Breast In Women Research Articles

Risk-based breast cancer screening: What are the challenges?

Population-based screening programs aim to detect the disease at an early stage, so less treatment will be needed as well as having better oncological outcomes when diagnosed earlier. In the majority of European countries, breast cancer screening programs are designed based on women age.Meta-analysis of randomized clinical trial data demonstrates a reduction in the relative risk of breast cancer mortality due to screening, which has been estimated to be approximately 20%.One of the controversies about the population breast screening programs is that age-based screening ignores women's individual breast cancer risk. Identification of high-risk women may intensify the screening measures and will optimize the population screening programs to align them to individual risks.Family history of breast cancer is one of the risk factors to consider along with the recently developed polygenic risk scores to stratify women into a risk group. Other factors to assess risk include: mammographic breast density; B3 lesions with atypia in breast biopsy specimens; hormonal and lyfestyle and, potentially, epigenetic markers. Still, there are some difficulties in validating these factors and reflecting the interaction between risk factors in the models.Ongoing screening trials (e.g., WISDOM and MyPebs) are currently evaluating the clinical acceptability and utility of risk-stratified screening programs in the general population, and should provide valuable information for the possible implementation of such programs.Communication of complex risk information to the women, as well as assessing ethical concerns need to be addressed before implementation of risk stratified programs.

Information Needs Among Thai Women Breast Cancer Patients During the Initial Treatment Phase: A Cross-Sectional Study.

To examine the information needs of breast cancer patients during the initial phase of treatment and to analyse the factors that influenced these needs. Providing comprehensive and timely information during early breast cancer treatment is crucial for informed decision-making and effective coping. Healthcare providers must address these needs to enhance patient support and improve outcomes. A cross-sectional study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. A total of 123 post-mastectomy patients were selected through purposive sampling and completed the Thai version of the Sri Lankan Information Needs Assessment Questionnaire-BC (SINAQ-BC). Direct associations between demographic data and information needs were analysed descriptively, while bivariate analysis and linear regression were used to identify significant predictors of information needs. The findings revealed that patients exhibited high overall information needs (224.7/260.0), with the greatest demand focused on physical care, treatment and diagnosis. In contrast, needs related to disease specifics and psychosocial care were less prominent. A total of 94 respondents (76.4%) expressed a particularly high demand for information regarding physical care. Education level was identified as an influencing factor, accounting for 7.7% of the variance in information needs among women with breast cancer. Patients with higher education levels had significantly greater information needs. Nursing staff should provide customised information packages that are tailored to the participants' education levels. Further testing of the Thai version of the SLINQ-BC would also be warranted. Patients are increasingly expected to manage their own care even as medical treatment grows more complex and technical. Nursing staff can contribute to the care of patients by being ready to evaluate, monitor and address breast cancer patient's individual information needs in the early stage of treatment based on factors such as educational level. No patient or public contribution because the nature of the study's design, data analysis and writing did not require patient or public contribution.

Relationship Between Perceived COVID-19 Risk and Change in Perceived Breast Cancer Risk: Prospective Observational Study.

Whether COVID-19 is associated with a change in risk perception about other health conditions is unknown. Because COVID-19 occurred during a breast cancer study, we evaluated the effect of COVID-19 risk perception on women's breast cancer risk perception. This study aims to evaluate the relationship between perceived risk of COVID-19 and change in perceived breast cancer risk. We hypothesized that women who perceived greater COVID-19 risk would evidence increased perceived breast cancer risk and this risk would relate to increased anxiety and missed cancer screening. Women aged 40-74 years with no breast cancer history were enrolled in a US breast cancer prevention trial in outpatient settings. They had provided breast cancer risk perception and general anxiety before COVID-19. We performed a prospective observational study of the relationship between the perceived risk of COVID-19 and the change in perceived breast cancer risk compared to before the pandemic. Each woman was surveyed up to 4 times about COVID-19 and breast cancer risk perception, general anxiety, and missed medical care early in COVID-19 (May to December 2020). Among 13,002 women who completed a survey, compared to before COVID-19, anxiety was higher during COVID-19 (mean T score 53.5 vs 49.7 before COVID-19; difference 3.8, 95% CI 3.6-4.0; P<.001) and directly related to perceived COVID-19 risk. In survey wave 1, anxiety increased by 2.3 T score points for women with very low perceived COVID-19 risk and 5.2 points for those with moderately or very high perceived COVID-19 risk. Despite no overall difference in breast cancer risk perception (mean 32.5% vs 32.5% before COVID-19; difference 0.24, 95% CI -0.47 to 0.52; P=.93), there was a direct relationship between change in perceived breast cancer risk with COVID-19 risk perception, ranging in survey wave 4 from a 2.4% decrease in breast cancer risk perception for those with very low COVID-19 risk perception to a 3.4% increase for women with moderately to very high COVID-19 risk perception. This was not explained by the change in anxiety or missed cancer screening. After adjustment for age, race, education, and survey wave, compared to women with very low perceived COVID-19 risk, perceived breast cancer risk increased by 1.54% (95% CI 0.75%-2.33%; P<.001), 4.28% (95% CI 3.30%-5.25%; P<.001), and 3.67% (95% CI 1.94%-5.40%; P<.001) for women with moderately low, neither high nor low, and moderately or very high perceived COVID-19 risk, respectively. Low perceived COVID-19 risk was associated with reduced perceived breast cancer risk, and higher levels of perceived COVID-19 risk were associated with increased perceived breast cancer risk. This natural experiment suggests that a threat such as COVID-19 may have implications beyond the pandemic. Preventive health behaviors related to perceived risk may need attention as COVID-19 becomes endemic.

“It’s a Low-key Thing of Eugenics”: Barriers to Cervical Cancer Screening and Disability Reproductive Justice for People with Disabilities During the COVID-19 Pandemic

Breast and cervical cancer screening is essential to the sexual and reproductive health of women and transgender people, resulting in reduced cancer incidence, improved outcomes, and lower mortality risk. However, previous studies have found lower rates of cancer screening among people with disabilities compared to those without disabilities, and increased rates of adverse associated outcomes, including later-stage cancer diagnosis and lower survival rates (Cuypers et al., 2022; Hughes et al., 2022). As such, this paper aims to mobilize the disability reproductive justice framework as a relevant lens for examining disparities in breast and cervical cancer screening that have a detrimental impact on people with disabilities. A mixed deductive and inductive approach was used to analyze 32 interviews with people who self-identified as having a physical, sensory, psychiatric, intellectual and/or developmental disability. This study was grounded in community- based research and was guided by peer researchers with lived experiences of disability and community partners. Our findings revealed that disparities in breast and cervical cancer screening for disabled women are present and ongoing. Themes that emerged included intersectional injustices, inaccessible spaces and systems, barriers to the right to reproductive health care, lack of autonomy and self-determination, and recommendations from people with disabilities. We conclude that this inaccessibility to cancer screening is a form of modern-day eugenics. The lack of accommodation for people with disabilities and recognition of them as sexual beings has contributed to these evident health inequities. While cancer screening services were delayed and disrupted for the entire population during COVID-19, there needs to be a consideration for the heightened vulnerability of this group, as well as the existing marginalization that creates barriers to access in the first place.

Financial Difficulty Over Time in Young Adults With Breast Cancer

Young adults aged 18 to 39 years represent the minority of breast cancer diagnoses but are particularly vulnerable to financial hardship. Factors contributing to sustained financial hardship are unknown. To identify financial hardship patterns over time and characterize factors associated with discrete trajectories; it was hypothesized that treatment-related arm morbidity, a key source of expense, would be associated with long-term financial difficulty. This cohort study included US young adults aged 40 years or younger treated between 2006 and 2016. Eligible patients were treated for stage 0 to stage III breast cancer at institutions participating in the Young Women's Breast Cancer Study, which included a specialized cancer institute and 12 other academic and community hospitals. Patients who responded at baseline and returned a 1-year survey were included in analysis. Data were analyzed in March 2024. Trajectory modeling classified patterns of financial difficulty from baseline through 10 years postdiagnosis using the Cancer Rehabilitation Evaluation System (CARES) scale. Multinomial regression examined characteristics, including treatment-related arm morbidity, associated with each trajectory. A total 1008 patients were included (median [IQR] age at diagnosis, 36 [33-39] years; 60 Asian [6.0%], 35 Black [3.5%], 47 Hispanic [4.7%], 884 White [87.7%]); 840 patients were college graduates (83.3%), 764 were partnered at baseline (75.8%), 649 were nulliparous (64.4%), and 908 were without comorbidities at enrollment (90.1%). Patients' tumors were primarily stage I-II (778 [77.2%]), estrogen receptor/progesterone receptor-positive (754 [74.8%]), and ERBB2-negative (formerly HER2) (686 [68.1%]). Patients were more frequently treated with mastectomy than breast conservation (771 [76.5%] vs 297 [29.5%]; P < .001). A majority of patients received radiation therapy (627 [62.2%]), chemotherapy (760 [75.4%]), and endocrine therapy (610 [60.6%]). A total of 727 patients (72.1%) reported arm symptoms within 2 years of surgery. Three distinct trajectories of experiences with finances emerged: 551 patients (54.7%) had low financial difficulty (trajectory 1), 293 (29.1%) had mild difficulty that improved (trajectory 2), and 164 (16.3%) had moderate to severe difficulty peaking several years after diagnosis before improving (trajectory 3). Hispanic ethnicity (OR, 3.71; 95% CI, 1.47-9.36), unemployment at baseline and 1 year (OR, 2.66; 95% CI, 1.63-4.33), and arm symptoms (OR, 1.77; 95% CI, 1.06-2.96) were associated with increased odds of experiencing trajectory 3. Having a college degree (OR, 0.20; 95% CI, 0.12-0.34) or being partnered (OR, 0.24; 95% CI, 0.15-0.38) were associated with increased odds of experiencing trajectory 1. In this cohort study of young adults with breast cancer, we identified a subset of patients who experienced a high degree of financial difficulty persisting into early survivorship. Targeted interventions to mitigate financial toxicity-modifiable factors that include support for the employability or return to work support for those experiencing arm symptoms after treatment-are needed.

The food environment and postdiagnosis weight gain among Black women breast cancer survivors in Maryland.

Weight management is included in the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guidelines for its clinical impact on breast cancer (BC) survivorship. Few studies have examined the impact of neighborhood-level factors associated with postdiagnosis weight change among Black BC survivors. We recruited 100 Black female BC survivors to complete an online survey, including demographic, clinical characteristics, and lifestyle factors, between January 5, 2022 and August 18, 2022. We utilized the 2023 County Health Rankings Food Environment Index (FEI), which ranges from 0 (worst) to 10 (best), to capture the food environment as the primary exposure for postdiagnosis weight gain. We calculated postdiagnosis weight gain as percent weight change from time at diagnosis to time of survey. Participants were grouped into categories of stable weight (within ± 3%) or weight loss (≤ -3%) compared to weight gain (≥ 3%). We calculated adjusted odds ratios (aORs) for the associations between county-FEI, clinical factors, and postdiagnosis weight gain. Among the 95 women who reported weight measurements, we observed that women living in counties with an FEI ≥ 8.8 (at or above median) were significantly less likely to experience weight gain (aOR 0.09; 95% CI 0.01-0.77). Stage, age at diagnosis, years since BC diagnosis, and BC treatments were not significantly associated with weight gain. Postdiagnosis weight gain is associated with poorer food environments among Black BC survivors in Maryland. Our findings will inform larger prospective studies and future interventions among this population.

Web-based interventions for fear of cancer recurrence: A scoping review with a focus on suggestions for the development and evaluation of future interventions.

The objective of this scoping review is to provide an overview of the available evidence on the effectiveness of web-based interventions for fear of cancer recurrence (FCR) and a discussion of drawbacks and possible improvements for web-based interventions identified in the reviewed studies. These steps fulfil the aim of this review, which is to offer suggestions for developing future web-based interventions based on the reviewed studies. Five databases (PubMed, MEDLINE, EMBASE, SCOPUS and Web of Science) were searched. Original peer-reviewed articles, written in English, on web-based interventions for FCR were included for review. The data from the included studies was synthesised thematically. We included 34 papers reporting on 28 interventions. Most of the studies in the papers were quantitative and mixed quantitative studies with a qualitative element, e.g. an interview post-intervention. Interventions were most commonly trialled with women breast cancer patients. Top three countries where studies were conducted were USA, Australia and the Netherlands. The most common theoretical framework for interventions is cognitive behavioural therapy (CBT), followed by mindfulness-based and mixed CBT, mindfulness, acceptance and commitment therapy (ACT), relaxation approaches. FCR was the primary focus/measure in 19 Studies, in 9 studies FCR was a secondary/related outcome/measure. Overall, the evidence of efficacy of web-based interventions on FCR is mixed. The existing research suggests several key points for producing more robust evidence about the effectiveness of web-based interventions for FCR. First, the studies suggest that it is a priority to better define eligibility criteria to proactively include people with higher levels of FCR. Second, there is a need for longer-term follow-up and outcome measuring period. Third, research examining the reasons for dropout from web-based interventions for FCR is critical to improve the effectiveness of web-based interventions. Fourth, while web-based interventions do not involve the costs of transportation, traveling time, space, equipment, cleaning, and other expenses, further cost utility analyses should be performed. Finally, future studies should assess how intervention accessibility, adherence, and effectiveness can be improved across different intervention designs, varying from intensive synchronous individual therapist-assisted web-based programme to blended designs combining the advantages of face-to-face and internet-based elements, to entirely self-managed programmes. Developing and evaluating more accessible FCR treatments have been identified among top international FCR research priorities (Shaw et al. 2021). While there is some evidence that web-based interventions can be as effective as face-to-face interventions, currently there is a dearth of systematic data about the ways in which the web-based modality specifically can enhance supportive care for FCR. Developing knowledge about effective web-based interventions has implications for cancer survivors as they can be presented with more accessible, low-cost and low-burden options for managing fear of cancer recurrence.

3D Wetting Gradient Janus Sports Bras for Efficient Sweat Removal: A Strategy to Improve Women's Sports Comfort and Health.

Developing Janus fabrics with excellent one-way sweat transport capacity is an attractive way for providing comfort sensation and protecting the health during exercise. In this work, a 3D wetting gradient Janus fabric (3DWGJF) is first proposed to address the issue of excessive sweat accumulation in women's breasts, followed by integration with a sponge pad to form a 3D wetting gradient Janus sports bra (3DWGJSB). The 3D wetting gradient enables the prepared fabric to control the horizontal migration of sweat in one-way mode (x/y directions) and then unidirectionally penetrate downward (z direction), finally keeping the water content on the inner side of 3DWGJF (skin side) at ≈0%. In addition, the prepared 3DWGJF has good water vapor transmittance rate (WVTR: 0.0409gcm-2h-1) and an excellent water evaporation rate (0.4704gh-1). Due to the high adhesion of transfer prints to the fabrics and their excellent mechanical properties, the 3DWGJF is remarkably durable and capable of withstanding over 500 laundering cycles and 400 abrasion cycles. This work may inspire the design and fabrication of next-generation moisture management fabrics with an effective sweat-removal function for women's health.

General practitioners’ perspectives on targeted breast ultrasound as primary diagnostic test in women with focal breast complaints: An interview study

IntroductionThe high diagnostic accuracy of ultrasound opens possibilities to shift towards an initial ultrasound approach for the evaluation of focal breast complaints in women, with only additional DBT in case of unclear or suspicious ultrasound findings. As general practitioners (GPs) are important stakeholders in the diagnostic pathway, this study focuses on GPs perspective on ultrasound as primary diagnostic imaging test, as well as the GP referral process. MethodsSixteen Dutch GPs were interviewed on the referral process and their perceived barriers and facilitators of initial ultrasound diagnostics in women presenting with focal breast complaints. Interview data were transcribed verbatim and analyzed thematically. ResultsThematic analysis identified themes related to 1) the routine breast consult (consult characteristics, referral decision, referral rationale and diagnostic imaging decision) and 2) considerations of an ultrasound-only approach. Regarding the latter, the theme diagnostic workflow emphasizes GPs concerns regarding long waiting times for ultrasound. Professional communication describes communicational barriers on patient-radiologist and radiologist-GP level. In the theme doctor-patient relationship shared decision-making was highlighted, while concerns existed on the lack of patient return to the GP after result disclosure at the hospital. Effectiveness of imaging is associated with GPs’ acceptance of the diagnostic performance of ultrasound as stand-alone modality. Personal expertise and workload is related to consequences of an initial ultrasound approach on GPs workload and professional tasks. Regarding the patient benefit-harm trade-off, various patient (dis)advantages were highlighted. Decentralization of diagnostic evaluation was considered a potential practical implication of ultrasound as primary diagnostic test. ConclusionParticipants seemed to welcome ultrasound-only diagnostics for the evaluation of women's focal breast complaints, emphasizing multiple benefits for both the patients and GPs. They, however, also addressed various challenges that should be taken into consideration when actually practicing an initial ultrasound approach.

Young Black Women's Breast Cancer Knowledge and Beliefs: A Sequential Explanatory Mixed MethodsStudy.

Black women under the age of 50 have a 111% higher breast cancer mortality rate than their White counterparts. The breast cancer mortality disparities among young Black women may be due in part to the fact that they are more likely to be diagnosed with late-stage, invasive breast cancer tumors. Psychosocial factors, such as lack of perceived risk for breast cancer, lack of awareness of breast cancer risk factors, and ambiguity about breast cancer screening guidelines are areas that are under investigated among young Black women. The purpose of this study was to identify young Black women's cancer beliefs and level of breast cancer risk knowledge. A sequential explanatory mixed methods study was conducted using quantitative data from the Health Information Trends Survey 6 (HINTS 6) (n = 25) and qualitative data from interviews with young Black female college students (n = 13). The results of the quantitative data analysis were used to guide the development of the qualitative interview guide. Data regarding participants' cancer beliefs, cancer risk factor knowledge, perceived cancer risk, and ambiguity about cancer screening behaviors were analyzed. The findings indicated young Black women have low perceived risk of developing cancer. Most participants were not aware of cancer recommendations that were targeted towards women under the age of 40. In addition, knowledge about lifestyle behavior risk factors for breast cancer was relatively low. Our findings underscore the importance of developing, disseminating, and implementing breast cancer education interventions that are targeted towards young Black women.

Tumor Metastasis to the Oral Soft Tissues and Jaw Bones: A Retrospective Study and Review of the Literature.

Metastasis to the oral soft tissues and jaw is rare and accounts for 1%-3% of maxillofacial malignancies. These lesions usually occur in the context of an extensive malignant tumor with a poor prognosis. Archived cases from the Oral and Maxillofacial Pathology Department of the Faculty of Dentistry and two hospital centers of Mashhad University of Medical Sciences were examined. Inclusion criteria were cases with available records of pathologically confirmed metastatic lesions of the oral cavity with or without diagnosed primary malignancy. Metastatic lesions in the oral cavity and jaw were found in 18 patients, including seven women and 11 men, with a mean age of 49.5 years. Metastatic lesions were more common in the jaw (66%) and particularly in the mandible (38%) than elsewhere. In the case of soft tissue metastases, the gingiva was more affected than other sites. The primary tumor was most commonly in the kidney in men and in the breast in women (36%-28%). In addition, the diagnosis of a metastatic lesion led to the detection of the primary tumor elsewhere in six out of 18 cases (33.3%). Early diagnosis of the lesions is challenging, given the absence of specific signs or symptoms, which, in some cases, nonetheless resemble inflammatory, benign, reactive lesions. Therefore, dentists play a crucial role in diagnosing such lesions, as they lead to the discovery of hidden distant primary tumors. Biopsy should always be considered for suspicious lesions, even if the probability is very low.

Preparation and characterization of functional dual network hydrogel for motion monitoring in smart bra

The smart bra is a kind of sports underwear with providing health monitoring and comfort protection for women breast in sports. Developing smart sensing materials that combine comfort and functionality for sensing breast condition remains a challenge. Here, natural polysaccharide sodium alginate (SA), acrylamide (AM) monomer and chitosan (CS) and polypyrrole (PPy) in-situ polymerized from pyrole (Py) monomer were used as raw materials to successfully synthesize double network conductive hydrogel by two-step method. The results show that in the hydrogels, the entanglement and interpenetration of macromolecules produce toughness (tensile/compressive strength is ∼0.248 MPa/∼2.836 MPa), elasticity (tensile/compression elastic recovery rate is∼94.06 %/∼98.41 %) and durability (after 30 tensile/compression cycles conducting at 25 %, 50 % and 100 % constant strain keep at high recovery rate). The rich moisture content provides its adhesion (adhesion strength ∼4.7557 kPa) and flexibility (bending stiffness 1.0843 cN cm∼), presenting sufficient adhesion reliability and robustness to different substrates. The addition of PPy enables the hydrogel to have conductivity (6.77 × 10−2 S cm−1) and sensing performance (tensile/compression sensitivity is ∼1.94/∼1.43). The conductive hydrogel, as a flexible strain sensor, shows good adhesion, flexibility, elasticity and sensitivity in application of sports smart bra, can detect both the tensile behavior of skin and the compression state of tissue through its mechano-electricity, and accurately sense the changes of physiological parameters during movement. The conductive hydrogel with high elasticity and strength has broad application prospects in smart bra.

The Role of Testin and Serum Test in Women Breast Cancer

The Role of Testin and Serum Test in Women Breast Cancer

Detection of BRCA1and BRCA2 mutation for Breast Cancer in Sample of Iraqi Women above 40 Years

Breast cancer is the commonest cancer affecting women worldwide. Different studies have dealt with the etiological factors of that cancer aiming to find a way for early diagnosis and satisfactory therapy. The present study clarified the relationship between genetic polymorphisms of BRCA1 &amp; BRCA2 genes and some etiological risk factors among breast cancer patients in Iraq. This investigation was carried out on 25 patients (all were females) who were diagnosed as breast cancer patients attended AL-Kadhemya Teaching Hospital in Baghdad and 10 apparently healthy women were used as a control, all women (patients and control) aged above 40 years. The Wizard Promega kit was used for DNA isolation from breast patients and normal individuals. By this method suitable quantities of DNA approximately (50 µl) with purity ranged from (1.7-1.9) were obtained from 100-200µg of fresh biopsy which had been taken from women breast patients. The extracted DNA was successfully used in amplification of BRCA1 &amp; BRCA2 genes by PCR and some mutation were detected. The outcome of genetic analysis indicated that the percentage of 185delAG mutation was 16 (4 patients) whereas, the percentage of 5382insC mutation was 32 (8patients) in BRCA1 gene and the third mutation 6174delT in BRCA2 present in 3 patients only (12%). The study demonstrated that the frequency of BRCA1 mutation (48%) was higher than BRCA2 (12%) in this sample of Iraqi women with breast cancer.

Therapeutic Potential of Pomegranate Extract for Women's Reproductive Health and Breast Cancer.

Pomegranate extract has potential benefits for women's reproductive health, including fertility enhancement, menstrual cycle regulation, pregnancy support, and polycystic ovary syndrome (PCOS) treatment. It possesses antioxidant properties, reducing oxidative stress and improving fertility. Pomegranate extract may help regulate hormonal imbalances and promote regular menstrual cycles. The extract's rich nutrient profile supports placental development and fetal growth and may reduce the risk of preterm birth. Additionally, pomegranate extract shows promise in improving insulin sensitivity and reducing inflammation and oxidative damage in PCOS. Some studies suggest its potential anticancer properties, particularly against breast cancer. However, further research, including human clinical trials, is necessary to establish its effectiveness and safety. The current evidence is limited and primarily based on in vitro studies, animal studies, and clinical trials. This review provides a comprehensive summary of the benefits of pomegranate extract for women's reproductive health and breast cancer, serving as a reference for future research.

Are Women's Breast Cancer Risk Appraisals in Line with Updated Clinical Risk Estimates Communicated? Results from a UK Family History Risk and Prevention Clinic.

The incorporation of breast density and a polygenic risk score (PRS) into breast cancer risk prediction models can alter previously communicated risk estimates. Previous research finds that risk communication does not usually change personal risk appraisals. This study aimed to examine how women from the family history risk study appraise their breast cancer risk following communication of an updated risk estimate. In the family history risk study, 323 women attended a consultation to receive an updated breast cancer risk estimate. A subset (n = 190) completed a questionnaire, assessing their subjective breast cancer risk appraisals, satisfaction with the information provided, and cancer-related worry. One hundred and three were notified of a decreased risk, 34 an increased risk, and 53 an unchanged risk. Women's subjective risk appraisals were in line with the updated risk estimates provided, with age, a PRS, and breast density explaining most of the variance in these appraisals. Those notified of an increased risk demonstrated higher subjective risk perceptions compared with those whose risk remained unchanged or decreased. Women's subjective breast cancer risk appraisals are amenable to change following updated risk feedback, with new information breast density and a PRS accepted and integrated into existing risk appraisals. Trust in the service, the analogies, and visual communication strategies used may have positively influenced the integration of this new information. Further research is warranted to assess whether similar patterns emerge for other illnesses and in different clinical contexts to determine the best strategies for communicating updated risk estimates.

Comparison between Digital Breast Tomosynthesis and Digital Mammography in the Assessment of Breast Cancer across Dense and Nondense Breast

Abstract Background Women's breast cancer is considered a serious public health issue. throughout the world. For asymptomatic women, digital mammography is the primary imaging modality used for breast cancer screening. It also has been shown to reduce breast cancer mortality. Digital breast tomosynthesis provides better detection of the abnormalities especially in females with dense breasts Aim to evaluate the impact of digital breast tomosynthesis (DBT) in comparison to digital mammography (DM) in improving the detection and characterization of breast cancer across the dense and non-dense breasts (according to BI-RADS Atlas) in correlation with ultrasound and histopathology. Material &amp; Method This study included 100 female patients according to our inclusion criteria. All patients performed full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) were classified according to breast density. To establish a correlation between mammographic findings and cancer diagnosis, high-resolution ultrasound (HHUS) and DBT were used following FFDM as the primary imaging modality. The cancer diagnosis was subsequently confirmed by histopathology. Results The current study was based on histopathology as a reference standard, This was correlated with the final diagnosis; the diagnostic indices of mammography at the whole group were a sensitivity of 73.9%, a specificity of 74.3%, a positive predictive value (PPV) 84.2%, a negative predictive value (NPV) of 60.5%, and a diagnostic accuracy of 74%. Diagnostic indices of DBT were a sensitivity of 100%, a specificity of 88.6%, a PPV of 94.2%, an NPV of 100%, and a diagnostic accuracy of 96%. In patients with dense breasts Radiology ACR (c and d), 78% of cases had changed their BI-RADS scoring with the addition of tomosynthesis. However, in 54% of individuals with non-dense breast ACR (a and b), the addition of DBT to FFDM changed the BIRADS score. Our results showed that 100% of lesions detected by tomosynthesis were malignant tumors. Conclusion We conclude that DBT exceeded Mammography in terms of sensitivity, specificity, and diagnostic accuracy at all breast densities, particularly dense breasts. This is because DBT enables more accurate identification and characterization of breast lesions, which reduces the number of recalled cases and negative biopsies.

Revising cancer incidence in a Central European country: a Hungarian nationwide study between 2011-2019 based on a health insurance fund database.

The nationwide HUN-CANCER EPI study examined cancer incidence and mortality rates in Hungary from 2011 to 2019. Using data from the National Health Insurance Fund (NHIF) and Hungarian Central Statistical Office (HCSO), our retrospective study analyzed newly diagnosed malignancies between Jan 1, 2011, and Dec 31, 2019. Age-standardized incidence and mortality rates were calculated for all and for different tumor types using both the 1976 and 2013 European Standard Populations (ESP). The number of newly diagnosed cancer cases decreased from 60,554 to 56,675 between 2011-2019. Age-standardized incidence rates were much lower in 2018, than previously estimated (475.5 vs. 580.5/100,000 person-years [PYs] in males and 383.6 vs. 438.5/100,000 PYs in females; ESP 1976). All-site cancer incidence showed a mean annual decrease of 1.9% (95% CI: 2.4%-1.4%) in men and 1.0% (95% CI:1.42%-0.66%) in women, parallel to mortality trends (-1.6% in males and -0.6% in females; ESP 2013). In 2018, the highest age-standardized incidence rates were found for lung (88.3), colorectal (82.2), and prostate cancer (62.3) in men, and breast (104.6), lung (47.7), and colorectal cancer (45.8) in women. The most significant decreases in incidence rates were observed for stomach (4.7%), laryngeal (4.4%), and gallbladder cancers (3.5%), with parallel decreases in mortality rates (3.9%, 2.7% and 3.2%, respectively). We found a lower incidence of newly diagnosed cancer cases for Hungary compared to previous estimates, and decreasing trends in cancer incidence and mortality, in line with global findings and the declining prevalence of smoking.

Primary Breast Necrotising Fasciitis in an Elderly Woman Managed with Nipple–Areola Conservation and Delayed Primary Closure in a Resource-Poor Setting A Case Report

Abstract Primary breast necrotising fasciitis is a rare disease that can rapidly progress with high morbidity and mortality rates. Due to its rare occurrence, it is often misdiagnosed. This case was a 65-year-old, obese, immobile, and newly diagnosed woman who presented with a 2-week history of progressive left breast pain and swelling with associated darkening of the breast skin and discharge of foul-smelling fluid. There was no history of fever and the nipple–areola complex was spared. The surrounding healthy skin has a characteristic peau d’orange and erythematous. Two discrete and slightly tender left axillary lymph nodes were noted. At the presentation, her blood sugar was high. Initially, a breast malignancy was suspected but later an ultrasound showed increased fibrous and fatty tissue architecture of the mammary gland. It also noted inflammatory collections within the mammary glands and thus concluded breast inflammation. Early intervention with antibiotic cover and wound debridement forestalled the progress of the disease and nipple–areola salvage. The wound was later covered by delayed primary closure after 14 days of wound dressing with a silver-based solution. Breast asymmetry was noted as a surgical complication. Early aggressive intervention in necrotising fasciitis of the breast in an elderly woman with comorbidities contributed to the preservation of nipple–areola complex with eventual satisfactory management using direct wound closure.

Artificial Intelligence Algorithm for Subclinical Breast Cancer Detection

Early breast cancer detection is associated with lower morbidity and mortality. To examine whether a commercial artificial intelligence (AI) algorithm for breast cancer detection could estimate the development of future cancer. This retrospective cohort study of 116 495 women aged 50 to 69 years with no prior history of breast cancer before they underwent at least 3 consecutive biennial screening examinations used scores from an AI algorithm (INSIGHT MMG, version 1.1.7.2; Lunit Inc; used September 28, 2022, to April 5, 2023) for breast cancer detection and screening data from multiple, consecutive rounds of mammography performed from September 13, 2004, to December 21, 2018, at 9 breast centers in Norway. The statistical analyses were performed from September 2023 to August 2024. Artificial intelligence algorithm score indicating suspicion for the presence of breast cancer. The algorithm provided a continuous cancer detection score for each examination ranging from 0 to 100, with increasing values indicating a higher likelihood of cancer being present on the current mammogram. Maximum AI algorithm score for cancer detection and absolute difference in score among breasts of women developing screening-detected cancer, women with interval cancer, and women who screened negative. The mean (SD) age at the first study round was 58.5 (4.5) years for 1265 women with screening-detected cancer in the third round, 57.4 (4.6) years for 342 women with interval cancer after 3 negative screening rounds, and 56.4 (4.9) years for 116 495 women without breast cancer all 3 screening rounds. The mean (SD) absolute differences in AI scores among breasts of women developing screening-detected cancer were 21.3 (28.1) at the first study round, 30.7 (32.5) at the second study round, and 79.0 (28.9) at the third study round. The mean (SD) differences prior to interval cancer were 19.7 (27.0) at the first study round, 21.0 (27.7) at the second study round, and 34.0 (33.6) at the third study round. The mean (SD) differences among women who did not develop breast cancer were 9.9 (17.5) at the first study round, 9.6 (17.4) at the second study round, and 9.3 (17.3) at the third study round. Areas under the receiver operating characteristic curve for the absolute difference were 0.63 (95% CI, 0.61-0.65) at the first study round, 0.72 (95% CI, 0.71-0.74) at the second study round, and 0.96 (95% CI, 0.95-0.96) at the third study round for screening-detected cancer and 0.64 (95% CI, 0.61-0.67) at the first study round, 0.65 (95% CI, 0.62-0.68) at the second study round, and 0.77 (95% CI, 0.74-0.79) at the third study round for interval cancers. In this retrospective cohort study of women undergoing screening mammography, mean absolute AI scores were higher for breasts developing vs not developing cancer 4 to 6 years before their eventual detection. These findings suggest that commercial AI algorithms developed for breast cancer detection may identify women at high risk of a future breast cancer, offering a pathway for personalized screening approaches that can lead to earlier cancer diagnosis.