Breast Area Research Articles

Carcinoma of Breast Expressing Human Epidermal Growth Factor Receptor 2: Case Report

Introduction: Breast carcinoma is a systemic disease in which micro metastasis of abnormal cells which can form the secondary malignant cells. Breast carcinoma is the rapid and uncontrolled growth of abnormal cells. Breast cancer is cancer of breast that develop from breast tissue.
 Case History: Clinical findings – patient 49 years old female, having pain in right upper quadrant of right breast, irritation and discomfort in breast, swelling in lower area of breast. Biochemical, Hematological and rediological investigation are decrease.
 Investigation: Physical examination -lump is found on right breast which is non tender and slightly movable. USG and Mammography shows A suspicious retroareolar lump in the right breast and two foci pleomorphic macro calcification in right breast, Histopathology – shows both the masses are malignant but in biopsy metastasis not detected.
 Therapeutic Intervention: Symptomatic treatment -tab acetaminophen -tab – hydrocortisone. Lumpectomy On the left breast and mastectomy done on right breast. Radiation therapy and Chemotherapy is given before and after surgery and Chemotherapy was continue after the surgery. Hormonal therapy also given for HER2 + receptor .all the complications of chemotherapy is managed by quality nursing care.
 Outcome: After all pharmacological, surgical and medical intervention and quality nursing care, patient is now in stable condition. During treatment her treatment response is good and she can very effectively cope up with her disease condition and she is able to do her daily activities effectively.

Improving Breast Cancer Classification using (SMOTE) Technique and Pectoral Muscle Removal in Mammographic Images

Computer-aided diagnosis methods are being developed to assist radiologists to improve the interpretation of mammograms for the detection and diagnose of breast cancer, reduce the errors and mistakes made by human beings. In addition, it provides a more accurate and reliable classification of benign and malignant abnormalities. In the mammogram diagnosis, the pectoral muscle appears in Mediolateral oblique views (MLO) of the right and left of the breast. Considering that, the pectoral muscle has the same density as the small suspicious masses in the image and can affect/bias the results of image processing methods. This paper presents a diagnosis method to detect an abnormality in mammograms automatically. Before abnormality identification, image-processing techniques are used to correctly segment the suspicious region-of-interest (ROI). The background of the mammograms has been darkened to distinguish the breast area from any blemishes or writings that will be removed. Then the breast area has been extracted after ignoring the empty regions around the breast in mammogram images. After that, the mammogram image is inverted and the inverted image is then subtracted from the initial image. For pectoral muscle removal, a region growing method using the K-means clustering method is used. Afterward, suspicious ROI is segmented utilizing the K-means with thresholding technique. To detect abnormalities in mammograms, shape-based features, moment invariants, and also fractal dimensions are extracted from the segmented ROI. The Mini-MIAS dataset is used to evaluate the proposed method and is predominately composed of benign samples with only a tiny percent of malignant samples. To accomplish far better classifier efficiency, the SMOTE algorithm is used to present new samples from the minority classes to get a balanced dataset. Random forest classifier utilized to classify the segmented region as benign and malignant. The experimental results obtained an accuracy of 97.1%, the sensitivity of 95.1%, and the achieved specificity is 98.5%.

Re-irradiation for intra-thoracic tumours and extra-thoracic breast cancer: dose accumulation, evaluation of efficacy and toxicity based on a literature review.

The improvement seen in the diagnostic procedures and treatment of thoracic tumours means that patients have an increased chance of longer overall survival. Nevertheless, we can still find those who have had a recurrence or developed a secondary cancer in the previously treated area. These patients require retreatment including re-irradiation. We have reviewed the published data on thoracic re-irradiation, which shows that some specific healthy tissues can tolerate a significant dose of irradiation and these patients benefit from aggressive treatment; however, there is a risk of damage to normal tissue under these circumstances. We analysed the literature data on re-irradiation in the areas of vertebral bodies, spinal cord, breast, lung and oesophagus. We evaluated the doses of primary and secondary radiotherapy, the treatment techniques, as well as the local control and median or overall survival in patients treated with re-radiation. The longest OS is reported in the case of re-irradiation after second breast-conserving therapy where the 5-year OS range is 81 to 100% and is shorter in patients with loco-reginal re-irradiation where the 5-y OS range is 18 to 60%. 2-year OS in patients re-irradiated for lung cancer and oesophagus cancer range from 13 to 74% and 18 to 42%, respectively. Majority grade ≥3 toxicity after second breast-conserving therapy was fibrosis up to 35%. For loco-regional breast cancer recurrences, early toxicity occurred in up to 33% of patients resulting in mostly desquamation, while late toxicity was recorded in up to 23% of patients and were mostly ulcerations. Early grade ≥3 lung toxicity developed in up to 39% of patients and up to 20% of Grade 5 hemoptysis. The most frequently observed early toxicity grade ≥3 in oesophageal cancer was oesophagitis recorded in up to 57% of patients, followed by hematological complications which was recorded in up to 50% of patients. The most common late complications included dysphagia, recorded in up to 16.7% of patients. We have shown that thoracic re-irradiation is feasible and effective in achieving local control in some patients. Re-irradiation should be performed with maximum accuracy and care using the best available treatment methods with a highly conformal, image-guided approach. Due to tremendous technological progress in the field of radiotherapy, we can deliver radiation precisely, shorten the overall treatment time and potentially reduce treatment-related toxicities.

Current trends in breast reconstruction.

Breast reconstruction is nowadays a component of surgical treatment of breast cancer; therefore plastic surgeons are widely involved in breast reconstruction procedures either after mastectomy or after wide quadrantectomy. The aim is to reduce the distortion of breast shape and to improve the aesthetic outcome of the oncological procedure taking in account the symmetric appearance of the breasts. In post quadrantectomy reconstruction, breast reshaping with mammoplasty pattern could be applied in large and ptotic breast; otherwise flaps from lateral thoracic area could be used as well in post mastectomy reconstruction. In the case of mastectomy, the mastectomy procedure itself has become increasingly conservative, thus allowing an improvement in the aesthetic results of the reconstruction, especially if an implant is used. If adequate thickness of the mastectomy flap is preserved, the prosthesis can be placed in front of the muscle (prepectoral reconstruction), rather than behind the muscle (submuscular reconstruction). In prepectoral reconstruction the postoperative recovery is easier and less distressing for the patient and the postoperative appearance is more natural then in submuscular reconstruction. Autologous breast reconstruction implies the use of flaps (tissue taken from donor areas and used to reconstruct the breast area after appropriate molding), this technique allows to obtain a natural appearance of the breast with similar characteristics to the original one, and can be used in the radiated field. Different options of flaps include flaps from back area (local flaps) and flaps from distant areas (free flaps), basically from abdomen and inner tight.

Peningkatan Pengetahuan dan Ketrampilan Ibu Menyusui Dalam Pemberian Terapy Komplementer Massage Endorphin dan Pijat Laktasi di Debong Lor

Breastfeeding is a natural process that is not easy to do. Exclusive breastfeeding coverage can not be separated from the problems that occur in the breastfeeding process including the false belief that breast milk comes out a little or breast milk is insufficient for the baby. This condition is caused by several factors including food and drinks consumed by the mother, the psychological or emotional condition of the mother, abnormal breast shape. New methods introduced to prevent and overcome this problem include endorphin massage and Lactation massage massage massage technique performed on the head or neck, back, spine, and breast areas that aim to stimulate the hormone prolactin and oxytocin. The purpose of this devotion is to increase the knowledge and skills of nursing mothers in doing endorphin massage and lactation massage. The method is to provide training starting with the material of the correct way of breastfeeding. The results of training that has been given to breastfeeding mothers who follow posyandu already know and skill in practicing endorphine massage and lactation massage

Preliminary Result in Endoscopic Video Assisted Breast Surgery

Background : The development of technology has grown rapidly in surgical science, especially the use of endoscopy to develop operations in producing minimal scar tissue. Endoscopic VABS is a surgical technique and began to develop since 1995. The technique has several approaches, namely through the chest wall, mammary and axilla. The descriptive study aims to report our first experience in the management of benign breast tumors with Endoscopic Video Assisted Breast Surgery.
 Methods : Ten patients with benign breast tumor have performed Endoscopic VABS in the period March 2017 to September 2017 at the Hospital in Surakarta. The largest diameter at the nodule, duration of operation, length of postoperative care, postoperative pain, cosmetic outcomes and complications were observed retrospectively.
 Result : All patients are women with median age 28 years. The largest diameter that can be taken is 3.5 cm with median 2 cm. One patient performed the conversion into a lumpectomy with conventional techniques due to difficult dissection and uncontrolled bleeding. The median duration of surgery was 60 minute with an average length of treatment for 2 days postoperatively. Average VAS Score was 4. No postoperative complications were found. But cosmetically, all patients are satisfied with the results of surgical wounds.
 Conclusion : The VABS endoscopic procedure is safe and effective procedure and has excellent cosmetic benefits because it does not show scar tissue in the breast area. This VABS Endoscopic technique has a weakness in terms of longer duration of operation compared to conventional techniques, but this can be overcome with the expertise and experience of the operator.

The Use of Thermal Imaging in the Evaluation of Temperature Effects of Radiotherapy in Patients after Mastectomy-First Study.

The aim of the study was to evaluate the temperature parameter of the breast area in patients undergoing radiotherapy at various intervals. The relationship between temperature changes on the patient’s skin and the time after the end of radiotherapy was studied. Measurements with a thermal imaging camera were performed in a group of twelve volunteers. Six of them were healthy women who did not have thermal asymmetry between the breasts, whereas six were diagnosed with breast cancer and underwent mastectomy due to the advanced stage of the disease. The patients were qualified for radiation therapy. Thermographic examinations were performed before treatment, two months later and then six months after the end of the treatment. Temperature differences between the healthy breasts and the treated areas were assessed. Additionally, the correlation between a patient’s skin temperature changes and the time after the end of radiotherapy was analyzed. The highest skin temperature increase (1.47 °C) was observed 6 months after the end of RT compared to the measurement before treatment. It seems that thermovision may bring a new tool for quantitative analyses of the temperature effects of radiotherapy.

An Efficient Method for Automated Breast Mass Segmentation and Classification in Digital Mammograms

Background: Automatic detection and classification of breast masses in mammograms are still challenging tasks. Today, computer-aided diagnosis (CAD) systems are being developed to assist radiologists in interpreting mammograms. Objectives: This study aimed to provide a novel method for automatic segmentation and classification of masses in mammograms to help radiologists make an accurate diagnosis. Materials and Methods: For an efficient mass diagnosis in mammograms, we proposed an automatic scheme to perform both mass detection and classification. First, a combination of several image enhancement algorithms, including contrast-limited adaptive histogram equalization (CLAHE), guided imaging, and median filtering, was investigated to enhance the visual features of breast area and increase the accuracy of segmentation outcomes. Second, the density of discrete wavelet coefficient density (DDWCs), based on the quincunx lifting scheme (QLS), was proposed to find suspicious mass regions or regions of interest (ROIs). Finally, mass lesions that appeared in the mammogram were classified into four categories of benign, probably benign, malignant, and probably malignant, based on the morphological shape. The proposed method was evaluated among 1593 images from the Curated Breast Imaging Subset-Digital Database for Screening Mammography (CBIS-DDSM) dataset. Results: The experimental results revealed that the suspected region localization had 100% sensitivity, with a mean of 6.4 ± 4.5 false positive (FP) detections per image. Moreover, the results showed an overall accuracy of 85.9% and an area under the curve (AUC) of 0.901 for the mass classification algorithm. Conclusion: The present results showed the comparable performance of our proposed method to that of the state-of-the-art methods.

METAPLASTIC CARCINOMA OF BREAST : A CASE REPORT

Metaplastic breast cancer constitute nearly 1 % of all breast carcinoma cases. There is metaplasia of normal epithelial components of the breast into other types. They are highly aggressive with very poor prognosis. Here we present a case of 30 year old female who presented with a breast lump in her left breast associated with dull aching pain. It was 10 x 10 cm in size involving upper inner, upper outer, lower outer quadrants and retroareolar area of left breast. USG was suugestive of BIRADS VI lesion. Axillary lymph nodes were not found enlarged clinically or radiologically. Core biopsy report showed Phylloides tumor of breast. The patient underwent simple mastectomy of left breast and histopathology revealed spindle cell variant of metaplastic breast cancer. The cell blocks sent for immunohistochemistry were negative for estrogen, progesterone receptors and Her2neu receptor. The post surgical treatment of this type of breast cancer is still under study.

A Novel 3-D-CAD for Breast and Lesion Segmentation of Axial Breast DCE-MRI

Abstract The present paper proposes a fully automated three-dimensional (3-D) system for breast and lesion segmentation of Dynamic Contrast Enhanced MRI (DCE-MRI). Such a system as the Computer-Aided Diagnostic system (CAD) can be used to support radiologists by marking suspicious areas. The proposed 3-D-CAD system includes three modules. The first one concerns breast area segmentation based on image content analysis, the Moore-Neighbor tracing algorithm, and the Dijkstra algorithm. The second one concerns the automation of locating and selecting lesions that starts by preprocessing the already segmented breast regions; then, a K-means algorithm allows extraction of regions including suspicious tissues. The third one is the superimposition of all detected lesions from selected slices to create a 3-D view of the lesion. The 3-D reconstruction is based on the Marching Cube algorithm. The validation of breast area segmentation reveals the robustness of the proposed process versus different breast densities, complex forms, and challenging cases. The segmentation of the breast part from 120 slices with the proposed method is achieved in 20.57 ± 5.2 s, which is faster than existing methods. In addition to calculated metrics as Dice similarity coefficient (DSC) and rates of true positives, the module of lesion extraction is validated by experimented radiologists. The proposed workflow of this module shows competitive results compared to the existing methods of automated lesion segmentation and a total ability for eliminating the extra regions to lesions.

Predicting the onset of breast cancer using mammogram imaging data with irregular boundary.

With mammography being the primary breast cancer screening strategy, it is essential to make full use of the mammogram imaging data to better identify women who are at higher and lower than average risk. Our primary goal in this study is to extract mammogram-based features that augment the well-established breast cancer risk factors to improve prediction accuracy. In this article, we propose a supervised functional principal component analysis (sFPCA) over triangulations method for extracting features that are ordered by the magnitude of association with the failure time outcome. The proposed method accommodates the irregular boundary issue posed by the breast area within the mammogram imaging data with flexible bivariate splines over triangulations. We also provide an eigenvalue decomposition algorithm that is computationally efficient. Compared to the conventional unsupervised FPCA method, the proposed method results in a lower Brier Score and higher area under the ROC curve (AUC) in simulation studies. We apply our method to data from the Joanne Knight Breast Health Cohort at Siteman Cancer Center. Our approach not only obtains the best prediction performance comparing to unsupervised FPCA and benchmark models but also reveals important risk patterns within the mammogram images. This demonstrates the importance of utilizing additional supervised image-based features to clarify breast cancer risk.

Repigmentation of nipple-areola complex after ReCell® treatment on breast vitiligo.

Nipple-areola complex is a naturally hyperpigmented skin area which can be involved in vitiligo. But limited study focused on the treatment of nipple-areola complex vitiligo, and few methods were proven to be effective. In this study, we aimed to explore the feasibility and efficacy of ReCell® on vitiligo in the nipple-areola complex area. Medical records of patients with vitiligo involving nipple-areola complex and underwent ReCell® treatment from October 2016 to April 2020 were retrospectively reviewed. The repigmentation rate of the nipple-areola complex and other breast area were calculated under the Wood's light at each follow-up. The grade of repigmentation and patient-reported satisfaction rate were also evaluated to prove the effect of ReCell® on vitiligo of breast and especially in the nipple-areola complex area. A total of 18 patients were included in this study. No surgical complications were reported. The mean postoperative repigmentation rate in the nipple-areola complex area (3rd-month, 78.7±5.8%; 6th-month, 87.6±5.1%; and 12th-month, 96.1±3.5%) was significantly higher than that in the other breast treatment area (3rd-month, 70.4±6.9%; 6th-month, 84.2±5.7%, and 12th-month, 93.2±3.6%). All patients showed good or excellent grades at the last follow-up, and 94.4% of them considered the overall treatment results satisfactory. ReCell® is a feasible and efficient treatment strategy in the nipple-areola complex vitiligo.

Clinical implementation of deep-learning based auto-contouring tools–Experience of three French radiotherapy centers

Deep-learning (DL)-based auto-contouring solutions have recently been proposed as a convincing alternative to decrease workload of target volumes and organs-at-risk (OAR) delineation in radiotherapy planning and improve inter-observer consistency. However, there is minimal literature of clinical implementations of such algorithms in a clinical routine. In this paper we first present an update of the state-of-the-art of DL-based solutions. We then summarize recent recommendations proposed by the European society for radiotherapy and oncology (ESTRO) to be followed before any clinical implementation of artificial intelligence-based solutions in clinic. The last section describes the methodology carried out by three French radiation oncology departments to deploy CE-marked commercial solutions. Based on the information collected, a majority of OAR are retained by the centers among those proposed by the manufacturers, validating the usefulness of DL-based models to decrease clinicians’ workload. Target volumes, with the exception of lymph node areas in breast, head and neck and pelvic regions, whole breast, breast wall, prostate and seminal vesicles, are not available in the three commercial solutions at this time. No implemented workflows are currently available to continuously improve the models, but these can be adapted/retrained in some solutions during the commissioning phase to best fit local practices. In reported experiences, automatic workflows were implemented to limit human interactions and make the workflow more fluid. Recommendations published by the ESTRO group will be of importance for guiding physicists in the clinical implementation of patient specific and regular quality assurances.

Welfare of broiler chickens reared under two different types of housing

AbstractWe compared closed- and open-sided industrial houses with respect to the welfare of broiler chickens in southern Brazil. Ten flocks from each design were evaluated and measures divided into the following categories: i) bird health: contact dermatitis on the breast and abdominal areas, bird soiling, foot-pad dermatitis, hock burn, lameness, fractures, bruising, scratches, dead on arrival, diseases; ii) environmental measurements: relative humidity, temperature, air velocity, ammonia (NH3), carbon dioxide (CO2), light intensity, litter moisture; iii) behaviour: bird behaviour, touch test; and iv) affective states: qualitative behaviour assessment. Closed-sided houses showed worse contact dermatitis on the breast and abdominal areas, lower exploratory behaviour prevalence, higher NH3(11.2 [± 6.8] vs 7.5 [± 3.9] ppm) and CO2(1,124.9 [± 561.5] vs 841.0 [± 158.0] ppm), lower light intensity (6.9 [± 6.3] vs 274.2 [± 241.9] lux), while open-sided houses had a higher prevalence for scratches and panting behaviour, and lower air velocity (2.1 [± 0.7] vs 1.1 [± 1.0] m s−1). Stocking densities of 13.9 (± 0.4) and 12.0 (± 0.3) per m2for closed- and open-sided houses, respectively, likely influenced some results. All values shown are means (± SD). Even though open-sided houses presented fewer animal welfare restrictions (according to five indicators as opposed to three for closed-sided houses), both revealed important welfare problems, evidenced by poor environmental indicators, behavioural restrictions and injuries.

Exoscope-based videocapillaroscopy system for in vivo skin microcirculation imaging of various body areas.

The capillary system immediately responds to many pathologies and environmental conditions. Accurate monitoring of its functioning often enables early detection of various diseases related to disorders in skin microcirculation. To expand the scope of capillaroscopy application, it is reasonable to visualize and assess blood microcirculation exactly in the areas of inflamed skin. Body vibrations, breathing, non-flat skin surface and other factors hamper the application of conventional capillaroscopes outside the nailfold area. In this paper, we propose an exoscope-based optical system for high-quality non-invasive computational imaging of capillary network in various areas of the body. Accurate image matching and tracking temporal intensity variations allow detecting the presence of blood pulsations, precise mapping of capillaries and photoplethysmogram acquisition. We have demonstrated the efficiency of the proposed approach experimentally by in vivo mapping and analysis of microvessels in wrist, forearm, upper-arm, breast and hip areas. We believe that the developed system will increase the diagnostic value of video capillaroscopy in clinical practice.

Deep-LIBRA: An artificial-intelligence method for robust quantification of breast density with independent validation in breast cancer risk assessment

Breast density is an important risk factor for breast cancer that also affects the specificity and sensitivity of screening mammography. Current federal legislation mandates reporting of breast density for all women undergoing breast cancer screening. Clinically, breast density is assessed visually using the American College of Radiology Breast Imaging Reporting And Data System (BI-RADS) scale. Here, we introduce an artificial intelligence (AI) method to estimate breast density from digital mammograms. Our method leverages deep learning using two convolutional neural network architectures to accurately segment the breast area. An AI algorithm combining superpixel generation and radiomic machine learning is then applied to differentiate dense from non-dense tissue regions within the breast, from which breast density is estimated. Our method was trained and validated on a multi-racial, multi-institutional dataset of 15,661 images (4,437 women), and then tested on an independent matched case-control dataset of 6368 digital mammograms (414 cases; 1178 controls) for both breast density estimation and case-control discrimination. On the independent dataset, breast percent density (PD) estimates from Deep-LIBRA and an expert reader were strongly correlated (Spearman correlation coefficient = 0.90). Moreover, in a model adjusted for age and BMI, Deep-LIBRA yielded a higher case-control discrimination performance (area under the ROC curve, AUC = 0.612 [95% confidence interval (CI): 0.584, 0.640]) compared to four other widely-used research and commercial breast density assessment methods (AUCs = 0.528 to 0.599). Our results suggest a strong agreement of breast density estimates between Deep-LIBRA and gold-standard assessment by an expert reader, as well as improved performance in breast cancer risk assessment over state-of-the-art open-source and commercial methods.

Segmentation of pectoral muscle from digital mammograms with depth-first search algorithm towards breast density classification

Digital mammography acts as a unique screening technology to protect the lives of females against breast cancer for the past few decades. Mammographic breast density is a well-known biomarker and plays a substantial role in breast cancer prediction and treatments. Breast density is calculated based on the opacity of fibro-glandular tissue reflected on digital mammograms concerning the whole area of the breast. The opacity of pectoral muscle and fibro-glandular tissue is similar to each other; hence, the small presence of the pectoral muscle in the breast area can hamper the accuracy of breast density classification. Successful removal of pectoral muscle is challenging due to changes in shape, size, and texture of pectoral muscle in every MLO and LMO views of mammogram. In this article, the depth-first search (DFS) algorithm is proposed to remove artifacts and pectoral muscle from digital mammograms. In the proposed algorithm, image enhancement is performed to improve the pixel quality of the input image. The whole breast as a single connected component is identified from the background region to remove the artifacts and tags. The depth-first search method with and without the heuristic approach is used to delineate the pectoral muscle, and then final suppression is performed on it. This algorithm is tested on 2675 images of the DDSM dataset, which is further divided into four density classes as per BIRADs classification. Segmentation results are calculated individually on each BIRADs density class of the DDSM dataset. Results are validated subjectively by the expert's Radiologist's ground truth with segmentation accuracy and objectively by the Jaccard coefficient and a dice similarity coefficient. This algorithm is found robust on each density class and provides overall segmentation accuracy of 86.18%, a mean value of Jaccard index, and a Dice similarity coefficient of 0.9315 and 0.9548, respectively. The experimental results show that the proposed algorithms applied for pectoral muscle removal follow the ground truth marked by an expert radiologist. The proposed algorithm can be part of the pre-processing unit of breast density measurement and breast cancer detection system used during clinical practice.

Evaluation of Given Dose Accuracy in Radiation Therapy of Patient with Breast Cancer Using Diode In Vivo Dosimetry

Background: The main goal of radiation therapy is to deliver the highest dose to the tumor and at the same time the lowest dose to the surrounding normal tissue. In vivo dosimetry is a quality control procedure that, instead of controlling the components separately, directly examines the dose reached to the tumor area. Objectives: In this study, the entrance, exit, and middle dose of the breast and supraclavicular area of patients with breast cancer under radiation therapy were measured and compared with calculations. Methods: In this experimental study, the entrance and exit doses of 33 patients with breast tumors treated with 6 MV and 18MV photons were measured simultaneously. The measurement was done, using p-type diodes after calibration and, then, the midpoint dose was calculated, using the transfer method and arithmetic mean method. Also, the entrance dose, exit dose, and midline dose measured with dosimeter were compared with the calculated values in the treatment planning system. Results: There was no significant difference between calculated and measured doses in the entrance, exit, and midline point in breast regions (P > 0.05), but in the supraclavicular region, a challenge was observed. The difference in entrance and midline point between calculation and measurement is not significant based on the transfer method, but there is a significant error based on the arithmetic mean method (P < 0.05). Conclusions: In vivo dosimetry by measured real given dose to the patient can perform a basic role in the quality control of the radiotherapy department. It seems in the entrance dose, the relative error is smaller but due to the smaller value of exit dose, the relative error in small values is more apparent.

Genetic Variants in COX2 and ALOX Genes and Breast Cancer Risk in White and Black Women.

COX and ALOX genes are involved in inflammatory processes and that may be related to breast cancer risk differentially between White and Black women. We evaluated distributions of genetic variants involved in COX2 and ALOX-related pathways and examined their associations with breast cancer risk among 1,275 White and 1,299 Black cases and controls who participated in the Women’s Circle of Health Study. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable-adjusted logistic regression models. Our results showed differential associations of certain genetic variants with breast cancer according to menopausal and ER status in either White or Black women. In White women, an increased risk of breast cancer was observed for COX2-rs689470 (OR: 2.02, P = 0.01) in the dominant model, and was strongest among postmenopausal women (OR: 2.72, P = 0.02) and for estrogen receptor positive (ER+) breast cancers (OR: 2.60, P = 0.001). A reduced risk was observed for ALOX5-rs7099874 (OR: 0.75, P = 0.01) in the dominant model, and was stronger among postmenopausal women (OR: 0.68, P = 0.03) and for ER+ cancer (OR: 0.66, P = 0.001). Four SNPs (rs3840880, rs1126667, rs434473, rs1042357) in the ALOX12 gene were found in high LD (r2 >0.98) in White women and were similarly associated with reduced risk of breast cancer, with a stronger association among postmenopausal women and for ER− cancer. Among Black women, increased risk was observed for ALOX5-rs1369214 (OR: 1.44, P = 0.003) in the recessive model and was stronger among premenopausal women (OR: 1.57, P = 0.03) and for ER+ cancer (OR: 1.53, P = 0.003). Our study suggests that genetic variants of COX2 and ALOX genes are associated with breast cancer, and that these associations and genotype distributions differ in subgroups defined by menopausal and ER status between White and Black women. Findings may provide insights into the etiology of breast cancer and areas for further research into reasons for breast cancer differences between races.

Assessment of breast arteries and lymph nodes by 3D MR angiography enhancement imaging: feasibility and pilot clinical results

BackgroundConventional dynamic contrast enhanced (DCE) magnetic resonance (MR) hardly achieves a good imaging performance of arteries and lymph nodes in the breast area. Therefore, a new imaging method is needed for the assessment of breast arteries and lymph nodes.MethodsWe performed prospective research. The research included 52 patients aged from 25 to 64 between June 2019 and April 2020. The isotropic e-THRIVE sequence scanned in the coronal direction after DCE-THRIVE. Reconstructed images obtained by DCE-THRIVE and the coronal e-THRIVE were compared mainly in terms of the completeness of the lateral thoracic artery, thoracodorsal artery, and lymph nodes. We proposed a criterion for evaluating image quality. According to the criterion, images were assigned a score from 1 to 5 according to the grade from low to high. Two board-certified doctors evaluated images individually, and their average score was taken as the final result. The chi-square test was used to assess the difference.ResultsThe coronal e-THRIVE score is 4.60, which is higher than the DCE-THRIVE score of 3.48, there are significant differences between the images obtained by two sequences (P = 1.2712e−8). According to the score of images, 44 patients (84.61%) had high-quality images on the bilateral breast. Only 3 patients’ (5.77%) images were not ideal on both sides. The improved method is effective for most patients to get better images.ConclusionsThe proposed coronal e-THRIVE scan can get higher quality reconstruction images than the conventional method to visualize the course of arteries and the distribution of lymph nodes in most patients, which will be helpful for the clinical follow-up treatment.