcinoma Intraductal não Infiltrante/cirurgia , Feminino , Humanos , Mamografia , Mastectomia , Mastectomia Segmentar , Estudos Retrospectivos
13.
Eur J Radiol ; 141: 109790, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34091135

RESUMO

OBJECTIVES: To identify associations between baseline ultrasound (US) and mammographic features and metastasis free survival (MFS) in women receiving neo-adjuvant chemotherapy (NACT) for breast cancer. METHODS: The data were collected as part of an ethically approved prospective study. Women with invasive breast cancer receiving NACT who were metastasis free at diagnosis were included. Baseline US and mammography were performed. Imaging was assessed by an experienced breast radiologist who was blinded to outcomes. US imaging features documented included posterior effect, skin thickening, size and stiffness using shear wave elastography (SWE). The mammographic features documented were spiculation and microcalcification. The development of metastatic disease was ascertained from computer records. Statistical analysis was performed using Kaplan Meier survival curves and Receiver Operator Characteristic (ROC) analysis. RESULTS: 171 women with 172 cancers were included in the study and 55 developed metastatic disease. Mean follow-up was 6.0 years. Women with mammographic calcification had significantly poorer metastasis free survival (MFS) compared to women without calcification (p = 0.043, 6 yr MFS 50 % vs 69 %). Women bearing cancer with distal shadowing had poorer MFS than women without shadowing (p = 0.025, 6 yr MFS 47 % vs. 73 %). Women with US skin thickening had poorer MFS compared to women without skin thickening (p = 0.032, 6 yr MFS 52 % vs. 68 %). Mammographic spiculation, US size and stiffness at SWE had no significant association with MFS. CONCLUSION: We have identified mammographic and US features associated with MFS in women receiving NACT. Such information may be useful when counselling patients about the benefits and risks of NACT.


Assuntos
Neoplasias da Mama , Terapia Neoadjuvante , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Feminino , Humanos , Mamografia , Estudos Prospectivos , Ultrassonografia
14.
BMJ Open ; 11(6): e046353, 2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34158298

RESUMO

BACKGROUND: Published estimations of the extent of breast cancer overdiagnosis vary widely, and there have been heated debates around these estimations. Some high estimates have even been the basis of campaigns against national breast cancer screening programmes. Identifying some of the sources of heterogeneity between different estimates would help to clarify the issue. METHODS: The simple case of neuroblastoma-a childhood cancer-screening is used to describe the basic principle of overdiagnosis estimation. The more complicated mechanism of breast cancer overdiagnosis is described based on data from Denmark, taking into account the type of data used, individual or aggregated. FINDINGS: The type of data used in overdiagnosis studies has a meaningful effect on the estimation: no study based on individual data provides an estimate higher than 17%, while studies based on aggregated data often provide estimates higher than 40%. This is too systematic to be random. The analysis of two Danish studies, one of each kind, highlights the biases that come with the use of aggregated data and shows how they can lead to overdiagnosis. INTERPRETATION: Many estimates of overdiagnosis associated with breast cancer screening programmes are serious overestimations.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico , Criança , Detecção Precoce de Câncer , Feminino , Humanos , Incidência , Mamografia , Programas de Rastreamento , Sobremedicalização
15.
Medicine (Baltimore) ; 100(26): e26531, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190189

RESUMO

ABSTRACT: The aim of this study was to compare the sensitivity of mammography (MG), ultrasound (US), magnetic resonance imaging (MRI), and combinations of these imaging modalities for the detection of small (≤2 cm) breast cancer and to evaluate the benefit of preoperative breast MRI after performing conventional imaging techniques for small breast cancer.This was an observational retrospective review of 475 patients with pathologically confirmed breast cancer. We reviewed the medical records; assessed the preoperative reports of MG, US, and MRI; and categorized them as benign features (BI-RADS 1-3) or malignant features (BI-RADS 4 or 5). The criterion standard for detection was the pathologic assessment of the surgical specimen. The sensitivities of the different techniques were compared using the McNemar test.Among the 475 women, the sensitivity of MG was significantly greater in patients with low breast density than in those with high breast density (84.5% vs 65.8%, P < .001). US had higher sensitivity than MG (P < .001), and the combination of MG + US showed better sensitivity than MG or US alone (P < .001). Further addition of MRI to the combination of MG and US statistically contributed to the sensitivity yield (from 93.3% to 98.2%; P < .001) but did not significantly increase the mastectomy rate (from 48.2% to 49.3%; P = .177).MG has limited diagnostic sensitivity in patients with small breast cancer, especially in those with dense breast tissue. US is better than MG at detecting small breast cancer, regardless of breast density. The addition of MRI to MG and US could increase sensitivity without increasing the mastectomy rate. This study suggests performing MRI routinely on the basis of MG and US for small (≤2 cm) breast cancer.


Assuntos
Neoplasias da Mama , Imageamento por Ressonância Magnética/métodos , Mamografia/métodos , Mastectomia , Ultrassonografia Mamária/métodos , Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , China/epidemiologia , Feminino , Humanos , Mastectomia/métodos , Mastectomia/estatística & dados numéricos , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Cuidados Pré-Operatórios/métodos , Estudos Retrospectivos , Carga Tumoral
16.
Eur J Radiol ; 141: 109826, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34174485

RESUMO

BACKGROUND: Atypical lesions found on percutaneous breast biopsy raise specific management issues. The aim of this study was to validate the previous performance of a decision tree defined by Forgeard et al to select a subset of patients at low-risk of surgical diagnostic upgrade that would be eligible for surveillance. METHODS: A consecutive series of 211 patients diagnosed with ADH on vacuum-assisted biopsy (VAB) of clustered microcalcifications alone, then operated in our institution, was reviewed. Histological findings on percutaneous cores were compared with definitive diagnoses on surgical specimens. The rate of cancer underestimation on VAB was analyzed in the four arms and two management attitudes defined in the scheme, using size and quality of microcalcification removal and the number of ADH foci. RESULTS: Ninety-eight women with ADH met the inclusion criteria. Overall, 20 cancers were diagnosed at surgery, showing a malignancy rate of 44% (17/39 patients) in the surgery group and of 5% (3/59 patients) in the surveillance group, which was not significantly different from the 2% rate in the monitored reference group (p > 0.64). The malignancy rate increased significantly with the size of clustered microcalcifications (0% when < 6mm, 17% when between 6mm and 21 mm, 48% when > 21 mm, p < 0001) and the number of ADH foci on VAB (14% when ≤ 2, 45% when > 2, p < 0.005). CONCLUSION: Our results corroborate - within the limits of large confidence intervals - those obtained with the reference decision tree. Due to statistical uncertainty, however, they need to be prospectively validated in a broader series.


Assuntos
Neoplasias da Mama , Calcinose , Carcinoma Intraductal não Infiltrante , Mama/diagnóstico por imagem , Mama/patologia , Mama/cirurgia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Calcinose/diagnóstico por imagem , Calcinose/patologia , Carcinoma Intraductal não Infiltrante/patologia , Árvores de Decisões , Feminino , Humanos , Hiperplasia/patologia , Mamografia , Seleção de Pacientes , Estudos Retrospectivos
17.
Phys Med ; 87: 90-98, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34130221

RESUMO

PURPOSE: Mammography is the diagnostic imaging practice used in screening to detect early lesions suspected of malignancy. It uses a low energy X-ray beam in which a low dose in the order of 2-3 mGy is delivered to patient breast cells. However, it has been speculated that it could lead to significant cell damage, when compared to conventional X-ray. We investigated the biological effects of low doses, with mean glandular doses (MGDs) of 2.5 mGy and 2.5 + 2.5 mGy, on mammary cells in vitro. METHODS: We used the non-tumorigenic cell line (MCF-10A) and two tumor cells lines (MCF-7 and MDA-MB-231). Colony formation, apoptosis, and double-strand DNA breaks (DSBs) were quantified. RESULTS: The selected MGD regimens did not alter the formation of colonies by any of the cell lines. MCF-7 cells exhibited a markedly increase in apoptosis, 24 h after the single-dose protocol; MCF-10A cells underwent apoptosis only after 72 h, with both irradiation regimens, while MDA-MB-231 cells (highly invasive and metastatic) were not susceptible to apoptosis. The detection of γH2AX histone in the nuclei of irradiated cells showed that the double-dose resulted in increase of DSBs, especially in tumor cell lines. CONCLUSIONS: Although the health benefits of early breast screening remain indisputable, our future perspective is to better understand the biological basis for the effects of low dose radiation on breast cells and to investigate if and under what conditions there would be a risky situation in repeated mammography screening, in both asymptomatic and symptomatic women.


Assuntos
Neoplasias da Mama , Mamografia , Mama , Linhagem Celular Tumoral , Quebras de DNA de Cadeia Dupla , Feminino , Humanos , Raios X
18.
Eur J Radiol ; 140: 109751, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34000600

RESUMO

PURPOSE: The aim of this work was to compare, in a clinical study, digital mammography and synthetic mammography imaging by evaluating the contrast in microcalcifications of different sizes. METHODS: A retrospective review of microcalcifications from 46 patients was undertaken. A Hologic 3-Dimensions mammography system and a HD Combo protocol was used for simultaneous acquisition of the digital and synthetic images. Microcalcifications were classified in accordance with their size, and patient breast images were classified in accordance with their density as adipose, moderately dense and dense. The contrast of the microcalcifications was measured and the contrast ratio between synthetic and digital images was compared. An additional qualitative assessment of the images was presented to correlate the conspicuity of the microcalcifications with the suppression of the structure noise. RESULTS: Microcalcifications in adipose background always exhibit a comparable or better contrast on synthetic images, regardless their size. For moderately dense background, synthetic images show a better contrast in 91.2 % of cases for small microcalcifications and in 90.9 % of cases for large microcalcifications. For a dense background, better contrast is seen in 89.5 % of cases for small microcalcifications, and in 85.7 % of cases for large microcalcifications. The contrast ratio increases with increasing breast glandularity. The suppression of structure noise also contributes to the enhancement of microcalcifications in the synthetic images. CONCLUSIONS: Synthetic mammography imaging is superior to digital mammography imaging in terms of microcalcification contrast, regardless their size and breast density.


Assuntos
Doenças Mamárias , Neoplasias da Mama , Calcinose , Mama/diagnóstico por imagem , Doenças Mamárias/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Humanos , Mamografia , Intensificação de Imagem Radiográfica , Estudos Retrospectivos
19.
Eur J Radiol ; 140: 109747, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34000597

RESUMO

PURPOSE: The primary aim was to develop and validate a novel mammography positioning measure, specifically incorporating parameters which might relate to mammography pain. We then explored relationships between the new adverse positioning score and (1) pain; (2) patient and technique factors. METHODS: A 15-item instrument incorporating positioning features with potential to relate to mammography pain was developed. Participants' mammograms (n = 310) were reviewed for presence of these features. Validity was investigated using the Rasch model. Scores produced by the resultant measure were investigated for associations with patients' pain scores and relevant patient and technique factors, using Pearson correlation, analysis of variance, and multiple linear regression. RESULTS: Statistical indices within the Rasch measurement framework provided good evidence that the measure reflected a coherent construct of adverse positioning. Thus, the scores produced with the measurement instrument were valid for use in further statistical analysis. There is, however, scope for improvement of the measure's discriminatory properties. Adverse positioning scores were higher for greater breast volumes (r = 0.12, p=.0391) and body mass index (BMI) (r = 0.13, p=.0349), and varied by mammographer (F(11,298) 2.38, p = .0078). The relationships with BMI and mammographer persisted in regression modelling. No relationship was found between adverse positioning and pain. CONCLUSIONS: Evidence from Rasch analysis suggests that this novel measure is valid for quantifying a coherent "adverse positioning" construct in mammography. Adverse positioning scores varied by mammographer and were related to higher patient BMI but not to mammography pain. The measure warrants expansion, further refinement, and testing in larger studies.


Assuntos
Mama , Mamografia , Humanos , Modelos Lineares , Posicionamento do Paciente , Reprodutibilidade dos Testes , Inquéritos e Questionários
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