Breast Cancer Screening Research Articles

РИСК ОСТЕОПОРОЗА У ЖЕНЩИН С ВЫЯВЛЯЕМЫМИ ПРИ МАММОГРАФИИ СОСУДИСТЫМИ КАЛЬЦИНАТАМИ МОЛОЧНЫХ ЖЕЛЕЗ

Abstract. Introduction. Calcium salt deposits in the breast vessel walls can share the mutual mechanisms compared to the ones of bone tissue mineralization mediated by the osteoprotegerin or receptors of the protein glycation end products. Aim: To assess the risk of osteoporosis or other mineral turnover disturbances in women with breast vascular calcifications found on mammography. Materials and Methods. Our study included 189 female patients who underwent mammography in 2018 and then were followed up to the year 2023. They were divided into the three groups: No calcifications group, moderate (grade 1-2) calcifications group, and pronounced (grade 3-4) calcifications group. All the patients underwent screening mammography, the dual-energy X-ray absorptiometry, and serum biochemistry tests (25-hydroxyvitamin D, total and ionized calcium, phosphorus, and magnesium). Results and Discussion. In 2018, 57 (30.16%) patients had breast vascular calcifications. The increased calcification degree was associated with the age. The most significant changes were found in TBS T-score values: In the moderate calcifications group, it was 27.5% lower compared to the no calcifications group (p=0.042); while in the pronounced calcifications group, it was 41.7% lower compared to the no calcifications group (p=0.007). Conclusions. Breast vascular calcifications are associated with the significant drop of TBS T-score values (from -2.31 to -3.97; р=0.008).

De-Mystifying the Clone-Censor-Weight Method for Causal Research Using Observational Data: A Primer for Cancer Researchers.

Regulators and oncology healthcare providers are increasingly interested in using observational studies of real-world data (RWD) to complement clinical evidence from randomized controlled trials for informed decision-making. To generate valid evidence, RWD studies must be carefully designed to avoid systematic biases. The clone-censor-weight (CCW) method has been proposed to address immortal time and other time-related biases. The objective of this manuscript is to de-mystify the CCW method for cancer researchers by describing and presenting its core components in an accessible and digestible format, using visualizations and examples from cancer-relevant studies. The CCW method has been applied in diverse settings, including investigations of the effects of surgery within a certain time after cancer diagnosis, the continuation of annual screening mammography, and chemotherapy duration on survival. The method handles complex data wherein the treatment group to which an individual belongs is unknown at the start of follow-up. The three steps of the CCW method involve cloning or duplicating the patient population and assigning one clone to each treatment strategy, artificially censoring the clones when their observed data are inconsistent with the assigned strategy and weighting the cloned and censored population to address selection bias created by the artificial censoring. The CCW method is a powerful tool for designing RWD studies in cancer that are free from time-related biases and successfully, to the extent possible, emulate features of a randomized clinical trial.

Utilizing OncomiR and TSmiR as Biomarkers for Screening Breast Cancer

Utilizing OncomiR and TSmiR as Biomarkers for Screening Breast Cancer

CÂNCER DE MAMA NO BRASIL - PREVALÊNCIA ENTRE 2014 E 2023 - E A IMPORTÂNCIA DA MAMOGRAFIA NO RASTREAMENTO

Breast cancer is one of the most prevalent neoplasms among women and a leading cause of cancer-related mortality worldwide, with variations influenced by genetic, environmental, and socioeconomic factors. In Brazil, the number of cases has risen in recent years, reflecting, among other factors, inequalities in access to healthcare services, with incidence rates varying across regions. Early detection, particularly through mammography, is crucial for reducing mortality rates; however, exam coverage remains insufficient, with significant regional disparities. Compared to developed countries, where screening programs are broader and initiated at younger ages, Brazil faces challenges in effectively implementing adequate mammographic screening. In this context, the present article aims to review epidemiological data on breast cancer in Brazil over the past decade, specifically from 2014 to 2023, and to analyze the impact and coverage of mammography as a screening method. Additionally, it seeks to review the latest scientific literature regarding screening recommendations and their impact on preventing malignant breast neoplasms.

Effectiveness of Contrast-Enhanced Mammography in Breast Cancer Screening: A randomized control Trial

Effectiveness of Contrast-Enhanced Mammography in Breast Cancer Screening: A randomized control Trial

Individual and Catchment Area Factors Associated With Breast and Cervical Cancer Screening Within the Military Health System.

Breast and cervical cancer screening is critical to identifying cases at earlier stages in order to begin treatment earlier and improve survival. Screening rates have been shown to vary within the Military Health System (MHS). The goal is to estimate drivers of variation in screening rates within the MHS. We used 2007-2019 MHS Data Repository Data to examine individual-level and catchment area-level factors associated with 1- and 2-year breast and cervical cancer screening rates. Specifically, we estimated univariate and multivariate association between 1- and 2-year probability of breast and cervical cancer screening rates and age group, marital status, rank, service branch, beneficiary type (service member vs. dependent), race/ethnicity of service members, catchment area fraction of overall care through purchased care and average per capita spending. The project was approved by both the Penn State Institutional Review Board (IRB) and the Defense Health Agency's electronic IRB. Overall, we observed a 45.6% 1 year and a 65.7% 2-year mammography screening rate and a 30.5% 1 year and a 51.9% 2-year Pap testing rate. For breast cancer screening, we found higher screening rates for older (ages 50-64 years), married, service members, more senior ranked women or those married to more senior ranked members, and non-Hispanic Black women in both unadjusted and multivariate analyses. Conversely, we found higher rates of cervical cancer screening for younger, unmarried, more junior ranked women as well as for non-Hispanic Black women. We also found higher rates for both breast and cervical cancer screening in catchment areas with a greater fraction of care delivered through the private sector. Our finding of higher screening in catchment areas with higher rates of purchased care warrants additional study to understand what factors may drive this result. The differential findings of the association between individual characteristics and breast and cervical cancer screening suggest important differences in these 2 types of screening with potentially different policies required to encourage and enhance breast vs. cervical cancer screening. Finally, our results showing higher screening among non-Hispanic Black women suggests important features of the MHS, such as universal, low-cost sharing coverage may help to reduce racial and ethnic disparities in breast and cervical cancer screening.

Age at first menstruation and clinical breast cancer screening utilization: insights from the 2021 Côte d'Ivoire demographic and health survey

BackgroundThere is a strong evidence showing that women who start menstruation early are at a greater risk of developing breast cancer. Recognizing that women will seek breast cancer screening when they have a high perceived risk, we hypothesized that women who experienced early menarche will be more likely to utilize clinical breast examination (CBE). Hence, we aimed to investigate the association between age at first menstruation and women’s utilization of CBE in Côte d'Ivoire.MethodsWe used data from the 2021 Côte d'Ivoire demographic and health survey. A sample of 14,685 women was used for the analysis. A descriptive analysis, as well as bivariate and multivariate logistic regression models were computed in STATA version 18. Adjusted odds ratio (AOR) and a 95% confidence interval was used to present the result.ResultsCBE utilization was 17.4%. Women who had their first menstruation before attaining 15 years were significantly less likely to utilize CBE services [AOR = 0.89; 95% CI 0.81–0.99]. A significantly higher utilization of CBE was found among those with primary [AOR = 1.48, 95% CI 1.29–1.70], secondary [AOR = 2.96, 95% CI 2.59–3.38], and higher education [AOR = 4.35, 95% CI 3.50–5.40] compared to those with no formal education. Increasing likelihood of CBE utilization was observed as age increased. Rural residence was associated with lower odds of CBE utilization (AOR = 0.84, 95% CI 0.74–0.95]. Increasing wealth status was associated with higher odds of CBE utilization with those in the richest households having the highest odds compared to women in the poorest household [AOR = 2.11, 95% CI 1.69–2.64].ConclusionUtilization of CBE is low among women of reproductive age in Côte d'Ivoire. We conclude that even though existing literature has established early age at first menstruation as a strong risk factor for breast cancer, CBE utilization is significantly low among those who had early menarche. Going forward, it is necessary for Côte d'Ivoire’s health Ministry to intensify breast cancer awareness in the country. Such awareness campaigns must emphasize age at menarche as a risk factor so as to motivate women with a history of early menstruation to utilize CBE.

Breast Cancer and Colorectal Cancer Screenings Among People with HIV: The Role of Individual and System-Level Factors on Screening Completion

Breast Cancer and Colorectal Cancer Screenings Among People with HIV: The Role of Individual and System-Level Factors on Screening Completion

An adaptation of hybrid binary optimization algorithms for medical image feature selection in neural network for classification of breast cancer

The performance of neural network is largely dependent on their capability to extract very discriminant features supporting the characterization of abnormalities in the medical image. Several benchmark architectures have been proposed and the use of transfer learning has further made these architectures return good performances. Study has shown that the use of optimization algorithms for selection of relevant features has improved classifiers. However continuous optimization algorithms have mostly been used though it allows variables to take value within a range of values. The advantage of binary optimization algorithms is that it allows variables to be assigned only two states, and this have been sparsely applied to medical image feature optimization. This study therefore proposes hybrid binary optimization algorithms to efficiently identify optimal features subset in medical image feature sets. The binary dwarf mongoose optimizer (BDMO) and the particle swarm optimizer (PSO) were hybridized with the binary Ebola optimization search algorithm (BEOSA) on new nested transfer functions. Medical images passed through convolutional neural networks (CNN) returns extracted features into a continuous space which are piped through these new hybrid binary optimizers. Features in continuous space a mapped into binary space for optimization, and then mapped back into the continuous space for classification. Experimentation was conducted on medical image samples using the Curated Breast Imaging Subset of Digital Database for Screening Mammography (DDSM+CBIS). Results obtained from the evaluation of the hybrid binary optimization methods showed that they yielded outstanding classification accuracy, fitness, and cost function values of 0.965, 0.021 and 0.943. To investigate the statistical significance of the hybrid binary methods, the analysis of variance (ANOVA) test was conducted based on the two-factor analysis on the classification accuracy, fitness, and cost metrics. Furthermore, results returned from application of the binary hybrid methods medical image analysis showed classification accuracy of 0.8286, precision of 0.97, recall of 0.83, and F1-score of 0.99, AUC of 0.8291. Findings from the study showed that contrary to the popular approach of using continuous metaheuristic algorithms for feature selection problem, the binary metaheuristic algorithms are well suitable for handling the challenge. Complete source code can be accessed from: https://github.com/NathanielOy/hybridBinaryAlgorithm4FeatureSelection

Breast cancer screening in transgender women with high-risk family history

A clinical decision report using: de Blok CJM, Wiepjes CM, Nota NM, et al. Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands. BMJ. 2019;365:l1652. https://doi.org/10.1136/bmj.l1652 for a transgender woman with family history of breast cancer.

Access to Breast Cancer Screening: Disparities and Determinants-AJR Expert Panel Narrative Review.

While breast cancer screening reduces mortality, disparities in access continue to limit equitable care. Medically underserved groups-including American Indian or Alaska Native, Black, Hispanic, disabled, and LGBTQ+ individuals-face significant barriers in accessing screening mammography services. This AJR Expert Panel Narrative Review leverages the National Institute on Minority Health and Health Disparities Research Framework to analyze persistent inequities in screening, focusing on race, ethnicity, socioeconomic status, disabilities, health insurance, and geography. Screening guidelines vary across organizations, complicating access for underserved groups. Legislative efforts, including breast density notification laws and the Find It Early Act, aim to address disparities but remain insufficient. Traditional risk models can yield inconsistent assessments of high-risk status and disparities in appropriate referral for genetic testing and supplemental screening. Emerging technologies like artificial intelligence (AI) promise to reduce these gaps by improving risk assessment and detection accuracy, although clinical integration requires careful evaluation to avoid exacerbating existing inequities. This article underscores the importance of policies and practices that address the needs of disabled individuals and other marginalized populations, focusing on creating inclusive and effective screening systems. Recommendations are provided to guide future research, policy development, and clinical practices aimed at mitigating disparities in breast cancer screening.

Attitudes towards risk-stratified breast cancer screening in Denmark – a qualitative study

BackgroundToday the prerequisites exist to initiate risk-stratified screening according to a woman’s individual risk of breast cancer as opposed to existing one-size-fits-all age-based programmes. This presupposes that the women accept having their personal risk score estimated and their screening intervals changed accordingly. Risk-stratified screening has not yet been implemented in any country, but in the future many European countries will very likely move towards more personalized screening.MethodsThis qualitative study among 46 women aged 50-69 years used an anthropological approach and interpretive description. Data was collected using semi-structured focus group interviews and telephone interviews. The interviews were analysed using systematic text condensation.ObjectiveThe aim of this study was to explore Danish women’s understanding of breast cancer risk and their attitudes towards the concept of risk-stratified breast cancer screening.ResultsThe women highly valued the current screening program, seeing regular mammograms as crucial for early detection. The women had good knowledge of the causes of breast cancer, but they had not given much thought to their own risk. They found a personalized screening approach more reliable than age-based screening, understanding that low risk is not the same as no risk just as high risk is not equal to ever developing breast cancer. Despite concerns about increased anxiety arising from knowing one’s risk, they appreciated the possibility of more frequent screenings for high-risk individuals.ConclusionIn general, the women showed acceptance of a new breast cancer screening concept estimating their personal risk score. Due to concerns about interval cancers and the prolonged screening intervals for women at low risk, offering more intensified screening for high-risk women may be less challenging than deescalating screening for low-risk women. Whether the expressed positive attitude and curious interest will translate into actual participation if implemented, remains to be investigated further in an ongoing Danish trial.

BREAST CANCER SCREENING IN WOMEN AGED 45-65 IN SAMARKAND REGION, UZBEKISTAN: A CROSS-SECTIONAL ANALYSIS OF DATA FROM 2023

Objective: Breast cancer is a leading cause of cancer-related mortality among women globally, and early detection through screening significantly reduces morbidity and mortality. This study evaluates the outcomes of breast cancer screening programs in the Samarkand region of Uzbekistan in 2023, focusing on participation rates, detection rates, and stage distribution across 17 districts and cities. Methods: Data were collected on women aged 45–65, including annual screening targets, the number of screenings performed, diagnosed cases, and cancer stage distribution (early stages 1–2 vs. late stages 3–4). Statistical analysis was conducted to determine completion and detection rates, as well as regional disparities in screening outcomes. Results: The screening program achieved promising outcomes in participation and early-stage cancer detection, with substantial variability among districts. A higher proportion of cases were detected at stages 1–2, indicating effective early diagnosis in some areas. However, significant regional disparities in screening completion and detection highlight inequitable access to services. Novelty: This study provides a comprehensive regional analysis of breast cancer screening outcomes in Uzbekistan, emphasizing the importance of addressing disparities to improve equitable access to early diagnosis and treatment. These findings underscore the need for targeted public health interventions to enhance program effectiveness and reduce the burden of late-stage breast cancer

Marketing healthcare services in Jordan: examining the elements influencing women’s intention to get early breast cancer screening

Marketing healthcare services in Jordan: examining the elements influencing women’s intention to get early breast cancer screening

An innovative approach to the multidisciplinary treatment of uninsured breast cancer patients.

A significant proportion of many populations remain uninsured. The aim of the study was to assess differences in breast cancer outcomes before and after the implementation of an innovative approach to the multidisciplinary treatment of uninsured breast cancer patients. Retrospective review was performed of patients seen at a safety net hospital from January 2000 to December 2020. Beginning July 2006, an innovative approach was implemented to lower patient costs and facilitate care of uninsured patients. The study included 1,797 patients, 661 patients before the changes (BCS), and 1136 patients after implementation of the new cost saving approach (ACS). The mean age was 53years. The majority were uninsured (56%) or insured by Medicaid (31%). Only 18% underwent screening mammography. The ACS group had a higher rate of breast conservation (75% vs 47%, p < 0.001). A higher percentage of the ACS group received adjuvant therapy: Chemotherapy (91% vs 70%, p < 0.001), Radiation therapy (91% vs 70%, p < 0.001), and initiated endocrine therapy (87% vs 67%, p < 0.001). After follow-up of 8years, these changes resulted in lower ipsilateral breast tumor recurrence (2% vs 16%, p < 0.001) and chest wall recurrence (5% versus 8%) and improvement in overall survival (90% vs 81%, p < 0.001). Peer-reviewed literature is replete of studies documenting disparities in breast cancer treatment. The current study describes a successful cost-limiting method which takes advantage of existing financial assistance programs to improve care in uninsured patients.

Analyzing the Effectiveness of AI-Generated Patient Education Materials: A Comparative Study of ChatGPT and Google Gemini.

The study aims to compare ChatGPT and Google Gemini-generated patient education guides regarding claustrophobia during MRI, mammography screening, and MR safe and unsafe items and the importance of knowing what items can be carried into an MR room. The study utilized ChatGPT 3.5 and Google Gemini to create patient education guides concerning claustrophobia during MRI, mammography screening, and MR safe and unsafe items. A Flesch-Kincaid calculator was used to evaluate readability and ease of understanding. QuillBot(QuillBot, Inc., Chicago, USA) was used to generate a similarity score to evaluate possible plagiarism. In order to assess the scientific reliability of the AI-generated responses, we utilized a modified DISCERN score. R Studio 4.3.2 (The R Foundation for Statistical Computing, Vienna, Austria) was used for statistical analyses, with unpaired t-tests used to determine statistical significance between variables. The average number of words in ChatGPT and Google Gemini were 468.7±132.07 and 328.7±163.65, respectively. The mean number of sentences was 35.67±18.15 for ChatGPT and 30.33±12.22 for Google Gemini. Ease of readability for ChatGPT responses was 36.30±7.01 and for Google Gemini 46.77±4.96. The similarity scores for the ChatGPT responses were 0.50±0.62 and for Google Gemini 9.43±6.20. The reliability score was evaluated at 2.67±0.25 for ChatGPT and 2.67± 0.58 for Google Gemini. The AI generated by ChatGPT and Google Gemini had no statistically significant difference in regard to word count, average word per sentence, average syllables per word, grade level comprehension score, or scientific reliability. However, the ease score was significantly greater for the ChatGPT response compared to Google Gemini. In addition, the similarity score was much higher in Google Gemini than in ChatGPT responses.

Skeptical reactions to breast cancer screening benefits and harms: Antecedents, consequences, and implications for screening communication.

When people receive information about the benefits and harms of mammography screening, they do not always accept it at face value and instead express skepticism. The purpose of this research was to identify the psychological drivers of this skepticism. Two theory-driven hypotheses were considered: One hypothesis proposes that skeptical reactions reflect a psychological defense against information that is emotionally aversive. Another proposes that skeptical reactions reflect a normative probabilistic inference that information that conflicts with prior beliefs is unlikely to be true. This work also identified the potential consequences of skepticism for people's screening preferences. A nationally representative sample of female participants ages 39-49 received information about the benefits and harms of mammography screening. Skepticism toward information about screening benefits and harms was measured, as well as hypothesis-relevant predictors of that skepticism. Participants' preferred age to have regular mammograms was also assessed. The results did not support the hypothesis that skepticism reflects an emotional defense. Instead, skepticism was associated with experiencing the information as conflicting with beliefs and past screening messages. Expressing more skepticism toward screening harms was associated with preferring to start screening at a younger age. These data suggest that people express skepticism toward mammography evidence not because it is aversive information, but instead because it conflicts with other things they believe and have been told. Consistent, coordinated messages from health experts about mammography evidence may therefore help to reduce skepticism, and help promote an informed patient population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prospective multicenter cohort study on breast cancer screening using an automated breast ultrasound with remote reading

Objective: To construct a remote screening network for breast cancer based on automated breast ultrasound (ABUS) and explore the value of ABUS with remote reading for breast cancer screening. Methods: We constructed a remote breast cancer screening network including one remote reading center and 48 image-acquisition centers. We recruited women to participate in breast cancer screening at one of these image-acquisition centers from January 2021 to January 2023. The technicians collected the whole breast images using the ABUS. The images were then sent to the reading center through the PVBUS System and interpreted independently by two radiologists using the Breast Imaging Reporting and Data System (BI-RADS). BI-RADS categories 1 and 2 indicate negative screening results, and women diagnosed with these categories were recommended for annual breast ultrasound screening. BI-RADS categories 3, 4, and 5 indicate positive results. Women with BI-RADS category 3 lesions were recommended for follow-up examinations every 6 months using ABUS or handheld ultrasound, while those with BI-RADS 4 and 5 lesions were suggested to undergo pathological examinations. Results: In our study, we enrolled 10 344 women who completed the ABUS screening and were followed up for more than 12 months. After remote reading, 6 164 women were diagnosed with BI-RADS category 1 and 2 626 woman were within BI-RADS category 2. In contrast, 1 404 women were within BI-RADS category 3, a total of 135 women were within BI-RADS category 4, and 15 women were within BI-RADS category 5. The positive screening rate of ABUS was 15.0% (1 554/10 344). The ABUS with remote reading had a detection rate of 3.7/1 000 (38/10 344) for breast cancer screening, with a sensitivity of 97.4% (38/39) and a specificity of 85.3% (8 789/10 305). Among the 38 breast cancer cases detected, 92.1% (35/38) were invasive carcinomas, and 63.2% (24/38) were stage 0 or Ⅰ breast cancers. Conclusions: Breast cancer screening based on ABUS with remote reading provided an efficient and feasible solution to the problem of unevenly distributed medical resources and medical staff levels in various regions of China, enabling the decentralization of high-quality medical resources and improving the accessibility of high-quality screening services. It has provided an alternative for breast cancer screening in China.

Longer travel times to acute hospitals are associated with lower likelihood of cancer screening receipt among rural-dwelling adults in the U.S. South.

Given rural hospitals' role in providing outpatient services, we examined the association between travel burdens and receipt of cancer screening among rural-dwelling adults in the U.S. South region. First, we estimated network travel times and distances to access the nearest and second nearest acute care hospital from each rural census tract in the U.S. South. After appending the Centers for Disease Control's PLACES dataset, we fitted generalized linear mixed models. Longer distances to the second nearest hospital are negatively associated with breast, colorectal, and cervical cancer screening receipt among eligible rural-dwelling adults. Rural-dwelling women in counties with 1 closure had reduced likelihood of breast cancer screening. Residence in a partial- or whole-county Health Professional Shortage Area (HPSA) was negatively associated with cancer screening receipt. Specialist (OB/GYN and gastroenterologist) supply was positively associated with receipt of cancer screening. Uninsurance was positively associated with cervical and breast cancer screening receipt. Medicaid expansion was associated with increased breast and cervical cancer screening. Rural residents in partial-county primary care HPSAs had the lowest rates of breast, cervical, and colorectal cancer screening, compared with whole-county HPSAs and non-shortage areas. These residents also faced the greatest distances to their nearest and second nearest hospital. This is notable because rural residents in the South face greater travel burdens for cancer care compared with residents in other regions. Finally, the positive association between uninsurance and breast and cervical cancer screening may reflect the CDC's National Breast and Cervical Cancer Early Detection Program's effectiveness.

Awareness of breast cancer and perceived barriers to breast screening methods: a community based cross-sectional study among women in Yemen

BackgroundIn Yemen, effective early detection and a comprehensive grasp of breast cancer symptoms and risk factors are vital in preventing its potentially deadly spread. However, challenges arise in combating breast cancer in Yemen due to the lack of patient registries, national strategies, and structured cancer treatment plans.ObjectiveThis research sought to evaluate the awareness levels of breast cancer and the perceived obstacles to breast cancer screening among adult Yemeni women.MethodsA community-based cross-sectional questionnaire study was conducted from September 2023 to January 2024 from two teaching and largest hospitals in the capital municipality, Sana’a, Yemen, where 533 women (≥ 18 years old) were conveniently selected in this study. Data were analyzed using SPSS software (version 23).. The Chi-square test was used to test associations. The factors associated with breast cancer awareness and barriers to breast cancer screening were analyzed separately, using multivariable logistic regression.ResultsThe study revealed that 88.6% of women were familiar with breast cancer, and 61.9% being knowledgeable about screening methods such as clinical breast examination (CBE) or mammography. The primary hindrance to screening (84.1%, n = 53) was the absence of symptoms or pain. The second most common reason for not undergoing screening was a lack of understanding about breast cancer and its treatment (61.9%, n = 39).ConclusionTo enhance breast cancer screening rates among Yemeni women consistently, targeted educational programs emphasizing the benefits of early detection and dispelling misconceptions and barriers related to the disease are essential.