Breast radiation dose with contrast-enhanced mammography-guided biopsy: a retrospective comparison with stereotactic and tomosynthesis guidance.

OBJECTIVES: This retrospective study aimed to compare the average glandular dose (AGD) per acquisition in breast biopsies guided by contrast-enhanced mammography (CEM), conventional stereotactic breast biopsy (SBB), and digital breast tomosynthesis (DBT). The study also investigated the influence of compressed breast thickness (CBT) and density on AGD. Furthermore, the study aimed to estimate the AGD per procedure for each guidance modality. METHODS: The study included 163 female patients (mean age 57 ± 10 years) who underwent mammography-guided biopsies using SBB (9%), DBT (65%), or CEM (26%) guidance. AGD and CBT data were extracted from DICOM headers, and breast density was visually assessed. Statistical analyses included two-sample t-tests and descriptive statistics. RESULTS: Mean AGD per acquisition varied slightly among CEM (1.48 ± 0.22 mGy), SBB (1.49 ± 0.40 mGy), and DBT (1.55 ± 0.47 mGy), with CEM presenting higher AGD at lower CBTs and less dose escalation at higher CBTs. For CBT > 55 mm, CEM showed reduced AGD compared to SBB and DBT (p < 0.001). Breast density had minimal impact on AGD, except for category A. The estimated AGD per procedure was approximately 11.84 mGy for CEM, 11.92 mGy for SBB, and 6.2 mGy for DBT. CONCLUSION: The study found mean AGD per acquisition to be similar for CEM and SBB, with DBT slightly higher. CEM demonstrated higher AGD at lower CBT but lower AGD at higher CBT, indicating reduced dose escalation with increasing thickness. While breast density had minimal overall impact, variations were noted in category A. DBT was more dose-efficient per procedure due to fewer acquisitions required. CLINICAL RELEVANCE STATEMENT: CEM guidance provides effective lesion visualization within safe radiation limits, improving the precision of percutaneous image-guided breast interventions and supporting its potential consideration in a wider range of breast diagnostic procedures. KEY POINTS: Limited data exist on the AGD using CEM guidance for breast biopsies. CEM and SBB exhibit similar AGD per acquisition; DBT demonstrated the lowest AGD per procedure. Radiation from CEM guidance fits within safe limits for percutaneous image-guided breast interventions.

Comparison of technical parameters and women's experience between self-compression and standard compression modes in mammography screening: a single-blind randomized clinical trial.

OBJECTIVES: We compared the compression force, breast thickness, and glandular dose, as well as the severity of discomfort and women's experience between the patient-assisted compression (PAC) and standard compression (SC) modes. MATERIALS AND METHODS: We conducted a prospective randomized controlled study at Hospital del Mar in Barcelona, Spain. We included 448 asymptomatic women aged 50 to 69 years old, attending their screening round from December 2017 to December 2019. Mammograms included the two bilateral views. In each woman, one breast was studied with SC and the other with PAC. The mode used in each breast was selected following a randomized list. Compression force, breast thickness, and average glandular dose were obtained for each of the 1792 images. We also recorded the degree of discomfort and women's experience, after mammogram acquisitions, using a predefined survey. RESULTS: Higher compression forces were obtained with PAC than with SC (99.27 N vs 83.25 N, p < 0.001). Breast thickness mode (56.11 mm vs 57.52 mm, p = 0.015) and glandular dose (1.34 mGy vs 1.37 mGy, p = 0.018) were lower in PAC. The discomfort score was slightly higher with PAC (mean 3.94 vs 3.69, p = 0.042), but in the satisfaction survey, more women reported that PAC caused less discomfort. Additionally, 63.2% of women (289/448) preferred PAC. CONCLUSION: PAC achieved higher compression forces without impairing the other technical imaging parameters and enhanced women's experience of screening mammography. We believe there were no clinically significant differences in the severity of discomfort between the two modes. KEY POINTS: • Self-compression allows higher compression forces than the standard compression mode. • Self-compression does not affect technical imaging parameters. • Self-compression improved women's experience of screening mammography when standard compression was used on one breast and self-compression on the other.

Does the patient-assisted compression mode affect the mammography quality? A within-woman randomized controlled trial.

OBJECTIVES: Evaluate the image quality of a mammography screening device using the patient-assisted compression (PAC) compared with the standard compression (SC) mode. METHODS: This prospective within-woman, randomized controlled trial was conducted between September 2017 and December 2019. Participants were asymptomatic women aged 50 to 69 years attending their second or subsequent screening mammography round. By random assignment, one breast underwent the SC and the other breast, the PAC. Image quality was evaluated as perfect, good, moderate, or inadequate (PGMI) on 10 criteria for the craniocaudal (CC) view and 8 criteria for the mediolateral oblique (MLO) view. Pearson's chi-square test, with Yates' correction if pertinent, was performed to compare image quality between compression modes. RESULTS: A total of 444 participants were included (mean [± standard deviation] age, 60 [± 4.9] years). There were no differences in the percentages of PGMI between the PAC and SC modes for the CC view (perfect, 37% [162/444] vs 37% [163/444]; good, 1% [5/444] vs 2% [9/444]; moderate, 62% [277/444] vs 61% [271/444]; inadequate, 0% vs 0.2% [1/444]; p = .88) or for the MLO view (perfect, 53% [237/444] vs 56% [247/444]; good, 22% [99/444] vs 22% [97/444]; moderate, 23% [102/444] vs 22% [98/444]; inadequate, 1% [6/444] vs 0.5% [2/444]; p = .72). No differences were found when we stratified by laterality or when analyzed by PGMI criteria. CONCLUSION: PAC does not seem to impair mammographic image quality. Future research should focus in a daily practice setting. KEY POINTS: No differences were found in the distribution of the PGMI classification, a tool for quality assessment, between patient-assisted compression and standard compression. Similar results were found on stratification of image quality by mammographic view and breast laterality for both types of compression. None of the PGMI criteria had significantly more errors in patient-assisted compression than in standard compression.

Mammographic features of benign breast lesions and risk of subsequent breast cancer in women attending breast cancer screening.

OBJECTIVES: To evaluate the mammographic features in women with benign breast disease (BBD) and the risk of subsequent breast cancer according to their mammographic findings. METHODS: We analyzed data from a Spanish cohort of women screened from 1995 to 2015 and followed up until December 2017 (median follow-up, 5.9 years). We included 10,650 women who had both histologically confirmed BBD and mammographic findings. We evaluated proliferative and nonproliferative BBD subtypes, and their mammographic features: architectural distortion, asymmetries, calcifications, masses, and multiple findings. The adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) for breast cancer were estimated using a Cox proportional hazards model. We plotted the adjusted cumulative incidence curves. RESULTS: Calcifications were more frequent in proliferative disease with atypia (43.9%) than without atypia (36.8%) or nonproliferative disease (22.2%; p value < 0.05). Masses were more frequent in nonproliferative lesions (59.1%) than in proliferative lesions without atypia (35.1%) or with atypia (30.0%; p value < 0.05). Multiple findings and architectural distortion were more likely in proliferative disease (16.1% and 4.7%) than in nonproliferative disease (12.8% and 1.9%). Subsequent breast cancer occurred in 268 (2.5%) women. Compared with women who had masses, the highest risk of subsequent breast cancer was found in those with architectural distortions (aHR, 2.21; 95% CI, 1.16-4.22), followed by those with multiple findings (aHR, 1.89; 95% CI, 1.34-2.66), asymmetries (aHR, 1.66; 95% CI, 0.84-3.28), and calcifications (aHR, 1.60; 95% CI, 1.21-2.12). CONCLUSION: BBD subtypes showed distinct mammographic findings. The risk of subsequent breast cancer was high in those who have shown architectural distortion, multiple findings, asymmetries, and calcifications than in women with masses. KEY POINTS: • The presence of mammographic findings in women attending breast cancer screening helps clinicians to assess women with benign breast disease (BBD). • Calcifications were frequent in BBDs with atypia, which are the ones with a high breast cancer risk, while masses were common in low-risk BBDs. • The excess risk of subsequent breast cancer in women with BBD was higher in those who showed architectural distortion compared to those with masses.

Breast density, benign breast disease, and risk of breast cancer over time.

OBJECTIVES: Assessing the combined effect of mammographic density and benign breast disease is of utmost importance to design personalized screening strategies. METHODS: We analyzed individual-level data from 294,943 women aged 50-69 years with at least one mammographic screening participation in any of four areas of the Spanish Breast Cancer Screening Program from 1995 to 2015, and followed up until 2017. We used partly conditional Cox models to assess the association between benign breast disease, breast density, and the risk of breast cancer. RESULTS: During a median follow-up of 8.0 years, 3697 (1.25%) women had a breast cancer diagnosis and 5941 (2.01%) had a benign breast disease. More than half of screened women had scattered fibroglandular density (55.0%). The risk of breast cancer independently increased with the presence of benign breast disease and with the increase in breast density (p for interaction = 0.84). Women with benign breast disease and extremely dense breasts had a threefold elevated risk of breast cancer compared with those with scattered fibroglandular density and without benign breast disease (hazard ratio [HR] = 3.07; 95%CI = 2.01-4.68). Heterogeneous density and benign breast disease was associated with nearly a 2.5 elevated risk (HR = 2.48; 95%CI = 1.66-3.70). Those with extremely dense breast without a benign breast disease had a 2.27 increased risk (95%CI = 2.07-2.49). CONCLUSIONS: Women with benign breast disease had an elevated risk for over 15 years independently of their breast density category. Women with benign breast disease and dense breasts are at high risk for future breast cancer. KEY POINTS: • Benign breast disease and breast density were independently associated with breast cancer. • Women with benign breast disease had an elevated risk for up to 15 years independently of their mammographic density category.

Revealing at the molecular level the role of the surfactant in the enhancement of the thermal properties of the gold nanofluid system used for concentrating solar power.

A molecular dynamics study based on gold nanofluids performed with and without the presence of tetraoctylammonium halide as a surfactant in a base fluid is presented. The base fluid consisting of a mixture of biphenyl and diphenyl oxide is used in concentrating solar power (CSP) plants. The radial distribution functions (RDFs) and spatial distribution functions (SDFs) were analysed with the temperature. Theoretical results indicate that the surfactant acts as a kind of net around the nanoparticle that plays an active role in enhancing the thermal properties of the gold nanofluid system. A greater lability of the base fluid-surfactant interactions than the base fluid-gold nanoparticle interactions is observed. At lower temperatures, there is an inner layer around the gold nanoparticle with two surfactant molecules close to the metal. At a higher temperature a ratio of gold nanoparticles : diphenyl oxide molecules of 1 : 4 is maintained in the inner layer for the systems with and without the presence of a surfactant. At the highest temperatures, the presence of the surfactant in a second shell impedes the approximation of the fifth diphenyl oxide molecule. Thus, the surfactant affects the macroscopic properties of the gold nanofluid system at the molecular level.

Imaging and pathology features to predict axillary tumor load in breast cancer.

AIM: We investigated if imaging and pathology features could help to identify a high axillary tumor burden (ATB) in breast cancer patients, in order to individualize decisions on axillary lymph node (ALN) dissection (ALND). METHODS: We retrospectively analyzed patients primarily treated with surgery in our unit between 2011 and 2014. We divided the patients in two groups: low ATB (LATB) if ≤ 2 ALN were infiltrated and high ATB (HATB) if > 2 ALN were infiltrated. RESULTS: Data of 105 patients was included in the study. Axillary ultrasound (AUS) features associated with HATB were any sign of ALN infiltration (76 vs 24%, P = 0.027) and > 2 suspicious ALNs (73% vs 27%, P = 0.018); however, when AUS revealed ≤ 2 suspicious ALNs, 39% of these patients had HATB. Any sign of ALN infiltration on magnetic resonance imaging was associated with HATB (48% vs 52%, P = 0.031). Positive preoperative ALN cytology or biopsy was associated with HATB (53% vs 47%, P = 0.008), while p53 positivity (80% vs 20%) and high histological grade (68% vs. 32%) correlated with LATB (P = 0.05 and P = 0.02, respectively). In multivariate analysis, only positive preoperative ALN cytology or biopsy was associated with HATB (P = 0.038). CONCLUSIONS: AUS was useful for detecting HATB but was not as effective in patients with LATB. Proving axillary infiltration with AUS-directed cytology or biopsy is the most effective method to predict HATB.

The Role of Surfactants in the Stability of NiO Nanofluids: An Experimental and DFT Study.

This study shows an analysis of the stability of nanofluids based on a eutectic mixture of diphenyl oxide and biphenyl, which is used as a heat transfer fluid (HTF) in concentrating solar energy, and NiO nanoparticles. Two surfactants are used to analyse the stability of the nanofluids: benzalkonium chloride (BAC) and 1-octadecanethiol (ODT). From an experimental perspective, the stability is analysed by means of UV/Vis spectroscopy, particle size measurements through the dynamic light-scattering technique, and ζ-potential measurements. The results show that the stability of the nanofluids improves with the use of BAC. DFT calculations are performed to understand the role played by the surfactants. The interaction of the surfactants with both the fluid and the NiO (100) surface is studied. Quantum theory of atoms in molecules (QTAIM) analysis shows that hydrogen bridge interactions favour the stability of the fluid-surfactant mixture. The more stabilising NiO-surfactant interaction involves the Ni-H interaction of the -SH and -CH3 groups of ODT and BAC. Also, nanofluids with BAC are favoured over those with ODT, which is in agreement with experimental results. The structural and electronic effects of incorporating the surfactant onto the NiO (100) surface are shown by using electron localisation function analysis, the non-covalent interaction index and projected density of states.

MoS2/Cu/TiO2 nanoparticles: synthesis, characterization and effect on photocatalytic decomposition of methylene blue in water under visible light.

Photodegradation processes are of great interest in a range of applications, one of which is the photodecomposition of pollutants. For this reason, analysing nanoparticles that improve the efficiency of these processes under solar radiation are very necessary. Thus, in this study, TiO2 was doped with Mo and Cu using low-temperature hydrolysis as the method of synthesis. Pure TiO2 and x%MoS2/Cu/TiO2 nanoparticles were prepared, where x is the theoretical quantity of MoS2 added (0.0%, 1.0%, 5.5%, 10.0%), setting the nominal quantity of Cu at 0.5 wt.%. The samples obtained were characterized by X-ray diffraction, Raman spectroscopy, X-ray electron spectroscopy and UV-Vis spectroscopy in diffuse reflectance mode. The results suggest that the TiO2 structure was doped with the Mo6+ and Cu2+ ions in the position of the Ti4+. The x%MoS2/Cu/TiO2 samples presented lower band gap energy values and greater optical absorption in the visible region than the pure TiO2 sample. Lastly, the photocatalytic activity of the samples was assessed by means of the photodegradation of methylene blue under visible light. The results show that when the quantity of Mo in the co-doped samples increased (x%MoS2/Cu/TiO2) there were significant increases of up to 93% in the photocatalytic activity.

A Study of Overheating of Thermostatically Controlled TiO2 Thin Films by Using Raman Spectroscopy.

In this study a classic Raman spectroscopy method is applied and the intensity ratio of Stokes and anti-Stokes peaks is used to measure the temperature of thermostatically controlled TiO2 thin films. In addition, three mathematical formulae are used and analyzed to estimate the temperature of the TiO2 thin films. Overheating of the samples above the thermostatically controlled temperature was observed while recording the Raman spectra, with a temperature increase of up to 30 K being detected. DFT-periodic calculations showed that the anatase (101) surface had a smaller band gap than bulk anatase. Thus, it can absorb the laser radiation with a wavelength of 532 nm that is used in the experimental setup. Part of the absorbed photon energy transfers into phonon energy, heating up the anatase phase, thus leading to the heating of the samples. Moreover, overheating of the samples indicates that the experimental method used in this study can lead to deviations in their real absolute temperature values.

Revealing the role of Pb(2+) in the stability of organic-inorganic hybrid perovskite CH3NH3Pb1-xCdxI3: an experimental and theoretical study.

This paper presents the synthesis of organic-inorganic hybrid perovskite CH3NH3Pb1-xCdxI3. The effect of incorporating Cd(2+) or Pb(2+) on the stability of the perovskite structure was analysed from a theoretical and experimental viewpoint. The XRD results showed that the tetragonal perovskite structure was formed for x values of up to 0.5, which seems to indicate that the presence of a considerable amount of Pb(2+) is necessary to stabilise the structure. In turn, UV-Vis spectroscopy showed how the presence of Cd(2+) led to a reduction in the optical band gap of the perovskite structure of up to 9% for CH3NH3Pb0.5Cd0.5I3 with regard to the MAPbI3 structure. Moreover, periodic-DFT calculations were performed to understand the effect of the increased concentration of Cd on the structural and electronic properties of MAPbI3 perovskites. The analysis of both the ELF and the non-covalent interaction (NCI) index show the important role played by the Pb(2+) ions in stabilizing this kind of hybrid perovskite structures. Finally, the DOS analysis confirmed the experimental results obtained using UV-Vis spectroscopy. The theoretical band gap values decreased as the concentration of Cd increased.

Electronic and structural properties of highly aluminum ion doped TiO(2) nanoparticles: a combined experimental and theoretical study.

This study presents the experimental and theoretical study of highly internally Al-doped TiO2 nanoparticles. Two synthesis methods were used and detailed characterization was performed. There were differences in the doping and the crystallinity, but the nanoparticles synthesized with the different methods share common features. Anatase to rutile transformation occurred at higher temperatures with Al doping. X-ray photoelectron spectroscopy showed the generation of oxygen vacancies, which is an interesting feature in photocatalysis. In turn, the band-gap energy and the valence band did not change appreciably. Periodic density functional calculations were performed to model the experimentally doped structures, the formation of the oxygen vacancies, and the band gap. Calculation of the density of states confirmed the experimental band-gap energies. The theoretical results confirmed the presence of Ti(4+) and Al(3+) . The charge density study and electron localization function analysis indicated that the inclusion of Al in the anatase structure resulted in a strengthening of the TiO bonds around the vacancy.

Experimental and theoretical study of the electronic properties of Cu-doped anatase TiO2.

A good correlation was obtained between the electronic properties of Cu-doped anatase TiO2 by virtue of both physical chemistry characterization and theoretical calculations. Pure and Cu-doped TiO2 were synthesized. The composition, structural and electronic properties, and the band gap energy were obtained using several techniques. The method of synthesis used produces Cu-doped anatase TiO2, and XRD, XPS and Raman spectroscopy indicate that Cu atoms are incorporated in the structure by substitution of Ti atoms, generating a distortion of the structure and oxygen vacancies. In turn, the band gap energy of the synthesized samples decrease drastically with the Cu doping. Moreover, periodic density functional theory (DFT-periodic) calculations were carried out both to model the experimentally observed doped structures and to understand theoretically the experimental structures obtained, the formation of oxygen vacancies and the values of the band gap energy. From the analysis of density of states (DOS), projected density of states (PDOS) and the electron localization function (ELF) a decrease in the band gap is predicted upon increasing the Cu doping. Thus, the inclusion of Cu in the anatase structure implies a covalent character in the Cu-O interaction, which involves the appearance of new states in the valence band maximum with a narrowing in the band gap.

Morphology does not matter: WSe2 luminescence nanothermometry unravelled.

Transition metal dichalcogenides, including WSe2, have gained significant attention as promising nanomaterials for various applications due to their unique properties. In this study, we explore the temperature-dependent photoluminescent properties of WSe2 nanomaterials to investigate their potential as luminescent nanothermometers. We compare the performance of WSe2 quantum dots and nanorods synthesized using sonication synthesis and hot injection methods. Our results show a distinct temperature dependence of the photoluminescence, and conventional ratiometric luminescence thermometry demonstrates comparable relative thermal sensitivity (0.68-0.80% K-1) and temperature uncertainty (1.3-1.5 K), irrespective of the morphology of the nanomaterials. By applying multiple linear regression to WSe2 quantum dots, we achieve enhanced thermal sensitivity (30% K-1) and reduced temperature uncertainty (0.1 K), highlighting the potential of WSe2 as a versatile nanothermometer for microfluidics, nanofluidics, and biomedical assays.

Thermal Energy Storage in Concrete by Encapsulation of a Nano-Additivated Phase Change Material in Lightweight Aggregates.

This work discusses the applicability of lightweight aggregate-encapsulated n-octadecane with 1.0 wt.% of Cu nanoparticles, for enhanced thermal comfort in buildings by providing thermal energy storage functionality to no-fines concrete. A straightforward two-step procedure (impregnation and occlusion) for the encapsulation of the nano-additivated phase change material in lightweight aggregates is presented. Encapsulation efficiencies of 30-40% are achieved. Phase change behavior is consistent across cycles. Cu nanoparticles provide nucleation points for phase change and increase the rate of progression of phase change fronts due to the enhancement in the effective thermal conductivity of n-octadecane. The effective thermal conductivity of the composites remains like that of regular lightweight aggregates and can still fulfil thermal insulation requirements. The thermal response of no-fines concrete blocks prepared with these new aggregates is also studied. Under artificial sunlight, with a standard 1000 W·m-2 irradiance and AM1.5G filter, concrete samples with the epoxy-coated aggregate-encapsulated n-octadecane-based dispersion of Cu nanoparticles (with a phase change material content below 8% of the total concrete mass) can effectively maintain a significant 5 °C difference between irradiated and non-irradiated sides of the block for ca. 30 min.

Emission properties of Pd-doped CsPbBr3 perovskite nanocrystal: Infrared emission due to the Pd-doping.

Perovskite-type materials have attracted great attention in recent times due to their interesting characteristics, such as their luminescent properties. The good photoluminescence quantum yields as well as the possibility of tuning the emission wavelength has allowed the study of these materials in several applications, such as sensors or LEDs. As sensors, making nanocrystals of these perovskites emitting in the near infrared (NIR) would open the possibility of using these materials in biomedical applications. In the present work, Pd-doped CsPbBr3 perovskite nanocrystals (NCs) were synthesized and characterized. We show here Pd-doped NCs synthesized emit in NIR, at about 875 nm, using a laser emitting at 785 nm as the excitation source. This result is really new and promising, because it opens the possibility of using these nanocrystals in many applications as sensor in the field of nanobiomedicine in the future.

Facile Fabrication of High-Performance Thermochromic VO2-Based Films on Si for Application in Phase-Change Devices.

This work reports on an alternative and advantageous procedure to attain VO2-based thermochromic coatings on silicon substrates. It involves the sputtering of vanadium thin films at glancing angles and their subsequent fast annealing in an air atmosphere. By adjusting thickness and porosity of films as well as the thermal treatment parameters, high VO2(M) yields were achieved for 100, 200, and 300 nm thick layers treated at 475 and 550 °C for reaction times below 120 s. Comprehensive structural and compositional characterization by Raman spectroscopy, X-ray diffraction, and scanning-transmission electron microscopies combined with analytical techniques such as electron energy-loss spectroscopy bring to the fore the successful synthesis of VO2(M) + V2O3/V6O13/V2O5 mixtures. Likewise, a 200 nm thick coating consisting exclusively of VO2(M) is also achieved. Conversely, the functional characterization of these samples is addressed by variable temperature spectral reflectance and resistivity measurements. The best results are obtained for the VO2/Si sample with changes in reflectance of 30-65% in the near-infrared at temperatures between 25 and 110 °C. Similarly, it is also proven that the achieved mixtures of vanadium oxides can be advantageous for certain optical applications in specific infrared windows. Finally, the features of the different structural, optical, and electrical hysteresis loops associated with the metal-insulator transition of the VO2/Si sample are disclosed and compared. These remarkable thermochromic performances hereby accomplished highlight the suitability of these VO2-based coatings for applications in a wide range of optical, optoelectronic, and/or electronic smart devices.

Accuracy of sentinel node mapping in patients with biopsy-proven metastatic axillary lymph nodes and upfront surgery: preliminary results of the Multimodal Targeted Axillary Surgery (MUTAS) trial.

Background: Some studies suggested that the patients included in the Z0011 trial may represent patients with ultrasound-negative axillary nodes and axillary invasion diagnosed by sentinel node (SN) biopsy. Nevertheless, the National Comprehensive Cancer Network (NCCN) guidelines recommend SN mapping if 1 or 2 suspicious lymph nodes are identified on axillary ultrasound (AU). The aim of this preliminary phase of the Multimodal Targeted Axillary Surgery (MUTAS) trial was to establish the accuracy of SN mapping in patients with axillary involvement undergoing upfront surgery. Methods: Between September 2019 and March 2022, we recruited patients with biopsy-proven metastatic axillary nodes and upfront surgery from a single center. We performed SN mapping in these patients before the surgical intervention, which included axillary lymph node dissection. The biopsy-proven metastatic node, SNs and the remaining axillary nodes were excised separately. SN status was considered representative of the status of the remaining axillary nodes. We calculated the sensitivity, specificity, negative predictive value and positive predictive value of the SN, overall and in patients with palpable nodes, in those with non-palpable nodes and an AU leading to diagnosis of axillary involvement, in those with 1 or 2 suspicious nodes on AU, and in patients with a single suspicious node on AU. We evaluated clinical, imaging and pathology features as predictors of the status of the remaining axillary nodes, false-negatives, and false-positives. Results: We included 25 patients in this phase. The false-negative rate of SN mapping was 28% overall, 21.42% for patients with palpable nodes, 36.36% for patients with non-palpable nodes and an AU diagnosis of axillary involvement, 28.75% for those with 1 or 2 suspicious nodes on AU, and 15.38% in patients with a single suspicious node on AU. The negative predictive value was highest in patients with a single suspicious node on AU (75%). The only significant predictive factor was that FN showed a higher Ki67 index score. Conclusions: In this study, SN mapping was not reliable in patients with biopsy-proven metastatic axillary nodes and upfront surgery for any of the subgroups studied. Further research should elucidate the best staging pathways in these patients to avoid premature de-escalation.

Long-Term Risk of Breast Cancer after Diagnosis of Benign Breast Disease by Screening Mammography.

Assessing the long-term risk of breast cancer after diagnosis of benign breast disease by mammography is of utmost importance to design personalised screening strategies. We analysed individual-level data from 778,306 women aged 50-69 years with at least one mammographic screening participation in any of ten breast cancer screening centers in Spain from 1996 to 2015, and followed-up until 2017. We used Poisson regression to compare the rates of incident breast cancer among women with and without benign breast disease. During a median follow-up of 7.6 years, 11,708 (1.5%) women had an incident of breast cancer and 17,827 (2.3%) had a benign breast disease. The risk of breast cancer was 1.77 times higher among women with benign breast disease than among those without (95% CI: 1.61 to 1.95). The relative risk increased to 1.99 among women followed for less than four years, and remained elevated for two decades, with relative risk 1.96 (95% CI: 1.32 to 2.92) for those followed from 12 to 20 years. Benign breast disease is a long-term risk factor for breast cancer. Women with benign breast disease could benefit from closer surveillance and personalized screening strategies.

Robocasting and Laser Micromachining of Sol-Gel Derived 3D Silica/Gelatin/ß-TCP Scaffolds for Bone Tissue Regeneration.

The design and synthesis of sol-gel silica-based hybrid materials and composites offer significant benefits to obtain innovative biomaterials with controlled porosity at the nanostructure level for applications in bone tissue engineering. In this work, the combination of robocasting with sol-gel ink of suitable viscosity prepared by mixing tetraethoxysilane (TEOS), gelatin and ß-tricalcium phosphate (ß-TCP) allowed for the manufacture of 3D scaffolds consisting of a 3D square mesh of interpenetrating rods, with macropore size of 354.0 ± 17.0 µm, without the use of chemical additives at room temperature. The silica/gelatin/ß-TCP system underwent irreversible gelation, and the resulting gels were also used to fabricate different 3D structures by means of an alternative scaffolding method, involving high-resolution laser micromachining by laser ablation. By this way, 3D scaffolds made of 2 mm thick rectangular prisms presenting a parallel macropore system drilled through the whole thickness and consisting of laser micromachined holes of 350.8 ± 16.6-micrometer diameter, whose centers were spaced 1312.0 ± 23.0 µm, were created. Both sol-gel based 3D scaffold configurations combined compressive strength in the range of 2-3 MPa and the biocompatibility of the hybrid material. In addition, the observed Si, Ca and P biodegradation provided a suitable microenvironment with significant focal adhesion development, maturation and also enhanced in vitro cell growth. In conclusion, this work successfully confirmed the feasibility of both strategies for the fabrication of new sol-gel-based hybrid scaffolds with osteoconductive properties.