Detection Of Breast Carcinoma Research Articles

Abstract A044: Utilizing breast cancer-specific micronuclei DNA features from erythrocytes for early detection of breast carcinoma

Abstract Background: Alongside traditional imaging, current development in non-invasive breast carcinoma (BC) diagnosis, such as cell-free DNA-based technologies, have demonstrated promising potential in BC diagnosis. However, achieving early detection remains a challenge. Micronuclei (MN) are extranuclear bodies containing damaged chromosome segments indicative of genomic instability. Elevated levels of MN-containing erythrocytes have been studied in genotoxicity testing and cancer diagnosis. Here, we sequenced the isolated and purified micronuclei DNA (MN-DNA) from erythrocytes in 2ml peripheral blood using a method we previously developed (WO2021/228246 A1) and identified a series of distinct features in read counts that enabled to detect early-stage BC patients. Methods: We collected a clinical study cohort of 172 BC patients and 216 non-BC controls from 1-2ml peripheral blood. MN-DNA was isolated from erythrocytes and performed whole-genome sequencing. We selected distinctive tumor-associated MN-DNA features identified by genome-wide analysis to differentiate between controls and BC for KEGG pathway enrichment and constructed a classification model based on these features. Results: Genome-wide analysis of MN-DNA revealed significant regions between controls and BC patients. Based on covered genes, we observed significant enrichment in the estrogen signaling pathway. Utilizing these distinct MN- DNA features, we constructed a classification model that achieved an AUC of 96%, with a 95% specificity and 88% sensitivity in the test cohort. The model identified early BC (stage 0-I) and advanced BC (stage II-IV) with sensitivities of 100% or 84%, respectively. Conclusions: Our findings highlight that MN-DNA, a form of cytoplasmic DNA, provides a valuable tool for the accurate detection of BC, particularly in its early stages. The MN-DNA pattern is linked to the estrogen signaling pathway, offering novel insights and mechanisms that differ from current diagnostic approaches. Research sponsor: Timing Biotech. Early Detection of Primary Cancer and Relapse Citation Format: Wenjv Mo, Xingyun Yao, Haobo Sun, Honghao Liang, Jie Jin, Xiaowen Ding, Xiaofei Gao. Utilizing breast cancer-specific micronuclei DNA features from erythrocytes for early detection of breast carcinoma [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr A044.

Role of Image-Guided Biopsy in Nonpalpable Breast Lesions: A Study in the Sub-Himalayan Region of North India

Background Nonpalpable breast lesions pose a challenge in their early diagnosis. Image-guided biopsy is preferred in these cases so that a pathological diagnosis of breast carcinoma is reached timely for a better prognosis as the disease has an increased chance of successful outcome with early identification and treatment. Objective The study aims at evaluating the role of stereotactic core needle biopsy (CNB) and percutaneous ultrasound-guided core needle biopsy (US-CNB) in diagnosing suspicious nonpalpable breast lesions. Methods Our study included 35 patients with nonpalpable breast lesions and having a Breast Imaging Reporting and Data System (BI-RADS) risk assessment category IV or V on mammography or sonography. These 35 lesions were subjected to percutaneous image-guided (stereotactic or US) biopsy for histopathological analysis. Results Out of a total of 35 cases, 17 were pathologically malignant (48.6%), with the most common subtype being invasive ductal carcinoma (82.3%). Twenty-nine cases underwent US-CNB, 16 (55.1%) of which were malignant and 13 (44.8%) were benign on histopathological evaluation (HPE). The remaining six cases, which on mammography showed no mass but suspicious malignant calcification only, were subjected to stereotactic CNB, out of which one (16.6%) was malignant and five (83.3%) were benign on HPE. Hence, the lesions visible on sonography were more likely to be malignant. Conclusion Sonography and mammography play a complimentary role in detecting breast carcinoma. Percutaneous biopsy under image guidance can be used as an accurate diagnostic alternative to open surgical excisional biopsy to avoid diagnostic delay.

Comparative Effectiveness of Mammography, Ultrasound, and MRI in the Detection of Breast Carcinoma in Dense Breast Tissue: A Systematic Review.

This systematic review aimed to critically assess the effectiveness of mammography, ultrasound, andmagnetic resonance imaging (MRI) in the detection of breast carcinoma within dense breast tissue. An exhaustive search of contemporary literature was undertaken, focusing on the diagnostic accuracy, false positive and negative rates, and clinical implications of the aforementioned imaging modalities. Each modality was assessed in isolation and side by side against the others to draw comparative inferences. While mammography remains a foundational imaging modality, its effectiveness waned within the context of dense breast tissue. Ultrasound demonstrated a strong differentiation prowess, especially among specific demographic cohorts. MRI, despite its exceptional precision and differentiation capabilities, exhibited a tendency for slightly elevated false positive rates. No single modality emerged as singularly superior for all cases. Instead, an integrated approach, combining the strengths of each modality based on individual patient profiles and clinical scenarios, is recommended. This tailored approach ensures optimized detection rates and minimizes diagnostic ambiguities, underscoring the significance of individualized patient care in the field of diagnostic radiology.

Evaluation of Features in Probably Benign and Malignant Nonmass Enhancement in Breast MRI.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a highly sensitive breast imaging modality in detecting breast carcinoma. Nonmass enhancement (NME) is uniquely seen on MRI of the breast. The correlation between NME features and pathologic results has not been extensively explored. Our goal was to evaluate the characteristics of probably benign and suspicious NME lesions in MRI and determine which features are more associated with malignancy. We performed a retrospective research after approval by the hospital ethics committee on women who underwent breast MRI from March 2017 to March 2020 and identified 63 lesions of all 400 NME that were categorized as probably benign or suspicious according to the BI-RADS classification (version 2013). MRI features of NME findings including the location, size, distribution and enhancement pattern, kinetic curve, diffusion restriction, and also pathology result or 6-12-month follow-up MRI were evaluated and analyzed in each group (probably benign or suspicious NME). Vacuum-guided biopsies (VAB) were performed under mammographic or sonographic guidance and confirmed with MRI by visualization of the inserted clips. Segmental distribution and clustered ring internal enhancement were significantly associated with malignancy (p value<0.05), while linear distribution or homogeneous enhancement patterns were associated with benignity (p value <0.05). Additionally, the plateau and washout types in the dynamic curve were only seen in malignant lesions (p value <0.05). The presence of DWI restriction in NME lesions was also found to be a statistically important factor. Understanding the imaging findings of malignant NME is helpful to determine when biopsy is indicated. The correlation between NME features and pathologic results is critical in making appropriate management.

Concordance between pathologists and between specimen types in detection of HER2-low breast carcinoma by immunohistochemistry

ContextRecent clinical trials indicate that HER2-targeted therapy may benefit HER2-low breast cancer patients including HER2 score 1+ or 2+ and no gene amplification.Concordance between pathologists and between core biopsy and surgical excision in establishing HER2-low status was evaluated. Design57 patients with HER2 negative breast cancer (IHC 0, 1+, or 2+, no gene amplification) by core biopsy were included. Core biopsy and representative tumor from corresponding surgical excision was immunostained for HER2. Original HER2 IHC scores were interpreted using 2018 guidelines. Three pathologists independently interpreted again under 2023 guidelines. Kappa statistic evaluated agreement of HER2 IHC scores. ResultsApplying 2023 guidelines, HER2 IHC scores were concordant among study pathologists in 46 of 57 (81 %) core biopsy and 50 of 57 (88 %) surgical resections. Kappa statistics were 0.78 and 0.85 (substantial agreement), for inter-pathologist agreement of core biopsy and surgical resections under 2023 guidelines; 0.55 (moderate agreement) for agreement between first interpretation by 2018 guidelines and second interpretation by 2023 guidelines; and 0.13 (slight agreement) for agreement in HER2 consensus scores between outside core and surgical resection and 0.49 (moderate agreement) for inside core and surgical resection. Low HER2 expression was found in 28 of 57 (49 %) core biopsy and in 25 of 57 (44 %) surgical excisions. ConclusionsInterobserver agreement among study pathologists was good in core biopsy and surgical excisions, applying updated 2023 guidelines. Intratumoral heterogeneity in protein expression and preanalytical factors may result in variable identification of HER2-low status in core biopsy and surgical excision specimens.

Comparison between 18F-FDG PET/CT and diffusion-weighted imaging in detection of invasive ductal breast carcinoma.

Breast carcinoma is the most common type of cancer in females. This study aims to compare fluorine-18-fluorodeoxyglucose (18F-FDG) uptake pattern and apparent diffusion coefficient (ADC) value for the detection of the primary tumour and axillary metastases of invasive ductal breast carcinoma. This study included 40 breast carcinoma lesions taken from 39 patients. After staging by positron emission tomography-computed tomography (PET/CT) and diffusion-weighted magnetic resonance imaging (MRI), breast surgery with axillary lymph node dissection or sentinel lymph node biopsy was performed. Primary lesion detection rate for PET/CT and diffusion-weighted MRI was high with 39 of 40 lesions (97.5%). The sensitivity and specificity for the detection of metastatic lymph nodes in axilla were 40.9%, 88.9%, with 18F-FDG PET/CT scans and 40.9%, 83.3%, for dw-MRI, respectively. No significant correlation was detected between ADC and SUVmax or SUVmax ratios. Estrogen receptor (p=0.007) and progesterone receptor (p=0.036) positive patients had lower ADC values. Tumour SUVmax was lower in T1 than T2 tumour size (p=0.027) and progesterone receptor-positive patients (p=0.029). Tumour/background SUVmax was lower in progesterone receptor-positive patients (p=0.004). Tumour/liver SUVmax was higher in grade III patients (p=0.035) and progesterone receptor negative status (p=0.043). This study confirmed the high detection rate of breast carcinoma in both modalities. They have same sensitivity for the detection of axillary lymph node metastases, whereas the PET/CT scan had higher specificity. Furthermore, ADC, SUVmax and SUVmax ratios showed some statistical significance among the patient groups according to different pathological parameters.

Detection of Breast Cancer using Deep Learning Techniques

Because of the current population boom in health research, early sickness diagnosis has become a vital concern. As the population expands, the risk of dying from breast cancer rises dramatically. Breast carcinoma has been identified whenever the second most dangerous of the previously described malignancies. The researcher automated illness detection system assists medical practitioners in disease diagnosis, provides consistent, effective, and punctual intervention, and reduces the risk of death. Any disease that is diagnosed appropriately and promptly may be treated with minimal human intervention. An overwhelming majority of people are unaware of their illness until it becomes chronic. It increases the world mortality rate. Breast carcinoma has emerged as one of the increasingly rare diseases that may be treated if detected early enough and before it spreads to other regions of the body. Breast carcinoma constitutes one of the most frequent malignancies in women globally, and early identification is critical for improving survival and treatment success. Breast cancer detection technologies in areas like mammography and ultrasound have limits outside in the sense of preciseness as well as sensitivity. Deep learning algorithms have begun to emerge as a potential strategy for enhancing the degree of certainty and efficiency belonging to breast cancer diagnosis in recent years. Deep learning is an artificial intelligence area that focuses down training multi-layer neural networks to gain knowledge of and extract complicated patterns from big datasets. Researchers have developed sophisticated models suited to successfully diagnosing breast cancer from several medical imaging modalities, which might involve mammograms, MRI scans, additionally histopathological images, by utilizing the power throughout deep learning algorithms. Breast carcinoma detection is an important subject of study with significant public health implications. Deep learning techniques, a subset of computational neuroscience (AI), demonstrate excellent results in identifying and identifying cases of breast cancer. Deep learning breast cancer detection technologies have significant research repercussions due to the fact that they enable early diagnosis, enhance exactness, automate screening processes, give personalized treatment, and together with expand healthcare services to underserved areas. Persevered research in this area has the potential to change breast cancer diagnostics, resulting in better patient outcomes and, eventually, lifesaving. In this research we will be using The Weighted Product Model. The Weighted Product Model (WPM) represents a decision-making approach that uses numerous criteria to evaluate and rank options. It applies a multiple-criteria analysis approach that considers the value or weight assigned to every criterion as well as the effectiveness or score residing in every possible outcome on those criteria. Taken of Alternative Parameters SVM, Random Forest, Logistic Regression, KNN, Naive Bayes. Taken of Evaluation Parameters Accuracy, Recall, Precision, FI-Score, ROC AUC. As per Weighted Normalized Decision Matrix we get to know that SVM got more value were Random Forest, Logistic Regression, Naive Bayes got less value. From the above results I conclude that as per Weighted Normalized Decision Matrix we get to know that SVM got more value than others.

Preparation, Radiolabeling with 68Ga/177Lu and Preclinical Evaluation of Novel Angiotensin Peptide Analog: A New Class of Peptides for Breast Cancer Targeting.

Angiotensin II (AngII) is known to play a significant part in the development of breast cancer by triggering cell propagation of breast cancer, tumor angiogenesis, and regulating tumor invasion and cell migration. AngII arbitrates its action via two G-protein-coupled receptors, AngII type 1 receptor (AT1) and AngII type 2 receptor (AT2). Overexpression of the AT1 receptor in breast cancer cells seems to promote tumor growth and angiogenesis, thus targeting the AT1 receptor using AngII peptide would facilitate the detection of breast carcinoma. We developed an AngII peptide intending to assess whether the peptide of the renin-angiotensin system holds the ability to target AT1 receptor-overexpressing breast cancer in vivo. DOTA-coupled AngII peptide was synthesized by conventional solid-phase peptide synthesis according to Fmoc/HATU chemistry. 68Ga/177Lu labeled AngII peptide was evaluated for its binding with TNBC MDA-MB-231 and ER+ MCF7 cell lines. Pharmacokinetics was studied in healthy balb/c mice and in vivo tumor targeting in nude mice with MDA-MB-231 tumors xenografts. DOTA-AngII peptide was labeled efficiently with 68Ga/177Lu with high labeling efficiency (≥90%). The stability of the radiopeptide in human plasma was found to be high. The AngII peptide analog showed nanomolar (<40 nM) AT1 receptor-specific binding affinity. The radioactivity internalized into MDA-MBA-231 and MCF7 cells were 14.97% and 11.75%, respectively. In vivo, biodistribution in balb/c mice exhibited efficient clearance of 68Ga/177Lu-DOTA-AngII peptide from the blood and elimination predominantly by the renal system due to its hydrophilic nature. A low amount of radioactivity was seen in the major organs including lungs, liver, stomach, spleen, and intestines (<3% ID/g) except the kidneys. A high renal-urinary excretion was observed for the radiotracer. In the TNBC MDA-MB-231 xenografts model, radiolabeled AngII peptide exhibited specific and effective AT1-based targeting in vivo. A rapid and efficient tumor targeting (2.18% ID/g at 45 min p.i.) together with fast renal excretion (~67% ID) highlights the tumor-targeting potential of the radiotracer. The AT1 receptor specificity of the radiotracer was validated by blocking assays. Furthermore, PET imaging provided sufficient visualization of MDA-MB-231 tumors in nude mice. Our findings suggest that 68Ga/177Lu-DOTA-AngII peptide can be useful for the theranostic application of breast carcinomas. This study suggests the potential of this innovative class of peptides for rapid and efficient targeting of tumors and warrants further evaluation.

Breast carcinoma detection in ex vivo fresh human breast surgical specimens using a fast slide-free confocal microscopy scanner: HIBISCUSS project.

New generation ultra-fast fluorescence confocal microscopy allows the ex vivo intraoperative analysis of fresh tissue. The High resolution Imaging for Breast carcInoma detection in ex vivo Specimens after breast Conserving sUrgery by hiStolog Scanner (HIBISCUSS) project aimed to develop an online learning program to recognize the main breast tissue features on ultra-fast fluorescence confocal microscopy images and to evaluate the performance of surgeons and pathologists in diagnosing cancerous and non-cancerous breast tissue in ultra-fast fluorescence confocal microscopy images. Patients who underwent conservative surgery or mastectomy for breast carcinoma (invasive or in situ lesions) were included. The fresh specimens were stained with a fluorescent dye and imaged using a large field-of-view (20 cm2) ultra-fast fluorescence confocal microscope. One hundred and eighty-one patients were included. The images from 55 patients were annotated to generate learning sheets and images from 126 patients were blindly interpreted by seven surgeons and two pathologists. The time for tissue processing and ultra-fast fluorescence confocal microscopy imaging was between 8 and 10 min. The training program was composed of 110 images divided into nine learning sessions. The final database for blind performance assessment comprised 300 images. The mean duration for one training session and one performance round was 17 and 27 min respectively. The performance of pathologists was almost perfect with 99.6 per cent (standard deviation (s.d.) 5.4 per cent) accuracy. Surgeons' accuracy significantly increased (P = 0.001) from 83 per cent (s.d. 8.4 per cent) in round 1 to 98 per cent (s.d. 4.1 per cent) in round 7 as well as the sensitivity (P = 0.004). Specificity increased without significance from 84 per cent (s.d. 16.7 per cent) in round 1 to 87 per cent (s.d. 16.4 per cent) in round 7 (P = 0.060). Pathologists and surgeons showed a short learning curve in differentiating breast cancer from non-cancerous tissue in ultra-fast fluorescence confocal microscopy images. Performance assessment for both specialties supports ultra-fast fluorescence confocal microscopy evaluation for intraoperative management. NCT04976556 (http://www.clinicaltrials.gov).

Can surgeons detect breast carcinoma in ex-vivo fresh human breast surgical specimens? A feasibility study using ultra-fast slide-free confocal microscopy

Can surgeons detect breast carcinoma in ex-vivo fresh human breast surgical specimens? A feasibility study using ultra-fast slide-free confocal microscopy

Bilateral Breast Cancer-Its clinicopathological profile and management: An experience from a tertiary care center from Eastern India.

Bilateral breast carcinoma (BBC), though not rare, is quite an uncommon clinical situation and hence guidelines regarding its diagnosis and management are not clear enough. It can be synchronous or metachronous depending on the interval between the time of presentation in bilateral breasts. We retrospectively reviewed our experience with 18 cases of bilateral breast malignancies presented and treated between January 2014 and December 2019. We analyzed clinical, pathological, and immunohistochemical profiles with their management. All the patients were staged separately for both breasts and received treatment according to prescribed guidelines. Among these 18 cases, 16 were synchronous and 2 were metachronous during the presentation. During the presentation of synchronous malignancies, eight patients had stage IV disease, whereas the other eight cases were nonmetastatic. Patients received combined modality treatment by surgery, chemotherapy, and radiotherapy depending on the stage of presentation. At a median follow-up period of 12 months, 10 (55.56%) patients were disease free, 2 (11.11%) patients had disease recurrence, and 5 (27.78%) patients succumbed to the disease, whereas 1 patient has lost follow-up. Diagnosis and management of bilateral breast malignancies pose a clinical challenge to the oncologist and hence should be vigilantly looked upon. The treatment decision is individualized according to the stage and molecular type of the particular patient. Regular follow-up and judicious use of clinical breast examination and mammography can help in the early detection of second breast carcinoma.

Can clinical evaluation by physiotherapist forms early detection of breast carcinoma?

Introduction: Modern living associated with greater health hazards including cancers. Among which breast carcinoma ranks with higher prevalence in adult women. Physical laboratory investigations and screening. Early identification to a larger extent can influence better outcome and longevity especially for breast cancer subjects. Objectives: As physical therapist frequently involved in treating neck and low back ache as first contact healthcare expert, this research highlights importance of patients with chronic neck pain to be screened for lymph nodes, other related complaints like stiff neck, increasing atrophy, constant continuous pain, most of these could be related to malignancy while these subjects can be referred to physician or oncologist for to be detected and treated with due medical care for an enhanced post onco surgical living standard. Materials and methods: 59-year-old diabetic subject with chronic continuous neck pain with nodules over posterior cervical spine was referred to undergo mammography by physiotherapist through physician. She was diagnosed later with hyper metabolic malignant lesion of left breast and underwent modified left radical mastectomy. Later, she was getting treated for her physical functioning in improving QOL were discussed with due evidence for the period 2020 to 2022. Results: With lesser follow up post mastectomy and early identification by physiotherapists remain key component of this research. Findings of this research can form foundation of onco physiotherapy in early clinical screening and referral to medical expert. Conclusions: If adhered can become novel means of physiotherapy evaluation as red flag and could be included in every patient physical evaluation in future.

Circulatory RNA based non-invasive detection and diagnosis of breast cancer

Breast carcinoma is the most prevalent and lethal form of carcinoma in women, as well as the most prominent source of cancer-related mortality in women. The most widespread form of non-invasive breast carcinoma is ductal carcinoma in situ (DCIS). Early detection of breast carcinoma improves the chances of rehabilitation and survival, lowering mortality rates. Limitations of mammography as a screening test have made it imperative to develop new, non-invasive, and more convenient alternatives for the prognosis of breast carcinoma. Circulatory RNAs (miRNAs) have been included in a novel category of non-coding, endogenous, small RNA fragments that can be considered gene expression regulators, influencing key processes in cancer development. Peculiar expressions and firmness of circulatory RNAs exhibit a promising possibility of their use as biomarkers in the prognosis of mammary tumor.

A Scoping Review on the Status of Female Breast Cancer in Asia with a Special Focus on Nepal.

This study aimed to provide updated evidence on the status of female breast cancer and cancer treatment facilities in Asia, with a special focus on Nepal. This review used search phrases that included, breast neoplasm or cancer, health status, epidemiology, breast cancer survivors, cancer care facilities, Asia, Nepal. Researchers examined databases from January 2011 to December 2020 (PubMed, PMC, Google Scholar, and the reference lists of included papers). Studies of any design and reviews, were included in the study, except for qualitative studies. The study findings are presented in a narrative synthesis format using Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. An initial search resulted in 974 papers, and 896 were reviewed after being checked for duplication using the Zotero software. Accordingly, utilizing the inclusion and exclusion criteria, 188 publications were selected, and after review of titles and abstracts, an additional 98 papers were removed for different reasons. Finally, the study looked at 90 female breast cancer papers. Results showed that the number of cases of breast cancer is growing all around the world, including in Asia and Nepal. Age, early menarche, late menopause, nulliparity, positive family history, excessive fat consumption, alcohol, and smoking are all frequent risk factors for breast cancer found in Asian women. Breast self-examination, clinical breast examination, and mammography screening are common methods for detecting breast carcinoma. Chemotherapy, radiation, and modified mastectomy are commonly used options for treatment. The number of breast cancer survivors is growing throughout the world, indicating better clinical care. There is a paucity of survival data in many Asian countries, including Nepal. There is also a scarcity of health workforce specialized in cancer care and treatment, as well as a few health facilities that are available to treat cancer cases in many Asian countries, including Nepal.

Multi-modal imaging probe for EpCAM overexpressed in breast cancer

Breast cancer is a highly lethal and aggressive form of cancer. Early-stager diagnosis and intraoperative guidance are important endeavors for reducing associated morbidity and mortality among breast cancer patients. Epithelial cell adhesion molecule (EpCAM) is aberrantly expressed in the majority of breast carcinoma, making it an attractive imaging biomarker. Herein, we have designed novel EpCAM-targeting peptides (denoted as YQ-S) for precise breast carcinoma detection. The greater binding affinity of the designed peptide YQ-S2 over YQ-S1 and the reported peptide SNF was displayed on different cell lines with flow cytometry analysis, showing a positive correlation with the expression of EpCAM. Besides, YQ-S2 displayed an ideal biosafety profile with no evidence of any acute toxicity. Thus, YQ-S2 was chosen to represent YQ-S. By linking with the near-infrared fluorescent dye (MPA), we further developed the EpCAM-targeting probe (YQ-S2-MPA) for real-time imaging and fluorescence-guided resection of breast cancer tumors. In vivo imaging of the MCF-7 tumor-bearing model demonstrated higher tumor uptake of YQ-S2-MPA compared with that of SNF-MPA. The maximum tumor-to-normal tissue signal ratio of YQ-S2-MPA was 5.1, which was about 2 times that of SNF-MPA. Meanwhile, the metastatic lesions in 4T1 lung metastasis, and lymph node metastasis (LNM) mice were successfully detected under this imaging system. Notably, YQ-S2-MPA had excellent performance in surgical navigation studies in the preclinical models. Moreover, we exploited the 99mTc-HYNIC-YQ-S2 to localize EpCAM positive tumors successfully. These data proved that YQ-S2 can distinguish EpCAM-positive orthotopic and metastatic tumors from surrounding normal tissues accurately, and possesses the clinical potential as a surgical navigation probe.

Application of CAD in the diagnosis of breast cancer

Breast cancer is an extremely dangerous disease, which if diagnosed in time has a high survival rate. The incidence and mortality rate from breast malignancies are increasing, so in order to reduce these numbers, new technological solutions are being looked into, that should enable the earliest possible detection of breast carcinoma. Although the original solution was seen in traditional computer-assisted detection systems, CAD, applied to various radiological breast imaging methods, the results of various studies discussed in this paper found that they did not meet their original expectations in breast cancer diagnosis. The use of conventional CAD systems still had too many limitations such as a decrease in particularity and positive predictive value with an increase in incorrect results and an increase in revocation rates. However, the development of artificial intelligence, AI-based algorithms has improved the quality and accuracy of conventional CAD systems. Unlike conventional CAD systems based on hand-crafted features, deep learning, as a subfield of AI, is based on representational learning. In representational learning, the algorithm itself during training determines features in the image that indicate the presence of lesions. Recently, such deep learning algorithms have been applied to various radiological methods. In this paper, the analysis of various studies discusses the possibilities, but also the limitations of new AI-based applications for different modalities of breast imaging. Due to the small number of studies conducted on the topic of AI systems and the need for an extremely large set of data for training and validation of the algorithm, many scientists still doubt this new method. Despite these limitations, the AI approach has the ability to detect useful features in an image that are still invisible to the human eye. Future advances in technology will significantly improve AI systems and their implementation in health systems will be inevitable.

Positive predictive value of Birads IV Lesions on mammogram in detection of breast carcinoma.

To determine the positive predictive value of Breast Imaging Reporting and Data System category IV lesions, and to evaluate interobserver agreement among radiologists in interpreting the subcategories. The cross-sectional study was conducted at the Dow Institute of Radiology, Dow University of Health Sciences, Karachi, from September 2018 to February 2019, and comprised adult females aged 30-60 years diagnosed with Breast Imaging Reporting and Data System IV. Already diagnosed breast carcinoma patients were excluded. The positive predictive value of Breast Imaging Reporting and Data System category IV was calculated using histopathology findings as the gold standard. Data was analysed using SPSS 22. There were 191 patients with a mean age of 49.01±11.79 years. Positive family history of breast cancer was found in 33(17.3%) subjects. Category IV-A was noted in 53(28.0%) subjects, IV-B in 45(23.6%) and IV-C in 93(48.7%). The overall positive predictive value of category IV was 151(79.1%), IV-A 27(50.9%), IV-B 35(77.7%) and IV-C 89(95.6%). Malignant disease was significantly associated with architectural distortion and suspicious microcalcifications (p<0.001). A good agreement was observed in the categorisation of Breast Imaging Reporting and Data System category IV between observers 1 and 2 (kappa 0.85, 95% confidence interval: 0.70-0.99), between observers 1 and 3 (kappa 0.77, 95% confidence interval: 0.61-0.94), and between observers 2 and 3 (kappa 0.63, 95% confidence interval: 0.43-0.83). Breast Imaging Reporting and Data System BI-RADS IV was found to have a high positive predictive value in the diagnosis of breast cancer. Besides the interobserver agreement in terms of identifying BI-RADS IV subcategories was good.

Synthesis, Radiolabeling, and Preclinical Evaluation of 68Ga/177Lu-Labeled Leuprolide Peptide Analog for the Detection of Breast Cancer.

Objectives: The expansion of novel and potent tumor receptor binding peptides is a promising approach for the precise targeting of various cancer. Leuprolide is a 9-residue peptide analog of gonadotropin-releasing hormone and is extensively used in the treatment of sex hormone-dependent tumors, including prostate, breast, and ovarian cancer. This preclinical study was undertaken to prepare a new radiolabeled leuprolide peptide for the detection of breast carcinoma. Methods: A 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid (DOTA)-coupled 9-amino acid leuprolide peptide was synthesized after typical 9-fluorenylmethyl-oxycarbonyl-based solid-phase peptide synthesis and radiolabeled with both 68Ga and 177Lu radionuclides for theranostic use. The systemic pharmacokinetics was done in healthy balb/c mice. The in vitro tumor cell binding affinity was determined on MCF7, T47D, and MDA-MB-231 breast cancer cell lines. In vivo tumor targeting and micro positron-emission tomography imaging was performed on nude mice with MCF7 breast tumor xenografts. Results: The leuprolide peptide was conveniently synthesized by solid-phase synthesis strategy and its identity and purity were validated by mass spectrometry and high-performance liquid chromatography. The peptide radiolabeled efficiently (˃94%) with both diagnostic (68Ga) and therapeutic (177Lu) radionuclides and displayed nanomolar binding potency to all three tested MCF7, T47D, and MDA-MB-231 cell lines. Fast and favorable pharmacokinetics was observed for 68Ga/177Lu-leuprolide in healthy Balb/c mice. In nude mice, 68Ga-leuprolide peptide exhibited rapid clearance from the blood circulation with low to moderate (up to 5% ID/g) uptake/retention by the major body organs. The accumulation in the estrogen receptor-positive MCF7 tumor was 2.24% ± 0.62% ID/g at 45 min p.i, with good tumor to blood and muscle uptake ratios. The radiolabeled peptide was excreted primarily through the renal pathway. Conclusion: The encouraging results of this initial study demonstrate that additional testing of this leuprolide peptide seems to be indicated because of its convincing potential to be a new agent for the management of breast carcinoma.

A cross-sectional research of breast self-examination awareness and practice in rural women in central India

Breast carcinoma is the most frequent carcinoma in females around the world, and it can be diagnosed early with self-examination. BSE is a low-cost, easy-to-use, noninvasive approach for detecting breast carcinomas early. As a result, understanding the process and practicing it consistently could protect females from severe morbidity and mortality from breast carcinoma. This research compared the knowledge and practice of BSE among females in Central India before and after they participated in the survey. This six-month cross-sectional research took place in the Tertiary Healthcare Centre’s Rural Health Training Centre (RHTC) service region in Central India. The research comprised 500 females who were over the age of 30. A questionnaire was utilized to collect data on understanding of breast carcinoma and BSE, as well as attitudes and BSE practices. The importance of BSE, how it's done, and how often it's done were all explained to the females. The same residences were visited again after a week, and females were asked if they practiced BSE, the actions they took, any findings they had, and whether they had contacted a surgeon. Three hundred and eighty (78%) of the 500 subjects were aware of breast carcinoma. Breast Self-Examination was known by 174 people (35%). (BSE). After receiving BSE education, the percentage of females carry outing BSE jumped from 21% to 85%. After taking part in the research and learning about BSE, the number of females who don't know anything about BSE dropped from 74 percent to 12 percent. BSE is regarded as a low-cost, fast, non-invasive, and non-hazardous technique. One of the most common reasons why females do not conduct BSE is a lack of knowledge about how to do it. Efforts should be made to develop educational initiatives to improve females’ understanding and practice of breast self-examination. Keywords: Awareness, Breast self-examination, Breast carcinoma, Females.

Automatic breast carcinoma detection in histopathological micrographs based on Single Shot Multibox Detector

BackgroundA diagnosis with histological classification by pathologists is very important for appropriate treatments to improve the prognosis of patients with breast cancer. However, the number of pathologists is limited, and assisting the pathological diagnosis by artificial intelligence becomes very important. Here, we presented an automatic breast lesions detection model using microscopic histopathological images based on a Single Shot Multibox Detector (SSD) for the first time and evaluated its significance in assisting the diagnosis. MethodsWe built the data set and trained the SSD model with 1361 microscopic images and evaluated using 315 images. Pathologists and medical students diagnosed the images with or without the assistance of the model to investigate the significance of our model in assisting the diagnosis. ResultsThe model achieved 88.3% and 90.5% diagnostic accuracies in 3-class (benign, non-invasive carcinoma, or invasive carcinoma) or 2-class (benign or malignant) classification tasks, respectively, and the mean intersection over union was 0.59. Medical students achieved a remarkably higher diagnostic accuracy score (average 84.7%) with the assistance of the model compared to those without assistance (average 67.4%). Some people diagnosed images in a short time using the assistance of the model (shorten by average 6.4 min) while others required a longer time (extended by 7.2 min). ConclusionWe presented the automatic breast lesions detection method at high speed using histopathological micrographs. The present system may conveniently support the histological diagnosis by pathologists in laboratories.