Breast Disease Research Articles

Use of web-based decision support to improve informed choice for chemoprevention: a qualitative analysis of pre-implementation interviews (SWOG S1904)

BackgroundWomen with high-risk breast lesions, such as atypical hyperplasia (AH) or lobular carcinoma in situ (LCIS), have a 4- to tenfold increased risk of breast cancer compared to women with non-proliferative breast disease. Despite high-quality data supporting chemoprevention, uptake remains low. Interventions are needed to break down barriers.MethodsThe parent trial, MiCHOICE, is a cluster randomized controlled trial evaluating the effectiveness and implementation of patient and provider decision support tools to improve informed choice about chemoprevention among women with AH or LCIS. For this pre-implementation analysis, 25 providers participated in semi-structured interviews prior to accessing decision support tools. Interviews sought to understand attitudes/beliefs and barriers/facilitators to chemoprevention.ResultsInterviews with 25 providers (18 physicians and 7 advanced practice providers) were included. Providers were predominantly female (84%), white (72%), and non-Hispanic (88%). Nearly all providers (96%) had prescribed chemoprevention for eligible patients. Three themes emerged in qualitative analysis. The first theme describes providers’ confidence in chemoprevention and the utility of decision support tools. The second theme elucidates barriers to chemoprevention, including time constraints, risk communication and perceptions of patients’ fear of side effects and anxiety. The third theme is the need for early implementation of decision support tools.ConclusionsThis qualitative study suggests that providers were interested in the early inclusion of decision aids (DA) in their chemoprevention discussion workflow. The DAs may help overcome certain barriers which were elucidated in these interviews, including patient level concerns about side effects, clinic time constraints and difficulty communicating risk. A multi-faceted intervention with a DA as one active component may be needed.Trial registrationThis trial was registered with the NIH clinical trial registry, clinicaltrials.gov, NCT04496739.

Promoting breast health among female adolescents: a comparative analysis of the effects of two didactic tools on knowledge and practice regarding breast self-examination in Southwest Nigeria

BackgroundTeaching effective methods for breast self-examination (BSE) to adolescent females is essential for promoting early detection and improving outcomes in breast cancer management. This study therefore aimed to compare two pedagogical tools for teaching BSE among adolescent females.MethodsA quasi-experimental design with a group for pre- and post-intervention tests was adopted. The sample included 970 female senior secondary school class I-III students. The Yamane formula was used to determine a sample size of 276. Pre- and post-intervention data were collected using an observation checklist for practice and a validated questionnaire with a Cronbach’s alpha coefficient of 0.76 for knowledge of BSE. A proportionate stratified random sampling technique was used to determine the number of participants for each group. Among the 276 participants, 161 were taught the traditional method (TM), i.e., a lecture, and 115 were taught using the modern method (MM) by watching a podcast that contained BSE lessons. Post-intervention data were collected after six weeks. The data were analysed using descriptive and inferential statistics at a 5% level of significance to compare the effectiveness of the methods.ResultsThe findings of this study showed that the participants’ mean ages across the two methods were 15.49 ± 1.65 and 15.43 ± 1.40 years for the traditional method (TM) and modern method (MM), respectively. Pre-intervention mean BSE knowledge scores in both the TM and MM groups were 8.19 ± 3.17 and 8.31 ± 2.39, respectively, and BSE practice scores were 7.17 ± 2.48 and 6.44 ± 2.75, respectively. Post-intervention knowledge mean scores in both the TM and MM groups increased to 13.75 ± 4.09 and 16.92 ± 2.91, respectively, and post-intervention practice scores increased to 13.06 ± 2.74 and 15.68 ± 3.12, respectively.ConclusionThis study revealed that both teaching methods were effective at teaching breast self-examination among female adolescents; nevertheless, modern methods are more effective at teaching breast self-examination among female adolescents.

Giant adolescent tubular adenoma of the breast mimicking giant fibroadenoma: a case report

Tubular adenomas are a rare benign breast neoplasm, often clinically indistinguishable from fibroadenomas or phyllodes tumors. We present a case of the largest adolescent tubular adenoma reported in the literature, measuring 12.5 cm. Radiological evaluation and histopathological assessment of the core biopsy sample was consistent with a giant fibroadenoma. However, the final histopathological analysis of the excisional biopsy sample confirmed a tubular adenoma. This case highlights the clinical conundrum of reaching the definitive diagnosis in a patient with a tubular adenoma. A contemporary review of the clinical features, radiology, histopathology and management options for tubular adenoma of the breast was undertaken.

Novel Drug Delivery Approach for Breast Cancer.

Bosom malignant growth, otherwise called carcinoma of the bosom tissues, is the most widely recognized disease that repeats in ladies and the main source of death around the world, guaranteeing almost 5 million lives yearly. The world’s most developed regions have a higher incidence rate of BC than less developed regions. Yet, the demise rate was found to be more prominent in immature countries. Fewer curative options were discovered in approximately 7% of women under the age of 40. A reasonable system for its initial recognition and viable treatment might come from recently created imaginative conveyance innovations. In order to work on the therapy of bosom disease, the current focus of cancer research is on developing new delivery methods for chemotherapeutic medicines, such as liposome assemblies, hydrogel-based extracellular particles, dendrimer, microspheres, microbubbles, phytosomes, micelles, and nanoformulations. In order to diagnose and treat BC, numerous cutting-edge medication delivery technologies and methods are discussed in this review.

Abstract A036: Hair relaxers use and breast cancer risk by tumor estrogen receptor status: Results from the Ghana Breast Health study

Abstract Background: Hair relaxer use is highly prevalent among women of African descent world-wide and in previous analyses within the Ghana Breast Health Study (GBHS) ever use was associated with a 60% elevated risk of breast cancer. Subsequent studies in the GBHS showed selected alterations in estrogen metabolites with hair relaxer use among controls, suggesting a possible hormonal mechanism may underlie the relation of hair relaxers to breast cancer risk. We investigated if the association between relaxer use and breast cancer risk differed by tumor estrogen-receptor (ER) status and hypothesized ever-users would be at a higher risk of ER+ tumors. Methods: The GBHS is a population-based case-control study conducted between 2013– 2015 in Accra and Kumasi of 1,071 cases with pathologically confirmed invasive breast cancer and 2,106 controls, aged 18-74 years. A standardized interview-based questionnaire collected information on currency and duration of use of hair relaxers and whether products used were lye or non-lye formulations. ER status was available for 915 cases, determined using either mRNA expression data from nCounter® Breast Cancer 360™ Panel (65% of 915 cases) or immunohistochemistry. We used multivariable multinomial logistic regression models to estimate odds ratios (OR) with 95% confidence intervals (CI) for ER+ vs. ER- breast cancers. Models were adjusted for age, hospital site, education, body size, age at menarche, parity, age at first birth, median breastfeeding months/child, menopausal status. To determine if risk related to exposure to relaxers differed by ER status, we used logistic regression analyses with ER+ tumors as the reference and calculated heterogeneity p-values (p-het). Results: The majority of women reported ever use of relaxers (96% of cases and 94% of controls). Of the 1,071 cases included in analyses, 422 (44%) were ER+, 438 (41%) ER-, and 156 (15%) unknown for ER. Elevated risk did not differ by ER status for ever compared to never use (OR ER+ =1.67, 95% CI [0.95–2.93]; OR ER - =1.59, 95% CI [0.92–2.76], p-het=0.90). Risks were highest among former users (OR ER+ =2.19, 95% CI [1.21–3.95]; OR ER- =2.21, 95% CI [1.24–3.93], p-het=0.98. Additional analyses showed elevated risk for those with long durations of use, and those who predominantly used non-lye products, but associations did not differ according to ER tumor status. Conclusion: Our analysis of relaxer use in Ghanaian women showed elevated breast cancer risk, particularly for former, long-term users of non-lye formulations, irrespective of tumor ER status. Additional analyses by tumor and other characteristics related to biologically aggressive tumor types needed to determine if associations differ beyond ER consistent with disparities seen in African ancestry women. Further, future research is warranted regarding specific products used that may provide insights into hormonal and non-hormonal mechanisms underlying observed associations. Citation Format: Kaitlin E. White, Quiera Booker, Nicholas Titiloye, Lawrence Edusei, Louise Brinton, Beatrice Wiafe, Ernest Adjei, Jonine Figueroa, On behalf of the Ghana Breast Health Study Team. Hair relaxers use and breast cancer risk by tumor estrogen receptor status: Results from the Ghana Breast Health study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A036.

Abstract B156: Exploring identity-specific stressors among Black women with a family history of cancer

Abstract Background: Compared to women of other racial/ethnic groups, Black women are more likely to be diagnosed with aggressive subtypes of breast cancer (including triple-negative breast cancer), diagnosed at younger ages, diagnosed at more advanced stages, and have higher mortality rates and poorer survival outcomes. Black women also experience higher rates of breast cancer recurrence, which further exacerbates the survival disparities. These disparities are influenced by a complex interplay of genetic, environmental, and social factors, including chronic stress and discrimination. Understanding identity-specific stressors will help identify potential risk factors impacting breast cancer outcomes among Black women.Objective: This study aims to identify common stressors among Black women aged 18 to 49 with a family history of cancer, exploring potential links to breast health risk. Methods: We conducted a grounded theory study, including qualitative interviews from Black women in the Augusta, Georgia, area (N=47) discussing life as a Black woman and sources of stress. Participants with a close family history of cancer (defined as having at least one first- or second-degree relative diagnosed with cancer) were selected for this analysis (n=22). We applied the Sort & Sift, Think & Shift method for analysis. Results: We identified three categories in response to the research question, including healthcare access barriers and medical invalidation (particularly in rural communities), intergenerational trauma, and Strong Black Woman persona (characterized by independence, emotional suppression, and a tendency to care for others while neglecting their own needs). Participants described these categories in reference to themselves and their female family members with cancer. Participants reported stress related to jobs and caregiving responsibilities, lack of adequate social support, lack of time and finances necessary for self-care, and racial discrimination in medical settings. Conclusion: The identified stressors highlight the complex interplay between familial cancer history and daily stress experiences among Black women. These findings suggest the need for targeted interventions to mitigate stress and potentially reduce breast cancer risk. Further research is warranted to explore these themes in relation to breast cancer outcomes. Citation Format: Samantha R. Jones, Debbynie Barsh, Kathleen McIntyre, Christy J.W. Ledford. Exploring identity-specific stressors among Black women with a family history of cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B156.

Abstract C181: Toward breast health equity: Insights into mammography access across Virginia’s social and structural landscape

Abstract Background: Breast cancer (BC) disparities across race, socioeconomic status, and location, stress the need for equitable access to screening. In Virginia (VA), BC is a major concern, with Petersburg City having the highest mortality rate nationwide. Understanding social and structural factors’ impact on mammography accessibility may provide insights on effectively serving screening-eligible women in VA, particularly those facing greater BC burden. Also, analyzing data at the census tract level is vital for accurate accessibility assessment, mitigating county-level data skewing and disparity concealment. Objective: Examine how social and structural factors (e.g., demographics, transportation, area deprivation) influence mammography facility and unit distribution in VA. Methods: We utilized a comprehensive approach to compile and analyze data at the census tract level. We employed Poisson regression models to predict the number of mammography facilities and units within each tract. The predictor variables included the number of bus stops (VA Transit Routes & Stops GTFS), percentage of Black residents (American Community Survey), area deprivation index (ADI) scores (Neighborhood Atlas®), and vehicle ownership rates (American Community Survey), with the logarithm of the population of females aged 40-74 used as an offset to account for population size. Separate models were built for VA, our catchment area, urban areas within our catchment, and rural areas within our catchment. We exponentiated the model coefficients to obtain relative risks, indicating the multiplicative effect of each predictor on the outcome variable. Results: Study findings highlighted statistically significant disparities in the distribution of mammography facilities and units within VA. Higher ADI scores, indicating greater socioeconomic deprivation, were linked to fewer mammography units. This association was notable in our rural catchment areas (RR = 0.5492), indicating a 45.08% reduction in mammography units, in our catchment area overall (RR = 0.8653), a 13.47% decrease, and in urban catchment areas (RR = 0.8800), a 12.00% decline. Similarly, an increase in the percentage of Black residents was consistently associated with a decrease in the number of mammography units, with a relative risk of 0.8828 within our catchment area, indicating a 11.72% decrease, 0.8793 in urban areas within our catchment, signifying a 12.07% decrease, and 0.9391 statewide, showing a 6.09% decrease. Conclusions: These findings stress the need for targeted resource allocation to enhance mammography access. For instance, findings suggest a specific need for increased mammography units in rural areas and areas with higher percentages of Black women, like Petersburg (67.5% to 94.9% Black population depending on the tract), specifically within our catchment. Implications from these findings provide a unique opportunity to leverage the expertise of residents, community leaders and local representatives to identify where additional resources can be allocated. Citation Format: Bianca D. Owens, Jinlei Zhao, Katherine Y. Tossas. Toward breast health equity: Insights into mammography access across Virginia’s social and structural landscape [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C181.

Abstract C181: Toward breast health equity: Insights into mammography access across Virginia’s social and structural landscape

Abstract Background: Breast cancer (BC) disparities across race, socioeconomic status, and location, stress the need for equitable access to screening. In Virginia (VA), BC is a major concern, with Petersburg City having the highest mortality rate nationwide. Understanding social and structural factors’ impact on mammography accessibility may provide insights on effectively serving screening-eligible women in VA, particularly those facing greater BC burden. Also, analyzing data at the census tract level is vital for accurate accessibility assessment, mitigating county-level data skewing and disparity concealment. Objective: Examine how social and structural factors (e.g., demographics, transportation, area deprivation) influence mammography facility and unit distribution in VA. Methods: We utilized a comprehensive approach to compile and analyze data at the census tract level. We employed Poisson regression models to predict the number of mammography facilities and units within each tract. The predictor variables included the number of bus stops (VA Transit Routes & Stops GTFS), percentage of Black residents (American Community Survey), area deprivation index (ADI) scores (Neighborhood Atlas®), and vehicle ownership rates (American Community Survey), with the logarithm of the population of females aged 40-74 used as an offset to account for population size. Separate models were built for VA, our catchment area, urban areas within our catchment, and rural areas within our catchment. We exponentiated the model coefficients to obtain relative risks, indicating the multiplicative effect of each predictor on the outcome variable. Results: Study findings highlighted statistically significant disparities in the distribution of mammography facilities and units within VA. Higher ADI scores, indicating greater socioeconomic deprivation, were linked to fewer mammography units. This association was notable in our rural catchment areas (RR = 0.5492), indicating a 45.08% reduction in mammography units, in our catchment area overall (RR = 0.8653), a 13.47% decrease, and in urban catchment areas (RR = 0.8800), a 12.00% decline. Similarly, an increase in the percentage of Black residents was consistently associated with a decrease in the number of mammography units, with a relative risk of 0.8828 within our catchment area, indicating a 11.72% decrease, 0.8793 in urban areas within our catchment, signifying a 12.07% decrease, and 0.9391 statewide, showing a 6.09% decrease. Conclusions: These findings stress the need for targeted resource allocation to enhance mammography access. For instance, findings suggest a specific need for increased mammography units in rural areas and areas with higher percentages of Black women, like Petersburg (67.5% to 94.9% Black population depending on the tract), specifically within our catchment. Implications from these findings provide a unique opportunity to leverage the expertise of residents, community leaders and local representatives to identify where additional resources can be allocated. Citation Format: Bianca D. Owens, Jinlei Zhao, Katherine Y. Tossas. Toward breast health equity: Insights into mammography access across Virginia’s social and structural landscape [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C181.

Abstract C022: Pathomics-based classifiers for inferring breast cancer genomic assays and prognosis in sub-Saharan Africa: Results from the Ghana Breast Health Study

Abstract Background: Although several gene expression-based assays are validated for informing prognosis and treatment decision-making for breast cancer (BC) patients, their uptake has been hampered by technical complexities and cost, particularly in underrepresented and low-resource settings. Here, we explored whether machine learning-based features on standard hematoxylin and eosin (H&E)-stained images can be used in conjunction with routinely available pathology data (pathomics) to infer clinically relevant tumor genomic assays among BC patients from a sub-Saharan African population. Methods: This study comprised 563 BC patients with diagnostic H&E-stained images, clinicopathological data, and Nanostring gene expression data from the Ghana Breast Health Study (GBHS), a population-based case-control study that recruited BC patients between 2013 and 2015. H&E images were analyzed using high-accuracy machine learning algorithms to extract data on several, prospectively selected, human interpretable imaging features. The assessed features encompassed characteristics of the tumor (e.g., average nuclear size, nuclear optical density, nuclear roundness, etc.) and stroma (e.g., degree of stromal cellularity, stromal cell phenotype, extent of stromal desmoplasia, remodeling, necrosis, etc.). Nanostring technology was used to generate data on PAM50 subtype [luminal (A and B), non-luminal (HER2-enriched and Basal), normal-like], 21-gene recurrence score (RS), and TP53 pathway function. Multivariable logistic regression models were fitted to luminal (vs other subtypes), non-luminal (vs other subtypes), TP53 mutant-like (vs wildtype-like), and RS (4th vs 1st quartile) data to develop predictive classifiers in a discovery set (60% of the data). The performance of the classifiers was then tested in a held-out internal validation set (40% of the data). Results: In the discovery set, the pathomics-based classifiers achieved varying but excellent discriminatory accuracy [AUROC = 0.90 (0.86-0.94), 0.94 (0.91-0.97), 0.95 (0.91-0.98), and 0.96 (0.94-0.99) for TP53, non-luminal, RS, and luminal classification, respectively]. In the held-out (validation) set, the corresponding AUROC values were 0.82 (0.75-0.88), 0.87 (0.81-0.92), 0.85 (0.77-0.92), and 0.88 (0.83-0.93) for TP53, non-luminal, RS, and luminal classification. The TP53 classifier was correlated with the luminal (R=-0.73), non-luminal (R=0.80), and RS (R=0.77) classifiers. The distribution of the pathomics-based TP53 probability score varied considerably between PAM50 subtypes (P<0.0001), and according to RS categories within both ER+ (P=0.009) and ER- (P=0.006) BC subtypes in the validation set. Conclusion: H&Es are cost-effective and routinely performed as part of the diagnostic workup for BC patients. Accordingly, the results open promising avenues for the use of interpretable, machine learning-based, H&E imaging and pathology data to infer breast tumor genomic signatures and prognosis in low-resource settings. Further work is required to validate findings in independent populations.: Citation Format: Mustapha Abubakar, Amber N. Hurson, Thomas U. Ahearn, Ebonee N. Butler, Alina M. Hamilton, Maire A. Duggan, Scott M. Lawrence, Ernest Adjei, Joe-Nat Clegg-Lamptey, Joel Yarney, Beatrice Wiafe-Addai, Baffour Awuah, Seth Wiafe, Kofi Nyarko, Francis Aitpillah, Daniel Ansong, Stephen Hewitt, Louise A. Brinton, Melissa A. Troester, Lawrence Edusei, Nicolas Titiloye, Jonine D. Figueroa, Montserrat Garcia-Closas. Pathomics-based classifiers for inferring breast cancer genomic assays and prognosis in sub-Saharan Africa: Results from the Ghana Breast Health Study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C022.

SPLHRNMTF: robust orthogonal non-negative matrix tri-factorization with self-paced learning and dual hypergraph regularization for predicting miRNA-disease associations

MicroRNAs (miRNAs) have been demonstrated to be closely related to human diseases. Studying the potential associations between miRNAs and diseases contributes to our understanding of disease pathogenic mechanisms. As traditional biological experiments are costly and time-consuming, computational models can be considered as effective complementary tools. In this study, we propose a novel model of robust orthogonal non-negative matrix tri-factorization (NMTF) with self-paced learning and dual hypergraph regularization, named SPLHRNMTF, to predict miRNA-disease associations. More specifically, SPLHRNMTF first uses a non-linear fusion method to obtain miRNA and disease comprehensive similarity. Subsequently, the improved miRNA-disease association matrix is reformulated based on weighted k-nearest neighbor profiles to correct false-negative associations. In addition, we utilize L2,1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$L_{2,1}$$\\end{document} norm to replace Frobenius norm to calculate residual error, alleviating the impact of noise and outliers on prediction performance. Then, we integrate self-paced learning into NMTF to alleviate the model from falling into bad local optimal solutions by gradually including samples from easy to complex. Finally, hypergraph regularization is introduced to capture high-order complex relations from hypergraphs related to miRNAs and diseases. In 5-fold cross-validation five times experiments, SPLHRNMTF obtains higher average AUC values than other baseline models. Moreover, the case studies on breast neoplasms and lung neoplasms further demonstrate the accuracy of SPLHRNMTF. Meanwhile, the potential associations discovered are of biological significance.

Serum exosomal miR-200c is a potential diagnostic biomarker for breast cancer

Background Breast cancer (BC) is one of the most common malignancies in women. Exosomes are widely found in body fluids and carry microRNAs (miRNAs) that reflect the biological properties of the parental cells. Our study aimed to investigate the differential expression of miR-200c in BC serum exosomes and its diagnostic value. Methodology miRNA profiles in culture supernatant exosomes of normal mammary epithelial cells MCF-10A and BC cells (MCF-7, MDA-MB-231, MCF-7 Taxol) were examined by miRNA deep sequencing to screen for significantly differentially expressed miRNAs; Transmission electron microscopy (TEM), Nanoparticle tracking analysis (NTA), and Western blot were used to identify exosomes; qPCR was used to detect the expression level of miR-200c in cellular exosomes and serum exosomes; The efficacy of individual and combined tests of each indicator to diagnose BC was evaluated using receiver operating characteristic (ROC) curves. Results We identified typical exosome features by TEM, NTA and Western blot, indicating successful exosome extraction. Then our miRNA sequencing results and qRT-PCR experiments showed that miR-200c was significantly down-regulated in BC cell exosomes. In addition, we divided the clinical serum samples into two cohorts according to region, and in independent cohort I, the serum exosomal miR-200c levels of BC patients were significantly lower than those of healthy controls. In cohort II, serum exosomal miR-200c expression was significantly lower in the BC group than in the control and benign breast disease (BBD) groups, whereas miR-200c expression in the BBD group was not statistically different from that in the control group. ROC analyses in both independent cohorts confirmed that serum exosomal miR-200c could differentiate between patients with and without BC disease and could be used as an early diagnostic marker for BC disease. Conclusion Serum exosome miR-200c can be used as a potential biomarker for the diagnosis of BC, and combined with conventional serum diagnostic markers AFP, CA125 and CA153 can help to improve diagnostic efficiency.

Risk Factors for Low Quality of Life among Women Using Different Types of Contraceptives in Saudi Arabia: A Questionnaire-Based Study.

This study aimed to assess and identify the risks for poor quality of life among female Saudi contraceptive users by administering an online questionnaire. The validity of the Arabic version of the Spanish Society of Contraception Quality of Life (SEC-QOL) questionnaire was assessed by incorporating the relevant items into an exploratory factor analysis and a subsequent confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha coefficient. p < 0.05 was statistically significant. Questionnaires completed by 652 eligible women were analyzed. The most common contraception method was oral pills (51.5% of respondents). Analysis of the internal consistency of the questionnaire revealed that overall reliability was >0.7, which is considered adequate (Cronbach's alpha = 0.845). Analysis of risk factors associated with higher overall SEC-QOL scores (worse overall quality of life) revealed several statistically significant variables. A "not good" relationship with their husbands, "heavy" menstrual flow, and premenstrual breast symptoms (breast pain, hypersensitivity, and increased size) were identified as risk factors for poor quality of life due to their association with the highest scores (poor quality of life). The Arabic version of the modified SEC-QOL is a valid and reliable tool to measure the quality of life of Saudi contraceptive users.

The effects of varying in incubation time and temperature of methyl salicylate as a clearing agent on the quality of breast tissue slides

Non-polar clearing agents have the ability to dissolve breast adipose tissue. While fat dissolution occurs during the clearing process, careful monitoring of adipose cell membranes mis crucial due to their impact on the behavior of breast cancer cells and disease progression. Xylol is a widely employed clearing agent. However, its toxicity and prolonged clearing time necessitate the exploration of alternatives. In this context, methyl salicylate emerges as a viable substitute. It is non-polar nature facilitates efficient fat dissolution, leading to quicker tissues clarification. This study adopted a quasi-experimental method, utilizing 24 pieces of breast tissue as the sample. These tissue sample were divided into six groups according to the treatment regimen. The treatment groups involved breast tissue clearing using xylol for 2x60 minutes at room temperature, methyl salicylate for 2x30 minutes at room temperature, and methyl salicylate at 60°C for 20 minutes, 30 minutes, 2x20 minutes, and 2x30 minutes. The quality of breast tissue slides was assessed by analyzing the color contrast between the nucleus and cytoplasm using ImageJ software, along with the clarity of adipose cell cell membrane using microscopy. The results indicated that prolonged exposure at high temperature resulted in poor quality breast tissue slides. Conversely, tissue clearing with methyl salicylate for 2x30 minutes at room temperature exhibited excellent contrast between the nucleus and cytoplasm, as well as clear adipose cell membranes. Further study is warranted to explore the applicability of methyl salicylate as a clearing agent in tissues with lower fat content.

Immunoglobulin G4-related breast disease: two cases treated successfully with rituximab

Immunoglobulin G4-related breast disease: two cases treated successfully with rituximab

>Efficacy of disease-modifying antirheumatic drugs in the treatment of granulomatous mastitis: a systematic review.

Idiopathic granulomatous mastitis (IGM) is an inflammatory breast disorder of unknown etiology. This benign condition can mimic the clinical presentation of breast cancer and is characterized by symptoms such as breast pain, erythema, and swelling. Over the past few years, Disease-Modifying Antirheumatic Drugs (DMARDs) have been increasingly used to manage this condition. However, strong evidence to support their use is lacking. This systematic review aimed to summarize the evidence and evaluate the efficacy of DMARDs in the management of IGM. A systematic literature review, adhering to PRISMA guidelines, was conducted across electronic databases, including PubMed, EMBASE, SCOPUS, directory of open access journals (DOAJ) and Cochrane Library from their inception until May 2024. We included retrospective and prospective studies while excluding case reports and case series of less than 10 patients. Eighteen studies met our eligibility criteria. Fifteen studies were retrospective, while 2 were prospective. No randomized controlled trials were identified. Of these, 16 papers examined the effect of methotrexate on IGM, revealing significant disease improvement in most cases. Several of the studies indicated that patients treated with azathioprine and mycophenolate mofetil also achieved favorable responses. Given the rarity of IGM, only a limited number of studies have explored the use of DMARDs as a pharmacological treatment option. A significant barrier to advancing our understanding is the substantial heterogeneity in the quality and volume of data provided by these studies. Therefore, there is a need for well-designed, randomized, placebo-controlled trials to rigorously assess the efficacy of DMARDs in the treatment of IGM.

A Breast Tumor Monitoring Vest with Flexible UWB Antennas-A Proof-of-Concept Study Using Realistic Breast Phantoms.

Breast cancers can appear and progress rapidly, necessitating more frequent monitoring outside of hospital settings to significantly reduce mortality rates. Recently, there has been considerable interest in developing techniques for portable, user-friendly, and low-cost breast tumor monitoring applications, enabling frequent and cost-efficient examinations. Microwave technique-based breast cancer detection, which is based on differential dielectric properties of malignant and healthy tissues, is regarded as a promising solution for cost-effective breast tumor monitoring. This paper presents the development process of the first proof-of-concept of a breast tumor monitoring vest which is based on the microwave technique. Two unique vests are designed and evaluated on realistic 3D human tissue phantoms having different breast density types. Additionally, the measured results are verified using simulations carried out on anatomically realistic voxel models of the electromagnetic simulations. The radio channel characteristics are evaluated and analyzed between the antennas embedded in the vest in tumor cases and reference cases. Both measurements and simulation results show that the proposed vest can detect tumors even if only 1 cm in diameter. Additionally, simulation results show detectability with 0.5 cm tumors. It is observed that the detectability of breast tumors depends on the frequency, antenna selection, size of the tumors, and breast types, causing differences of 0.5-30 dB in channel responses between the tumorous and reference cases. Due to simplicity and cost-efficiency, the proposed channel analysis-based breast monitoring vests can be used for breast health checks in smaller healthcare centers and for user-friendly home monitoring which can prove beneficial in rural areas and developing countries.

Huaier-induced suppression of cancer-associated fibroblasts confers immunotherapeutic sensitivity in triple-negative breast cancer

BackgroundTriple-negative breast cancer (TNBC) is the most intractable subgroup of breast neoplasms due to its aggressive nature. In recent years, immune checkpoint inhibitors (ICIs) have exhibited potential efficacy in TNBC treatment. However, only a limited fraction of patients benefit from ICI therapy, primarily because of the suppressive tumor immune microenvironment (TIME). Trametes robiniophila Murr (Huaier) is a traditional Chinese medicine (TCM) with potential immunoregulatory functions. However, the underlying mechanism remains unclear. PurposeThe present study aimed to investigate the therapeutic role of Huaier in the TIME of TNBC patients. MethodsSingle-cell RNA sequencing (scRNA-seq) was used to systematically analyze the influence of Huaier on the TNBC microenvironment for the first time. The mechanisms of the Huaier-induced suppression of cancer-associated fibroblasts (CAFs) were assessed via real-time quantitative polymerase chain reaction (qRT‒PCR) and western blotting. A tumor-bearing mouse model was established to verify the effects of the oral administration of Huaier on immune infiltration. ResultsUnsupervised clustering of the transcriptional profiles suggested an increase in the number of apoptotic cancer cells in the Huaier group. Treatment with Huaier induced immunological alterations from a "cold" to a "hot" state, which was accompanied by phenotypic changes in CAFs. Mechanistic analysis revealed that Huaier considerably attenuated the formation of myofibroblastic CAFs (myoCAFs) by impairing transforming growth factor-beta (TGF-β)/SMAD signaling. In mouse xenograft models, Huaier dramatically modulated CAF differentiation, thus synergizing with the programmed cell death 1 (PD1) blockade to impede tumor progression. ConclusionsOur findings demonstrate that Huaier regulates cancer immunity in TNBC by suppressing the transition of CAFs to myoCAFs and emphasize the crucial role of Huaier as an effective adjuvant agent in immunotherapy.

“Mammograms are kind of my pacifier”: The cultural context of women's preference for annual mammograms in a risk-based screening cohort

Population genetic testing and risk-based screening have the potential to shift how we determine risk and screen for breast cancer. While much attention has been paid to the experiences of individuals who may be at elevated risk for breast cancer, less is known about how those at average risk make decisions about their health. Through qualitative interviews with 30 participants, we explore how those enrolled in a risk-based screening trial who are determined to be at average risk for breast cancer make screening decisions. We consider how the social context of breast health, known as ‘pink ribbon culture,’ and the pervasiveness of annual mammography as the standard of care make risk-based screening less acceptable for many participants. Risk-based screening paradigms assume that individuals will assess their risk quantitatively based on the risk models that are used. Yet, our findings demonstrate that social and cultural factors influence decision-making surrounding breast cancer screening, an important consideration when implementing risk-based screening programs. We will begin to address a gap in knowledge about how women who are told they are average risk after risk-based screening (most of the population) and recommended to screen less than annually make screening decisions.

Diagnosis and features of the treatment algorithm of non-lactational chronic mastitis on the example of a clinical case

Inflammatory processes in the mammary gland (MG) do not lose their relevance, the frequency of occurrence reaches 16% among all diseases of the MG. Non-lactational mastitis (NM) – inflammation in the MG outside the period of pregnancy and lactation – stands out among them [1]. With untimely and non-radical treatment of acute forms, there is a transition to chronic, with the formation of bacterial biofilm in the focus of inflammation and thick scar capsule after repeated surgical interventions, which is due to a vicious circle. The clinical picture of non-lactational chronic mastitis in most cases resembles a diffuse (mastitis-like, edematous-infiltrative) form of breast cancer (BC), which determines the differential-diagnostic difficulties in referring to a doctor both at initial treatment and at recurrence. This problem is faced by doctors of different specialties: oncologists, surgeons, gynecologists, therapists, specialists in radiation and radiological diagnostics [2, 3]. Radiation diagnostics is always the «gold standard» in the diagnosis of breast diseases, but has a number of disadvantages in the inflammatory process in the breast, and, in some cases, it is worth prioritizing the ultrasound method of investigation [4]. Through the combined interpretation of clinical data and ultrasound (USG) findings, the following parameters should be evaluated: skin thickness, pre-mammary fatty tissue, structure of glandular parenchyma of the MJ, presence and boundaries of inflammatory infiltrate/infiltrates in the MJ tissue; formation of «rarefaction» zones, microabscesses and/or already formed «draining» abscess cavities, assess the content of fluid cavities (homogeneity/homogeneity), the presence of pyogenic capsule, as well as the boundaries of inflammation/abscessing with unchanged breast tissue, taking into account possible «microfoci» outside the main mass of changes (like «satellites», «fluid spurs»). It is important to analyze the state of the ductal system of the breast (ductal diameter dilation, intraluminal content) and possible connection of ducts with abscessed areas, which may be a predictor of further spread of the process, recurrence or chronicization of the disease. Inflammation on the background of subacute and chronic process can lead to the development of fistulas [5]. However, there is not always the classic ultrasound picture of a purulent focus in the breast [6–9].

Microcalcifications in benign breast biopsies: association with lesion type and risk.

To characterize associations of microcalcifications (calcs) with benign breast disease lesion subtypes and assess whether tissue calcs affect risks of ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC). We analyzed detailed histopathologic data for 4,819 BBD biopsies from a single institution cohort (2002-2013) followed for DCIS or IBC for a median of 7.4years for cases (N = 338) and 11.2years for controls. Natural language processing was used to identify biopsies containing calcs based on pathology reports. Univariable and multivariable regression models were applied to assess associations with BBD lesion type and age-adjusted Cox proportional hazard regressions were performed to model risk of IBC or DCIS stratified by the presence or absence of calcs. Calcs were identified in 2063 (42.8%) biopsies. Calcs were associated with older age at BBD diagnosis (56.2 versus 49.0years; P < 0.001). Overall, the risk of developing IBC or DCIS did not differ significantly between patients with calcs (HR 1.13, 95% CI 0.90, 1.41) as compared to patients without calcs. Stratification by BBD severity or subtype, age at BBD biopsy, outcomes of IBC versus DCIS, and mammography technique (screen-film versus full-field digital mammography) did not significantly alter association between calcs and risk. Our analysis of calcs in BBD biopsies did not find a significant association between calcs and risk of breast cancer.