Breast Examination In Women Research Articles

Predictive model for determining the indications for automated 3D ultrasound for screening patients at low risk of developing breast tumors

Automatic ultrasound examination of the breast (3D ultrasound) has become an important tool in the diagnosis of breast cancer. It is believed that 3D ultrasound has high reproducibility, low dependence on the operator, less time spent on obtaining images, and automatic three-dimensional reconstruction of the entire breast.Purpose of the study. To develop indications for 3D ultrasound based on predictive screening models for patients with a low risk of developing breast tumors based on the identification of the most significant risk factors.Patients and methods. A retro-prospective clinical study has been conducted from February 2019 to May 2023. A total of 2794 patients were included in the study. All patients underwent clinical examination, palpation, collected information on socio-demographic data and potential risk factors for breast cancer, and 2D ultrasound was also performed. The group under the age of 40 included 1,511 patients, of whom 628 underwent 3D ultrasound. The sample of 40 years and older included 1,283 patients, 655 of whom underwent 3D ultrasound. Mammography was performed in patients aged 40 and older. Quantitative and qualitative indicators of anamnesis and clinical examination, as well as MMH results in patients over 40 years old, were recorded. Based on these data, a logistic regression was compiled, followed by the selection of the most significant model by cutting off insignificant factors according to the p-level of significance and presenting the model as a ROC curve.Results. The most significant risk factors for the detection of breast cancer were identified. Based on their screening with 3D ultrasound in a group up to 40 years of age, it can be used in 95.96 % and is not indicated in 4.04 %. The presented model in the group up to 40 years worked correctly in 99.21 %. While screening with 3D ultrasound in a group of 40 years and older in 84.26 % is appropriate and not indicated in 15.74 %. The presented model worked correctly in 97.12 %.Conclusion. The study identified important pre-diagnostic factors for the choice of a diagnostic algorithm for breast examination in women of different age groups, and determined the indications for 3D ultrasound. The developed algorithms will help optimize screening and referral for additional examinations, which is of practical importance for improving diagnostics and optimizing healthcare resources.

Factors related to clinical breast examination: A cross-sectional study

ABSTRACTBackground and Aim:Breast cancer is one of the most common types of cancer among women as well as one of the most serious and important public health issues in developing countries. The aim of the present study was to evaluate the factors related to clinical breast examination in women in Tehran.Method:This cross-sectional study was conducted on 859 women in Tehran, Iran in 2020. Logistic regression was applied to identify determinant factors that related to clinical breast examination.Result:The prevalence of clinical breast examination was 52.6%. Results indicated significant differences between those who underwent clinical breast examination and those who had a nonclinical breast examination in terms of age, housing conditions, marital status, problem in the breast, perceived susceptibility, perceived barriers, fatalism, and self-care.Conclusion:It is essential to inform and educate women about breast cancer and associated complications and problems after being diagnosed with breast cancer as well as about the screening and diagnostic methods, including the need for clinical breast examination by a specialist.

The Relationship between Knowledge and Practice in Clinical Breast Examination among Women in Baghdad, Iraq

Aim: This study aims to determine both the level of knowledge, attitude, and practice in clinical breast examination in women and the relationship between knowledge and practice.Data collection was performed within a three-month period starting from February 2019 on. Subjects and Method: A cross-sectional analytical study included 657 non-randomly selected women visiting primary health care centers in Baghdad city with an average of age between (20-59) years old. Results: Only 51.8% ever heard of clinical breast examination. The mean knowledge score for clinical breast examination was (51.2±44). Only 5.5% of women performed regular clinical breast examinations. Participants who adequately practice clinical breast examination had a statistically significance higher mean score of knowledge than those without adequate clinical breast examination (100 vs 44.2), (P<0.001). Conclusion: The study has concluded that practices of clinical breast examination were inadequate in the majority of participants and need to be improved by educational programs.

Cancer of Unknown Primary: A Review on Clinical Guidelines in the Development and Targeted Management of Patients with the Unknown Primary Site.

Cancer of unknown primary (CUP) is a malignant widespread metastatic disease without an identifiable primary site after extensive clinical investigation. Recently, a decline is observed in the diagnosis of CUP, mainly due to improvement in detection of the primary tumors, thus decreasing the unknown primaries. Worldwide, CUP is the sixth to eighth most common malignancy, accounting for 2.3% to 5% of a new cancer diagnosis. CUP is third to fourth most common cause of death due to cancer-related mortality. The prognosis of CUP is depressing with the median survival of three to six months in the previous studies, but according to recent studies, median survival is less than one year. High risk for developing CUP is seen in heavy smokers (26 or more cigarettes/day) and individuals with the lowest quartiles of waist circumference. A weak association is observed with the use of alcohol consumption and low level of education. Human papillomavirus DNA plays a role in those with squamous cell carcinoma of unknown primaries in head and neck regions. In the diagnosis of CUP, comprehensive medical history, complete physical examination (including genitourinary, rectal exam, and breast examination in women) and necessary laboratory tests are crucial.Whole-body positron emission tomography-computed tomography (PET/CT) is the investigation of choice to assess the entire body for CUP. Multiparametric 3T-MRI (MP-MRI) is used to examine the local soft tissue status, helps in the staging of the tumor, and to determine the extent of involvement of tissue for medical as well as prognostic purposes. Immunohistochemistry outlines the specific markers, including caudal-related homeobox protein (CDX2), homeobox protein Nkx-3.1 (NKX3-1), paired box gene 8 (PAX8), special AT-rich sequence-binding protein 2 (SATB2), thyroid transcription factor 1 (TTF-1), and splicing factor 1 (SF1) with the focus on the effectiveness of lineage-restricted transcription factors. Patients response to treatment can be evaluated by the gene expression profiling (GEP) test that also predicts tissue of origin (TOO). Tumor identified through gene profiling is sensitive to platinum/taxane therapy, others that are not TOO tumors are resistant to platinum/taxane. The new therapeutic method based on molecular profiling is associated with higher treatment response. In comprehensive genomic profiling, it is observed that there is at least one clinically appropriate genomic alteration in CUP that can influence the targeted therapy. The targeted therapeutic approach will not only improve the disease outcome but will also be cost-effective and save time from finding the primary site.

Barriers to Breast Cancer Screening in Nursing and Midwifery Personnel of Hospitals of Birjand, Iran

Background: Breast cancer is the most common cancer in women and the fifth leading cause of cancer death worldwide. In developing countries, early diagnosis of breast cancer through available screening methods is the main strategy to reduce mortality. Objectives: This study aimed at investigating the barriers to breast cancer screening methods in nursing and midwifery personnel of hospitals of Birjand, Iran. Methods: In this cross sectional study, a total of 202 female nursing and midwifery personnel working in hospitals of Birjand (lasted from July 2015 to September 2015) were selected using the stratified sampling method. The barriers to breast self-examination and clinical breast examination were investigated using a researcher-made questionnaire. The data were analyzed with the SPSS software (V. 16) using descriptive statistic and chi-square test. P values of < 0.05 were considered significant. Results: The results showed that only 11.3% (N = 16) of the participants, who performed breast self-examination, did it on a monthly basis. Intervals between CBE performance in 35.5% of women was 5 or more than 5 years. The main barriers to breast self-examination and clinical breast examination in women were, respectively, lack of time, negligence, lack of symptoms of breast cancer, fear of potential surgery for cancer, and fear of losing beauty. There was a significant association between age, marital status, educational field of study, tenure, and BSE. History of having a child increases performance of CBE yet results also showed that females, who had a history of benign breast diseases, were less prone to perform CBE. Conclusions: According to the results of this study, it seems that interventions, such as changes in psychological and educational programs, to increase the performance and knowledge and create a positive attitude towards these methods in females are needed.

FEASIBILITY STUDY OF BREAST CANCER RISK MONITORING USING THERMOGRAPHY TECHNIQUE IN MALAYSIA

Breast cancer remains as a serious health issue in Malaysia and most presentation of breast cancer incidences are at the later stage which will reduce the survival rate. Breast Self-Examination for all women (BSE), Clinical Breast Examination for women above 40 years old (CBE) and Mammography for the older and high-risk groups are the current policies that are available in the government hospitals and selected clinics. However, BSE and CBE could not detect the early stage breast cancer while Mammography is less sensitive in detecting tumor in high dense breast tissue. Both factors have caused an increase in the overall percentage of later stage presentation of breast cancer in Malaysia. In this paper, a feasibility study of breast cancer screening and risk monitoring using Thermography technique is presented. Thermography technique is capable in identifying any physiological changes occur prior to lump formation. This technique is simple, cheaper, and produce no radiation which will allow a safe regular screening. In this study, a series of screenings has been performed on carcinogenic induced rats and thermal images acquired were then analyzed for risk monitoring. Visual analysis shown that the presence of hotspot and asymmetrical temperature profile could be an indicator of a high risk patient while temperature measurement on both induced and control groups shows a significant difference in standard deviation of the surface temperature with smaller deviation of 0.31±0.08 observed in control group while bigger deviation of 2.23±0.78 observed in the induced group. Hence, it is shown that Thermography technique could be a potential modality for upfront breast screening in Malaysia.

In Newly Diagnosed Breast Cancer, Screening MRI of the Contralateral Breast Detects Mammographically Occult Cancer, Even in Elderly Women: The Mayo Clinic in Florida Experience

The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution. MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopausal status, breast density, and primary-tumor characteristics. Logistic regression was used to explore the association between contralateral carcinoma and potential patient risk factors. A total of 425 women were evaluated, of whom 129 (30%) were aged 70 years or older. A contralateral biopsy was recommended and performed solely on the basis of MRI in 72 of the 425 women (17%). Sixteen of these 72 women (22%) had pathologically confirmed carcinoma, including seven in the older subgroup. The prevalence of clinically and mammographically occult contralateral carcinoma detected by MRI was 3.8% (16/425) overall and 5.4% (7/129) in the group of older women. When potential risk factors for contralateral breast cancer were evaluated, postmenopausal status was the only significant predictor of contralateral cancer detected by MRI (p = 0.016). We concluded that contralateral breast screening with MRI should be considered in postmenopausal women with newly diagnosed breast cancer, even those aged 70 years or older at diagnosis.

Trends in Mammography and Clinical Breast Examination: A Population-Based Study

There are well-accepted clinical guidelines for early detection of breast cancer through mammography and clinical breast examination. The purpose of this study was to determine trends in the utilization of these techniques over the past 5 years. The National Health Interview Survey is a population-based computer survey of noninstitutionalized civilian Americans conducted annually by the National Center for Health Statistics, Centers for Disease Control and Prevention. We evaluated the reported use of mammography and clinical breast examination in women 40 years of age and older between 2000 and 2005. Data were evaluated using SAS and SAS-callable SUDAAN software. Surveyed were 10,994 and 11,128 women over age 40 in 2000 and 2005, respectively. Between these years, there was a decline in women >or=40 years old who reported ever having a mammogram (80.79% versus 79.52%, P<0.0001) and in those who had a mammogram within the preceding 2 years (87.98% versus 86.30%, P=0.0040). In addition, there was a drop in women reporting ever having a clinical breast exam (82.12% versus 75.91%, P<0.0001) and in those reporting having had a clinical breast exam in the 2 years prior to the survey (89.24% versus 87.63%, P=0.0012). Similar results were found in the population aged 50-69. Despite well-established clinical guidelines for early detection of breast cancer, there has been a decline in the rates of annual mammography and clinical breast exam in women over the age of 40 over the past 5 years.

MEMORANDUM FOR: Science Writers and Editors on the Journal Press List: Mammography Does Not Reduce Breast Cancer Mortality When Added to Careful Breast Examination for Women Aged 50-59 Years

MEMORANDUM FOR: Science Writers and Editors on the Journal Press List: Mammography Does Not Reduce Breast Cancer Mortality When Added to Careful Breast Examination for Women Aged 50-59 Years

Feasibility of Universal Screening Mammography

It is estimated that 44,500 American women will die of breast cancer in 1991. The breast cancer screening guidelines of the American Cancer Society and the National Cancer Institute calling for annual mammography for all women older than 50 years have been endorsed by numerous professional groups. Third-party reimbursement for screening mammography is becoming more prevalent, and payment for screening mammography is now a Medicare benefit. Our studies, conducted as part of a National Cancer Institute grant to increase the routine use of screening mammography and clinical breast examination in women 50 to 75 years of age, have uncovered a number of significant barriers to the implementation of screening guidelines among women, primary care physicians, and providers of mammography services. These barriers, as well as methods to assure the quality of mammography, need to be addressed before universal screening is feasible.

Family Practice Residents’ Compliance with Preventive Medicine Recommendations

We conducted a medical records survey of 270 randomly selected patients 20 years of age or older seen by family practice residents in a university-based training program. This study concerned residents' compliance with certain preventive recommendations made by four expert groups: the American Cancer Society, the Canadian Task Force on the Periodic Health Examination, the Immunization Practices Advisory Committee, and the National Institutes of Health Consensus Development Conference on treating elevated cholesterol. The interventions studied were breast examination, mammography, pelvic examination, Pap testing, digital rectal examination, stool guaiac slide testing, serum cholesterol screening, and pneumococcal and influenza vaccinations. We calculated the percentage of eligible patients receiving each of these interventions. The highest rates of resident compliance with health screening recommendations were for Pap testing in women 20-34 and 35-59 years of age (31.7% and 22.6%, respectively), breast examination in women 20-39 years of age (27.3%), and influenza vaccination (23.0%). There were no other rates of compliance that exceeded 20%. Our data thus indicate that residents in this program did not comply well with health maintenance recommendations.

Alopecia neoplastica. Hair loss resembling alopecia areata caused by metastatic breast cancer.

In two women almost circular areas of baldness which closely resembled alopecia areata were actually caused by metastatic cancer of the breast. Groups and strands of adenocarcinoma cells throughout the dermis of the scalp lesion initiated a desmoplastic reaction that appeared to cause atrophy and disappearance of the hair follicles. The need for breast examination in women with hair loss resembling common alopecia areata is obvious. A punch biopsy of alopecia areatalike lesions in women in the cancerprone age group could resolve the diagnosis.