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Zhang H, Zhang XY, Wang Y. Value of magnetic resonance diffusion combined with perfusion imaging techniques for diagnosing potentially malignant breast lesions. World J Clin Cases 2022; 10:6021-6031. [PMID: 35949832 PMCID: PMC9254209 DOI: 10.12998/wjcc.v10.i18.6021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/23/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Lesions of breast imaging reporting and data system (BI-RADS) 4 at mammography vary from benign to malignant, leading to difficulties for clinicians to distinguish between them. The specificity of magnetic resonance imaging (MRI) in detecting breast is relatively low, leading to many false-positive results and high rates of re-examination or biopsy. Diffusion-weighted imaging (DWI), combined with perfusion-weighted imaging (PWI), might help to distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.
AIM To evaluate the value of DWI and PWI in diagnosing BI-RADS 4 breast lesions.
METHODS This is a retrospective study which included patients who underwent breast MRI between May 2017 and May 2019 in the hospital. The lesions were divided into benign and malignant groups according to the classification of histopathological results. The diagnostic efficacy of DWI and PWI were analyzed respectively and combinedly. The 95 lesions were divided according to histopathological diagnosis, with 46 benign and 49 malignant. The main statistical methods used included the Student t-test, the Mann-Whitney U-test, the chi-square test or Fisher’s exact test.
RESULTS The mean apparent diffusion coefficient (ADC) values in the parenchyma and lesion area of the normal mammary gland were 1.82 ± 0.22 × 10-3 mm2/s and 1.24 ± 0.16 × 10-3 mm2/s, respectively (P = 0.021). The mean ADC value of the malignant group was 1.09 ± 0.23 × 10-3 mm2/s, which was lower than that of the benign group (1.42 ± 0.68 × 10-3 mm2/s) (P = 0.016). The volume transfer constant (Ktrans) and rate constant (Kep) values were higher in malignant lesions than in benign ones (all P < 0.001), but there were no significant statistical differences regarding volume fraction (Ve) (P = 0.866). The sensitivity and specificity of PWI combined with DWI (91.7% and 89.3%, respectively) were higher than that of PWI or DWI alone. The accuracy of PWI combined with DWI in predicting pathological results was significantly higher than that predicted by PWI or DWI alone.
CONCLUSION DWI, combined with PWI, might possibly distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.
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Affiliation(s)
- Hui Zhang
- Department of Radiology, Hebei General Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Xin-Yi Zhang
- Department of Radiology, the First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Yong Wang
- Department of Radiology, the First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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2
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Vouxinou AD, Iatrakis GM, Zervoudis S, Bothou A, Tsitsiou S, Markja A, Margelis Z, Tooulias CA, Antoniou E. Bilateral Breast Edema: Case Report and Review of the Literature. REPORTS 2020; 3:18. [DOI: 10.3390/reports3030018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Both benign and malignant conditions related to regional or systemic disorders could be included in the differential diagnosis of bilateral breast edema. Some of them are often unilateral, including stromal infiltration and lymphatic obstruction presented in “peau d’ orange”, which is the usual presentation of breast cancer. However, the term “idiopathic” could be included in the spectrum of diagnoses. Here, we present a woman of 78 years old who came into our breast unit with a bilateral, painless edema of the breasts (appeared one month ago). Clinical examination revealed that both breasts were swollen with widespread erythema and the appearance of an orange peel/“peau d’ orange”. On palpation, the breasts were not sensitive, and no tumor was palpable. However, clinically palpable lymph nodes were found in both axillas. Her temperature was normal. The breast edema could not be explained from her medical history nor the medications taken. Breast ultrasound, Mammography and Magnetic Resonance Imaging were non-conclusive (BI-RADS 0) and bilateral core biopsy was negative for cancer. Anti-inflammatory plus antibiotic therapy was prescribed for 10 days and at the end of treatment, regional redness and edema were disappeared and reduced, respectively. Total recovery was found one month after the initial findings. It can be concluded that bilateral breast edema is correlated to regional or systemic conditions or it is presented as an “idiopathic” disorder of unknown etiology.
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3
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“Harms” Associated with Breast Cancer Screening and Reliability of Frozen Section in Older Women: In the Case of an 80 Year Old Woman. REPORTS 2020. [DOI: 10.3390/reports3020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of this paper is to present a rare case with negative final histologic examination despite abnormal findings of all previous exams indicating breast cancer in an 80 year old woman. Mammographic and magnetic resonance imaging findings were concordant with the frozen section biopsy result of DCIS. However, the final histologic diagnosis was radial scar (benign breast lesion that can radiologically mimic malignancy). As a conclusion, abnormal mammographic and magnetic resonance imaging findings with positive for DCIS frozen section reports are not always confirmed in the final histologic examination. Furthermore, considering that screening does not seem to be associated with a reduction in mortality due to breast cancer after the age of 75, breast cancer screening could be individualized in this age group.
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4
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Brown AL, Phillips J, Mehta TS, Brook A, Sharpe RE, Slanetz PJ, Dialani V. Breast MRI ordering practices in a large health care network. Breast J 2019; 25:262-268. [PMID: 30746809 DOI: 10.1111/tbj.13198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to evaluate providers' ordering practices and perceptions of breast magnetic resonance imaging (MRI) in an academic network in order to better understand and educate a referral base. An online survey was distributed to primary care providers (PCPs) and specialists in our hospital and community practices. Questions included provider demographics, current ordering practices, challenges to ordering, and perceptions about breast MRI. Of 525 ordering providers, 134 responded (26% response rate). Of 134 providers, 57 (42%) order breast MRI in practice. Of those who do not, the most consistent reason was a lack of familiarity with the use of breast MRI (32/77 [42%] of cases). Of 57 cases, 45 (79%) order less than 10 exams annually. The most frequent indication is for high-risk screening (40/47 [84%]). PCPs order fewer breast MRI compared with specialists (P = 0.01). Both PCPs and specialists have mixed perceptions of the clinical utility of breast MRI. However, 30% of all providers are ordering more breast MRI since the enactment of breast density legislation in Massachusetts. Furthermore, 29% report they would order breast MRI more often to screen women with dense breasts if there was a low cost option. Referring provider surveys are useful tools for assessing a radiology practice. Our study suggests a growing clinical interest in breast MRI for screening; however, there is a need for provider education on the clinical utility of breast MRI. Increasing the radiologist's role in targeted educational interventions may help improve awareness and lead to more appropriate utilization of resources.
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Affiliation(s)
- Ann L Brown
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
- Division of Breast Imaging, Department of Radiology, University of Cincinnati Medical Center and College of Medicine, Cincinnati, OH, USA
| | - Jordana Phillips
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Tejas S Mehta
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Alexander Brook
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Richard E Sharpe
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
- Colorado Permanente Medical Group, Kaiser Permanente, Denver, CO, USA
| | - Priscilla J Slanetz
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Vandana Dialani
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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Fang L, Wang Y, Gao Y, Chen X. Overexpression of CXXC5 is a strong poor prognostic factor in ER+ breast cancer. Oncol Lett 2018; 16:395-401. [PMID: 29928427 PMCID: PMC6006432 DOI: 10.3892/ol.2018.8647] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 04/26/2018] [Indexed: 12/13/2022] Open
Abstract
CXXC5 is a newly identified CXXC-type zinc finger family protein, which is encoded by the CXXC5 gene localised to the 5q31.3 chromosomal region. Previous studies revealed that CXXC5 is associated with various malignant tumours. The aim of the present study was to investigate the prognosis prediction of CXXC5 in different breast cancer subtypes via the Gene Expression Omnibus database and bc-GenExMiner. CXXC5 overexpression was observed as associated with a poor prognosis for oestrogen receptor positive (ER+) breast cancer. Basal-like breast cancer and triple-negative breast cancer also suggest a poor prognosis, however their CXXC5 expression was low and could not be used as a prognostic factor. The CXXC5 correlated genes and their enriched Gene Ontology (GO) terms were obtained. Among those enriched GO terms, GO:0070062 (extracellular exosome) had the greatest number of associated genes and the associated genes of GO:0000122 (negative regulation of transcription from RNA polymerase II promoter) and GO:0008134 (transcription factor binding) contained CXXC5. These results suggest that overexpression of CXXC5 is a strongly poor prognostic factor in ER+ breast cancer. However, the role of CXXC5 in breast cancer requires further investigation.
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Affiliation(s)
- Lei Fang
- Department of Pathology and Pathophysiology, Jinzhou Medical University, Jinzhou, Liaoning 121000, P.R. China
| | - Yu Wang
- Department of Radiology and NFCR Center for Molecular Imaging, Case Western Reserve University, Cleveland, OH 44106-5065, USA
| | - Yang Gao
- Department of Oncology, The First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning 121000, P.R. China
| | - Xuejun Chen
- Department of Pathology and Pathophysiology, Jinzhou Medical University, Jinzhou, Liaoning 121000, P.R. China
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6
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Kondov B, Isijanovska R, Milenkovikj Z, Petrusevska G, Jovanovski-Srceva M, Bogdanovska-Todorovska M, Kondov G. Impact of Size of the Tumour, Persistence of Estrogen Receptors, Progesterone Receptors, HER2Neu Receptors and Ki67 Values on Positivity of Axillary Lymph Nodes in Patients with Early Breast Cancer with Clinically Negative Axillary Examination. Open Access Maced J Med Sci 2017; 5:825-830. [PMID: 29362604 PMCID: PMC5771280 DOI: 10.3889/oamjms.2017.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 10/20/2017] [Accepted: 10/24/2017] [Indexed: 11/22/2022] Open
Abstract
AIM: The study aimed to identify factors that influence the positivity of axillary lymph nodes in patients with early breast cancer and clinically negative axillary lymph nodes, who were subjected for modified radical mastectomy and axillary lymphadenectomy. MATERIAL AND METHODS: This study included 81 surgically treated, early breast cancer patients during the period from 08-2015 to 05-2017. All the cases have been analysed by standard histological analysis including macroscopic and microscopic examination by routine H&E staining. For determination of molecular receptors, immunostaining by PT LINK immunoperoxidase has been done for HER2neu, ER, PR, p53 and Ki67. RESULTS: Patients age ranged between 31-73 years, an average of 56.86 years. The mean size of a primary tumour in the surgically treated patient was 20.33 ± 6.0 mm. Axillary dissection revealed from 5 to 32 lymph nodes, with an average of 14. Metastases have been found in 1 to 7 lymph nodes, with an average 0.7. Only 26 (32.1%) of the patients showed metastases in the axillary lymph nodes. The univariant regression analysis showed that the size of a tumour and presence of HER2neu receptors on cancer cells influence the positivity of the axillary lymph nodes. The presence of the estrogen receptors, progesterone receptors have no influence on the positivity for metastatic deposits of lymph nodes. Multivariant model and logistic regression analysis as significant independent factors or predictors of positivity of the axillary lymph nodes are influenced by the tumour size only. CONCLUSION: Our study showed that the metastatic involvement of the axillary lymph nodes is mainly influenced by the size of a tumour and presence of HER2neu receptors in the univariant analysis. This point to the important influence of positivity of the axillary lymph nodes but, in multi-variant regressive analysis the lymph node status correlates with the tumour size only.
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Affiliation(s)
- Borislav Kondov
- University Clinic for Thoracic and Vascular Surgery, Clinical Centre "Mother Theresa", Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Rosalinda Isijanovska
- Institute for Epidemiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Zvonko Milenkovikj
- University Clinic for Infective Diseases and Febrile Conditions, Clinical Centre "Mother Theresa", Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Gordana Petrusevska
- Institute for Pathology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Marija Jovanovski-Srceva
- University Clinic for Anesthesia and Reanimation, Clinical Centre "Mother Theresa", Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | | | - Goran Kondov
- University Clinic for Thoracic and Vascular Surgery, Clinical Centre "Mother Theresa", Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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7
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Browne JE, Cannon LM, McDermott R, Ryan M, Fagan AJ. Pilot Investigation into the Use of an Anthropomorphic Breast Sonography Phantom as a Training and Assessment Tool. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2733-2740. [PMID: 28843619 DOI: 10.1016/j.ultrasmedbio.2017.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 07/12/2017] [Accepted: 07/19/2017] [Indexed: 06/07/2023]
Abstract
A device for the training and quantitative assessment of the competency of trainee radiologists in the technically challenging area of breast sonography was developed and evaluated. Currently, suitable commercially available devices are lacking, and there is a growing realization that the reliance on direct exposure to patients for learning may not represent best practice from either the trainees' or patients' perspective. Three devices (PI, PII and PIII) were designed to produce very realistic sonographic images of breast morphology with a range of embedded pathologies. The pilot evaluation used a case study research design to evaluate the role of the anthropomorphic breast sonography training device in training and assessment in a clinical environment. Through the case study, it was possible to evaluate the process and relationships when using this type of training intervention for a small group of radiology resident trainees. The investigation involved a baseline assessment of trainees' (n = 4) ability to detect and characterize all lesions in PI, followed by a 4-wk training period on PII and a post-training assessment using PIII. The evaluation revealed an improvement of 30% ± 8% in the trainee's performance from pre- to post-training. It was expected that the performance of the trainees would improve as the training phantom described in this study aligns with the learning theory of constructivism and fits the ideal specifications of a medical training device in terms of its realism and facilitation of self-directed learning and deliberate practice of the trainees. The device provides a useful platform upon which training and assessment can be facilitated.
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Affiliation(s)
- Jacinta E Browne
- School of Physics and Clinical & Optometric Sciences, & Medical Ultrasound Physics and Technology Group, Centre of Industrial Engineering Optics, FOCAS, Dublin Institute of Technology, Dublin, Ireland.
| | - Louise M Cannon
- School of Physics and Clinical & Optometric Sciences, & Medical Ultrasound Physics and Technology Group, Centre of Industrial Engineering Optics, FOCAS, Dublin Institute of Technology, Dublin, Ireland
| | - Ronan McDermott
- Diagnostic Imaging Department, St. James's Hospital, Dublin, Ireland
| | - Max Ryan
- Diagnostic Imaging Department, Cork University Hospital, Cork, Ireland
| | - Andrew J Fagan
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College Dublin, Dublin, Ireland
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8
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de Almeida JRM, Gomes AB, Barros TP, Fahel PE, Rocha MDS. Diffusion-weighted imaging of suspicious (BI-RADS 4) breast lesions: stratification based on histopathology. Radiol Bras 2017; 50:154-161. [PMID: 28670026 PMCID: PMC5487229 DOI: 10.1590/0100-3984.2015.0224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective: To test the use of diffusion-weighted imaging (DWI) in stratifying suspicious
breast lesions (BI-RADS 4), correlating them with histopathology. We also
investigated the performance of DWI related to the main enhancement patterns
(mass and non-mass) and tested its reproducibility. Materials and Methods: Seventy-six patients presented 92 lesions during the sampling period. Two
independent examiners reviewed magnetic resonance imaging studies, described
the lesions, and determined the apparent diffusion coefficient (ADC) values.
Differences among benign, indeterminate- to high-risk, and malignant
findings, in terms of the ADCs, were assessed by analysis of variance. Using
receiver operating characteristic (ROC) curves, we compared the performance
of ADC values in masses and non-mass lesions, and tested the reproducibility
of measurements by determining the coefficient of variation and smallest
real difference. Results: Among the 92 lesions evaluated, the histopathology showed that 37 were
benign, 11 were indeterminate- to high-risk, and 44 were malignant. The mean
ADC differed significantly among those histopathological groups, the value
obtained for the malignant lesions (1.10 × 10-3
mm2/s) being significantly lower than that obtained for the
other groups (p < 0.001). ROC curves demonstrated that DWI performed
better when applied to masses than when applied to non-mass lesions (area
under the curve, 0.88 vs. 0.67). Reproducibility was good (coefficient of
variation, 7.03%; and smallest real difference, ± 0.242 ×
10-3 mm2/s). Conclusion: DWI can differentiate between malignant and nonmalignant (benign or
indeterminate- to high-risk) lesions, showing better performance for masses.
Nevertheless, stratification based on histopathological criteria that are
more refined has yet to be achieved.
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Affiliation(s)
| | - André Boechat Gomes
- MD, Radiologist, Department of Diagnostic Imaging, Clínica de Assistência à Mulher - Grupo CAM, Salvador, BA, Brazil
| | - Thomas Pitangueira Barros
- BMSc, Clínica de Assistência à Mulher - Grupo CAM, Department of Biomedicine, Escola Bahiana de Medicina e Saúde Pública - Campus Brotas, Salvador, BA, Brazil
| | - Paulo Eduardo Fahel
- MD, Pathologist, Clínica de Assistência à Mulher - Grupo CAM, Salvador, BA, Brazil
| | - Mario de Souza Rocha
- MD, PhD, Department of Medicine, Escola Bahiana de Medicina e Saúde Pública - Campus Brotas, Salvador, BA, Brazil
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9
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Kondov B, Kondov G, Spirovski Z, Milenkovikj Z, Colanceski R, Petrusevska G, Pesevska M. Prognostic Factors on the Positivity for Metastases of the Axillary Lymph Nodes from Primary Breast Cancer. ACTA ACUST UNITED AC 2017; 38:81-90. [PMID: 28593885 DOI: 10.1515/prilozi-2017-0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIM The aim of the study was to identify the impact of T stage, the presence of estrogen, progesterone, HER2neu receptors and the values of the Ki67 on the positivity for metastases of the axillary lymph nodes, from primary breast cancer. MATERIAL AND METHODS 290 surgically treated patients for breast cancer were included in the study. All cases have been analyzed by standard histological analysis including microscopic analysis on standard H&E staining. For determining the molecular receptors - HER2neu, ER, PR, p53 and Ki67, immunostaining by PT LINK immunoperoxidase has been done. RESULTS Patients age was ranged between 18-90 years, average of 57.6+11.9. The mean size of the primary tumor in the surgically treated patient was 30.27 + 18.3 mm. On dissection from the axillary pits 8 to 39 lymph nodes were taken out, an average of 13.81+5.56. Metastases have been found in 1 to 23 lymph nodes, an average 3.14+4.71. In 59% of the patients there have been found metastases in the axillary lymph nodes. The univariate regression analysis showed that the location, size of tumor, differentiation of the tumor, stage, the value of the Ki67 and presence of lymphovascular invasion influence on the positivity of the axillary lymph nodes. The presence of the estrogen receptors, progesterone receptors and HER2neu receptors showed that they do not have influence on the positivity for metastatic deposits in axillary lymph nodes. The multivariate model and the logistic regression analysis as independent significant factors or predictors of positivity of the axillary lymph nodes are influenced by the tumor size and the positive lymphovascular invasion. CONCLUSION Our study showed that the involving of the axillary lymph nodes is mainly influenced by the size of the tumor and the presence of lymphovascular invasion in the tumor. Ki67 determined proliferative index in the univariate analysis points the important influence of positivity in the axillary lymph nodes, but not in the multivariate regressive analysis.
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Affiliation(s)
- Borislav Kondov
- University Clinic for Thoracic and Vascular Surgery, Skopje, Majka Tereza 17, 1000 Skopje
| | - Goran Kondov
- University Clinic for Thoracic and Vascular Surgery - Medical Faculty Skopje
| | - Zoran Spirovski
- University Clinic for Thoracic and Vascular Surgery - Medical Faculty Skopje
| | - Zvonko Milenkovikj
- University Clinic for Infective Disease and Febrile Conditions - Medical Faculty Skopje
| | - Risto Colanceski
- University Clinic for Thoracic and Vascular Surgery - Medical Faculty Skopje
| | | | - Meri Pesevska
- University Clinic for Oncology and Radiotherapy- Medical Faculty Skopje
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10
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Berghuis AMS, Koffijberg H, Prakash J, Terstappen LWMM, IJzerman MJ. Detecting Blood-Based Biomarkers in Metastatic Breast Cancer: A Systematic Review of Their Current Status and Clinical Utility. Int J Mol Sci 2017; 18:E363. [PMID: 28208771 PMCID: PMC5343898 DOI: 10.3390/ijms18020363] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 01/27/2017] [Accepted: 02/03/2017] [Indexed: 12/28/2022] Open
Abstract
Reviews on circulating biomarkers in breast cancer usually focus on one single biomarker or a selective group of biomarkers. An overview summarizing the discovery and evaluation of all blood-based biomarkers in metastatic breast cancer is lacking. This systematic review aims to identify the available evidence of known blood-based biomarkers in metastatic breast cancer, regarding their clinical utility and state-of-the-art position in the validation process. The initial search yielded 1078 original studies, of which 420 were assessed for eligibility. A total of 320 studies were included in the final synthesis. A Development, Evaluation and Application Chart (DEAC) of all biomarkers was developed. Most studies focus on identifying new biomarkers and search for relations between these biomarkers and traditional molecular characteristics. Biomarkers are usually investigated in only one study (68.8%). Only 9.8% of all biomarkers was investigated in more than five studies. Circulating tumor cells, gene expression within tumor cells and the concentration of secreted proteins are the most frequently investigated biomarkers in liquid biopsies. However, there is a lack of studies focusing on identifying the clinical utility of these biomarkers, by which the additional value still seems to be limited according to the investigated evidence.
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Affiliation(s)
- A M Sofie Berghuis
- Health Technology and Services Research, University of Twente, Enschede 7500 AE, The Netherlands.
| | - Hendrik Koffijberg
- Health Technology and Services Research, University of Twente, Enschede 7500 AE, The Netherlands.
| | - Jai Prakash
- Biomaterials Science and Technology, University of Twente, Enschede 7500 AE, The Netherlands.
| | | | - Maarten J IJzerman
- Health Technology and Services Research, University of Twente, Enschede 7500 AE, The Netherlands.
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11
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Wilczek B, Wilczek HE, Rasouliyan L, Leifland K. Adding 3D automated breast ultrasound to mammography screening in women with heterogeneously and extremely dense breasts: Report from a hospital-based, high-volume, single-center breast cancer screening program. Eur J Radiol 2016; 85:1554-63. [DOI: 10.1016/j.ejrad.2016.06.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 05/27/2016] [Accepted: 06/06/2016] [Indexed: 11/27/2022]
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12
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Szloch J, Marczyk E, Kołodziej-Rzepa M, Komorowski AL. Impact of different type of cancer treatment on the effectiveness of breast reconstruction. Gland Surg 2016; 5:444-9. [PMID: 27562472 DOI: 10.21037/gs.2016.05.06] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
For women undergoing mastectomy as part of their breast cancer treatment, breast reconstruction is an important part of therapy. However, neoadjuvant, adjuvant treatments as well as other patient-related factors can compromise the results of breast reconstruction techniques. In this article we have reviewed current approaches to the management of complications and risks that neoadjuvant and adjuvant therapies pose on breast reconstruction after mastectomy for breast cancer. Non-treatment related factors influencing reconstruction techniques were reviewed as well.
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Affiliation(s)
- Joanna Szloch
- Department of Surgical Oncology, Maria Skłodowska-Curie Memorial Institute of Oncology, Cancer Centre, Krakow, Poland
| | - Elżbieta Marczyk
- Department of Surgical Oncology, Maria Skłodowska-Curie Memorial Institute of Oncology, Cancer Centre, Krakow, Poland
| | - Marta Kołodziej-Rzepa
- Department of Surgical Oncology, Maria Skłodowska-Curie Memorial Institute of Oncology, Cancer Centre, Krakow, Poland
| | - Andrzej L Komorowski
- Department of Surgical Oncology, Maria Skłodowska-Curie Memorial Institute of Oncology, Cancer Centre, Krakow, Poland
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13
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Eisenbrey JR, Dave JK, Forsberg F. Recent technological advancements in breast ultrasound. ULTRASONICS 2016; 70:183-190. [PMID: 27179143 DOI: 10.1016/j.ultras.2016.04.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/20/2016] [Accepted: 04/24/2016] [Indexed: 06/05/2023]
Abstract
Ultrasound is becoming increasingly common as an imaging tool for the detection and characterization of breast tumors. This paper provides an overview of recent technological advancements, especially those that may have an impact in clinical applications in the field of breast ultrasound in the near future. These advancements include close to 100% fractional bandwidth high frequency (5-18MHz) 2D and 3D arrays, automated breast imaging systems to minimize the operator dependence and advanced processing techniques, such as those used for detection of microcalcifications. In addition, elastography and contrast-enhanced ultrasound examinations that are expected to further enhance the clinical importance of ultrasound based breast tumor screening are briefly reviewed. These techniques have shown initial promise in clinical trials and may translate to more comprehensive clinical adoption in the future.
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Affiliation(s)
- John R Eisenbrey
- Thomas Jefferson University, Department of Radiology, Division of Ultrasound, 132 South 10th St., Philadelphia, PA 19107, United States.
| | - Jaydev K Dave
- Thomas Jefferson University, Department of Radiology, Division of Ultrasound, 132 South 10th St., Philadelphia, PA 19107, United States
| | - Flemming Forsberg
- Thomas Jefferson University, Department of Radiology, Division of Ultrasound, 132 South 10th St., Philadelphia, PA 19107, United States
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Gadobutrol-Enhanced Magnetic Resonance Imaging of the Breast in the Preoperative Setting. Invest Radiol 2016; 51:454-61. [DOI: 10.1097/rli.0000000000000254] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Langer A, Meleis A, Knaul FM, Atun R, Aran M, Arreola-Ornelas H, Bhutta ZA, Binagwaho A, Bonita R, Caglia JM, Claeson M, Davies J, Donnay FA, Gausman JM, Glickman C, Kearns AD, Kendall T, Lozano R, Seboni N, Sen G, Sindhu S, Temin M, Frenk J. Women and Health: the key for sustainable development. Lancet 2015; 386:1165-210. [PMID: 26051370 DOI: 10.1016/s0140-6736(15)60497-4] [Citation(s) in RCA: 240] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ana Langer
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Afaf Meleis
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Felicia M Knaul
- Harvard Global Equity Initiative, Harvard Medical School, Boston, MA, USA
| | - Rifat Atun
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | | | - Ruth Bonita
- University of Auckland, Auckland, New Zealand
| | - Jacquelyn M Caglia
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | | | | | - Jewel M Gausman
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Annie D Kearns
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Tamil Kendall
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rafael Lozano
- National Institute of Public Health, Cuernavaca, Mexico
| | - Naomi Seboni
- International Planned Parenthood Federation Governing Council, London, UK
| | - Gita Sen
- Indian Institute of Management, Bangalore, India
| | | | - Miriam Temin
- Center for Global Development, Washington, DC, USA
| | - Julio Frenk
- Harvard T H Chan School of Public Health, Boston, MA, USA
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Lim YP, Lin CL, Lin YN, Ma WC, Hung DZ, Kao CH. Tamoxifen Treatment and the Reduced Risk of Hyperlipidemia in Asian Patients With Breast Cancer: A Population-Based Cohort Study. Clin Breast Cancer 2015; 15:294-300. [PMID: 25922283 DOI: 10.1016/j.clbc.2015.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/18/2015] [Indexed: 12/19/2022]
Abstract
PURPOSE The association between tamoxifen (TMX) treatment and the risk of developing hyperlipidemia remains unclear. METHODS The records of 41,726 patients with breast cancer (28,266 received TMX and 13,460 did not) were obtained from the Taiwan National Health Insurance Research Database for the period from January 2000 to December 2008. Three-fold women without breast cancer were the control group (N = 125, 178). The main end point was developing hyperlipidemia during the follow-up. RESULTS During a mean follow-up of 9 years, the patients with breast cancer demonstrated a rate of developing hyperlipidemia that was 6% less (adjusted hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.90-0.97) than that of the control participants without breast cancer. Stratification by age group indicated that only women aged ≥ 55 years who were diagnosed with breast cancer exhibited a significantly reduced risk of hyperlipidemia compared with the control group. With the use of 2 types of adjusted models, we observed that the TMX users (aged ≥ 55 years) consistently exhibited a significantly lower risk of hyperlipidemia than the non-TMX users and control participants (adjusted HRs, 0.79 and 0.82 from models 1 and 2, respectively). Within the 8-year follow-up period, patients with breast cancer and 366 to 1500 days of TMX therapy and > 1500 days of TMX therapy had significantly lower risks of hyperlipidemia compared with patients with ≤ 365 days of TMX therapy (adjusted HR, 0.54; 95% CI, 0.50-0.59; adjusted HR, 0.21; 95% CI, 0.18-0.24, respectively). CONCLUSIONS In Asian patients with breast cancer, TMX use was associated with reduced risks of hyperlipidemia.
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Affiliation(s)
- Yun-Ping Lim
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan; Department of Emergency, Toxicology Center, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Yen-Ning Lin
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
| | - Wei-Chih Ma
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
| | - Dong-Zong Hung
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan; Department of Emergency, Toxicology Center, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
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Bosu WK. Learning lessons from operational research in infectious diseases: can the same model be used for noncommunicable diseases in developing countries? ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2014; 5:469-82. [PMID: 25506254 PMCID: PMC4259801 DOI: 10.2147/amep.s47412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
About three-quarters of global deaths from noncommunicable diseases (NCDs) occur in developing countries. Nearly a third of these deaths occur before the age of 60 years. These deaths are projected to increase, fueled by such factors as urbanization, nutrition transition, lifestyle changes, and aging. Despite this burden, there is a paucity of research on NCDs, due to the higher priority given to infectious disease research. Less than 10% of research on cardiovascular diseases comes from developing countries. This paper assesses what lessons from operational research on infectious diseases could be applied to NCDs. The lessons are drawn from the priority setting for research, integration of research into programs and routine service delivery, the use of routine data, rapid-assessment survey methods, modeling, chemoprophylaxis, and the translational process of findings into policy and practice. With the lines between infectious diseases and NCDs becoming blurred, it is justifiable to integrate the programs for the two disease groups wherever possible, eg, screening for diabetes in tuberculosis. Applying these lessons will require increased political will, research capacity, ownership, use of local expertise, and research funding.
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Affiliation(s)
- William K Bosu
- Department of Epidemics and Disease Control, West African Health Organisation, Bobo-Dioulasso, Burkina Faso
- Correspondence: William K Bosu, Department of Epidemics and Disease Control, West African Health Organisation, 175 Ouzzein Coulibaly Avenue, Bobo-Dioulasso 01 BP 153, Burkina Faso, Email
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