Diagnosis Of Breast Cancer Research Articles

All-in-One Fusogenic Nanoreactor for the Rapid Detection of Exosomal MicroRNAs for Breast Cancer Diagnosis.

Molecular-profiling-based cancer diagnosis has significant implications for predicting disease prognosis and selecting targeted therapeutic interventions. The analysis of cancer-derived extracellular vesicles (EVs) provides a noninvasive and sequential method to assess the molecular landscape of cancer. Here, we developed an all-in-one fusogenic nanoreactor (FNR) encapsulating DNA-fueled molecular machines (DMMs) for the rapid and direct detection of EV-associated microRNAs (EV miRNAs) in a single step. This platform was strategically designed to interact selectively with EVs and induce membrane fusion under a specific trigger. After fusion, the DMMs recognized the target miRNA and initiated nonenzymatic signal amplification within a well-defined reaction volume, thus producing an amplified fluorescent signal within 30 min. We used the FNRs to analyze the unique expression levels of three EV miRNAs in various biofluids, including cell culture, urine, and plasma, and obtained an accuracy of 86.7% in the classification of three major breast cancer (BC) cell lines and a diagnostic accuracy of 86.4% in the distinction between patients with cancer and healthy donors. Notably, a linear discriminant analysis revealed that increasing the number of miRNAs from one to three improved the accuracy of BC patient discrimination from 78.8 to 95.4%. Therefore, this all-in-one diagnostic platform performs nondestructive EV processing and signal amplification in one step, providing a straightforward, accurate, and effective individual EV miRNA analysis strategy for personalized BC treatment.

ThP1.7 - Moving to a specialist nurse-led service for genetic testing in breast cancer

Abstract Aims To assess the impact of a genetics nurse led clinic in breast cancer patients treatment. Methods A specialist, nurse-led breast cancer genetics service was set up in September 2022 for patients meeting the R208 and R444 criteria. A prospective data collection was performed from September 2022 to October 2023 and included patient demographics, test result and if the result led to any alteration in management of patient. Results 78 eligible patients, with a mean age of 52.8 (31-90) years. 4 (5.1%) were male. 1 (1.3%) patient declined testing, a further 1 (1.3%) patient was undecided and 1 (1.3%) wished for storage only. Patients waited 1-2 weeks following a breast cancer diagnosis to see the nurse specialist and 4-6 weeks for urgent results. The pathogenic variants identified were BRCA1 (5.3%), BRCA2 (6.7%), CHEK2 (2.7%) and PALB2 (1.3%). Of the remainder 84% of patients tested negative. Altered management occurred in 8 (10.7%) patients, 4 (50%) received risk reducing surgery, 2 (25%) received Olaparib and 2 (25%) received Olaparib and underwent risk reducing surgery. Conclusion The move to a nurse-led service has proved to be successful in terms of reduced waiting times for genetic testing appointments and results. It also ensured that all appropriate patients with breast cancer were offered genetic testing, leading to more effective and efficient treatment decisions, such as risk reducing surgery and tailored chemotherapy which could improve long-term health outcomes.

Breast cancer characterization using region-based convolutional neural network with screening and diagnostic mammogram

Background: Detection and classification of microcalcifications in breast tissues is crucial for early breast cancer diagnosis and long-term treatment. Objective: This paper aims to propose a robust model capable of detection and classification of breast cancer calcifications in digital mammogram images using Deep Convolutional Neural Networks (DCNN). Materials and methods: An expert breast radiologist annotated the 3,265 clinical mammogram images to create a comprehensive ground truth dataset comprising 2,500 annotations for malignant and benign calcifications. This dataset was utilized to train our model, a two-stage detection system incorporating a Region-based Convolutional Neural Network (RCNN) with AlexNet and support vector machines to enhance the system’s robustness. The proposed model was compared to the one-stage detection, utilizing YOLOv4 combined with the Cross-Stage Partial Darknet53 (CSPDarknet53) architecture. A separate dataset of 504 mammogram images was explicitly set aside for model testing. The efficacy of the proposed model was evaluated based on key performance metrics, including precision, recall, F1 score, and mean average precision (mAP). Results: The results showed that the proposed RCNN-2 model could automatically identify and categorize calcifications as malignant or benign, outperforming the YOLOv4 models. The RCNN-2’s overall effectiveness, as evaluated by precision, recall, F1 score, and mean average precision (mAP), achieved scores of 0.82, 0.85, 0.83, and 0.74, respectively. Conclusion: The proposed RCNN-2 model demonstrates very effective detection and classification of calcification in mammogram images, especially in high-dense breast images. The performance of the proposed model was compared to that of YOLOv4, and it can be concluded that the proposed RCNN model yields outstanding performance. The model can be a helpful tool for radiologists.

Universal Genetic Testing for Newly Diagnosed Invasive Breast Cancer

Between 5% and 10% of breast cancer cases are associated with an inherited germline pathogenic or likely pathogenic variant (GPV) in a breast cancer susceptibility gene (BCSG), which could alter local and systemic therapy recommendations. Traditional genetic testing criteria misses a proportion of these cases. To evaluate the prevalence and clinicopathological associations of GPVs in 2 groups of BCSGs among an ethnically diverse cohort of women with newly diagnosed breast cancer. This cross-sectional study, conducted at 3 Montreal hospitals between September 2019 and April 2022, offered universal genetic counseling and testing to all women with a first diagnosis of invasive breast cancer. Women were offered an obligatory primary panel of BRCA1, BRCA2, and PALB2 (B1B2P2) and an optional secondary panel of 14 additional BCSGs. Eligible participants were women 18 years of age or older who received a diagnosis of a first primary invasive breast cancer not more than 6 months before the time of referral to the study. Data were analyzed from November 2023 to June 2024. Of 1017 referred patients, 805 were eligible and offered genetic counseling and testing, and 729 of those 805 (90.6%) consented to be tested. The median age at breast cancer diagnosis was 53 years (range, 23-91 years), and 65.4% were White and of European ancestry. Fifty-four GPVs were identified in 53 patients (7.3%), including 39 patients (5.3%) with B1B2P2 and 15 patients (2.1%) with 6 of the 14 secondary panel BCSGs (ATM, BARD1, BRIP1, CHEK2, RAD51D, and STK11). On multivariable analysis, clinical factors independently associated with B1B2P2-positive status included being younger than 40 years of age at diagnosis (odds ratio [OR], 6.83; 95% CI, 2.22-20.90), triple-negative breast cancer (OR, 3.19; 95% CI, 1.20-8.43), high grade disease (OR, 1.68; 95% CI, 1.05-2.70), and family history of ovarian cancer (OR, 9.75; 95% CI, 2.65-35.85). Of 39 B1B2P2-positive patients, 13 (33.3%) were eligible for poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors. In this cross-sectional universal genetic testing study of women with newly diagnosed invasive breast cancer, the prevalence of GPVs was 7.3%, with 5.3% of patients testing positive for B1B2P2. Among B1B2P2-women women, one-third were eligible for PARP inhibitors.

Challenges and improvements in HER2 scoring and histologic evaluation: insights from a national proficiency testing scheme for breast cancer diagnosis in China

BackgroundIn 2022, our team launched the pioneering national proficiency testing (PT) scheme for the pathological diagnosis of breast cancer, rapidly establishing its credibility throughout China. Aiming to continuously monitor and improve the proficiency of Chinese pathologists in breast pathology, the second round of the PT scheme was initiated in 2023, which will expand the number of participating institutions, and will conduct a nationwide investigation into the interpretation of HER2 0, 1+, and 2+/FISH- categories in China.MethodsThe methodology employed in the current round of PT scheme closely mirrors that of the preceding cycle in 2022, which is designed and implemented according to the “Conformity assessment—General requirements for proficiency testing”(GB/T27043—2012/ISO/IEC 17043:2010). More importantly, we utilized a statistics-based method to generate assigned values to enhance their robustness and credibility.ResultsThe final PT results, published on the website of the National Quality Control Center for Cancer (http://117.133.40.88:3927), showed that all participants passed the testing. However, a few institutions demonstrated systemic biases in scoring HER2 0, 1+, and 2+/FISH- with accuracy levels below 59%, considered unsatisfactory. Especially, the concordance rate for HER2 0 cases was only 78.1%, indicating challenges in distinguishing HER2 0 from low HER2 expression. Meanwhile, areas for histologic type and grade interpretation improvement were also noted.ConclusionsOur PT scheme demonstrated high proficiency in diagnosing breast cancer in China. But it also identified systemic biases in scoring HER2 0, 1+, and 2+/FISH- at some institutions. More importantly, our study highlighted challenges in the evaluation at the extreme lower end of the HER2 staining spectrum, a crucial area for further research. Meanwhile, it also revealed the need for improvements in interpreting histologic types and grades. These findings strengthened the importance of robust quality assurance mechanisms, like the nationwide PT scheme conducted in this study, to maintain high diagnostic standards and identify areas requiring further training and enhancement.

Association Between False-Positive Results and Return to Screening Mammography in the Breast Cancer Surveillance Consortium Cohort.

False-positive results on screening mammography may affect women's willingness to return for future screening. To evaluate the association between screening mammography results and the probability of subsequent screening. Cohort study. 177 facilities participating in the Breast Cancer Surveillance Consortium (BCSC). 3 529 825 screening mammograms (3 184 482 true negatives and 345 343 false positives) performed from 2005 to 2017 among 1 053 672 women aged 40 to 73 years without a breast cancer diagnosis. Mammography results (true-negative result or false-positive recall with a recommendation for immediate additional imaging only, short-interval follow-up, or biopsy) from 1 or 2 screening mammograms. Absolute differences in the probability of returning for screening within 9 to 30 months of false-positive versus true-negative screening results were estimated, adjusting for race, ethnicity, age, time since last mammogram, BCSC registry, and clustering within women and facilities. Women were more likely to return after a true-negative result (76.9% [95% CI, 75.1% to 78.6%]) than after a false-positive recall for additional imaging only (adjusted absolute difference, -1.9 percentage points [CI, -3.1 to -0.7 percentage points]), short-interval follow-up (-15.9 percentage points [CI, -19.7 to -12.0 percentage points]), or biopsy (-10.0 percentage points [CI, -14.2 to -5.9 percentage points]). Asian and Hispanic/Latinx women had the largest decreases in the probability of returning after a false positive with a recommendation for short-interval follow-up (-20 to -25 percentage points) or biopsy (-13 to -14 percentage points) versus a true negative. Among women with 2 screening mammograms within 5 years, a false-positive result on the second was associated with a decreased probability of returning for a third regardless of the first screening result. Women could receive care at non-BCSC facilities. Women were less likely to return to screening after false-positive mammography results, especially with recommendations for short-interval follow-up or biopsy, raising concerns about continued participation in routine screening among these women at increased breast cancer risk. National Cancer Institute.

Own Experience of Using Next-Generation Sequencing in the Diagnosis of BRCA-Associated Breast Cancer

Own Experience of Using Next-Generation Sequencing in the Diagnosis of BRCA-Associated Breast Cancer

Breast cancer and cervical cancer: a comparison of the period before and during the COVID-19 pandemic

BackgroundThe coronavirus 2019 (COVID-19) pandemic impacted cancer health care in several countries, with delays in the detection and treatment of breast and cervical cancer. The objective of this study is to analyze and compare the screening, diagnosis and treatment of breast and cervical cancer in the pre-COVID period and during the COVID-19 period.MethodsCross-sectional study with secondary data collected from the Mortality Information System (SIM), Hospital Information System (SIH), Ambulatory Information System (SIA) and the Oncology Panel (PO) of breast cancer notifications with ICD C50.0 to C50.9 and cervix ICD C53.0 to C53.9, The analyzed period before the pandemic was from March 1 to October 1, 2019, and during the pandemic from March 1 to October 1, 2020. The period from 2013 to 2022 was also analyzed with the same information, including the number of diagnoses, treatments, and deaths from breast cancer and cervical cancer. The study population consisted of Brazilian women aged 25 to 70 years. In order to compare categorical variables between periods, the Chi-Square or Fisher’s Exact tests, and Mann-Whitney U tests were applied, and the Poisson Regression model was applied to model the number of reported cases of COVID-19 and the amount of procedures.ResultsThere was a decrease in the number of mammograms and cytopathological exams during COVID-19, as well as a decrease in cases of breast and cervical cancer. The Poisson regression showed that the increase in the number of COVID-19 cases caused a decrease in the number of breast cytopathological examinations, cervical-vaginal cytopathological examinations/microflora and screening, diagnosis, initiation of treatment for breast cancer and deaths from this disease. Meanwhile, in some regions of Brazil, as the number of Covid-19 increased, there was a significantly increase in the number of mammograms performed and cervical cancer diagnoses.ConclusionsThe COVID-19 period in 2020 significantly impacted screening, diagnosis, treatment for breast and cervical cancer.

Revolutionizing breast ultrasound diagnostics with EfficientNet-B7 and Explainable AI

Breast cancer is a leading cause of mortality among women globally, necessitating precise classification of breast ultrasound images for early diagnosis and treatment. Traditional methods using CNN architectures such as VGG, ResNet, and DenseNet, though somewhat effective, often struggle with class imbalances and subtle texture variations, leading to reduced accuracy for minority classes such as malignant tumors. To address these issues, we propose a methodology that leverages EfficientNet-B7, a scalable CNN architecture, combined with advanced data augmentation techniques to enhance minority class representation and improve model robustness. Our approach involves fine-tuning EfficientNet-B7 on the BUSI dataset, implementing RandomHorizontalFlip, RandomRotation, and ColorJitter to balance the dataset and improve model robustness. The training process includes early stopping to prevent overfitting and optimize performance metrics. Additionally, we integrate Explainable AI (XAI) techniques, such as Grad-CAM, to enhance the interpretability and transparency of the model’s predictions, providing visual and quantitative insights into the features and regions of ultrasound images influencing classification outcomes. Our model achieves a classification accuracy of 99.14%, significantly outperforming existing CNN-based approaches in breast ultrasound image classification. The incorporation of XAI techniques enhances our understanding of the model’s decision-making process, thereby increasing its reliability and facilitating clinical adoption. This comprehensive framework offers a robust and interpretable tool for the early detection and diagnosis of breast cancer, advancing the capabilities of automated diagnostic systems and supporting clinical decision-making processes.

Quantum imaging-based nanobiosensors: Pioneering point-of-care approach for early diagnosis of environmental-linked breast cancer

Early detection is paramount for successful treatment outcomes in cancer diagnosis. Among women across the globe, breast cancer (BC) ranks as one of the deadliest forms of cancer. Prolonged exposure to numerous environmental pollutants has been linked to epigenetic reprogramming, which entails changes in the expression patterns of non-coding RNAs. These alterations have been strongly linked to an increased risk of developing BC. Women are confronted with hazardous smoke from polluting stoves and fuels for longer as they often perform home duties such as cooking. Inefficient combustion emits black carbon (sooty particles), which enters the bloodstream and is strongly connected to an elevated risk of BC. The use of several analytical methods, such as real-time polymerase chain reaction, microarray, and sequencing, has numerous disadvantages, such as high expenses, limitations in sensitivity, and lack of accuracy. However, the emergence of quantum dots (QDs), nanoscale semiconductor particles with unique optical properties, and the development of quantum imaging-based sensors offer a glimpse into the future of medical technology. These sensors have the potential to completely change the medical field by offering highly precise, non-invasive, and reliable techniques for early diagnosis. Our article delves into the intricacies of QDs imaging-based sensors, their applications in BC detection, and their transformative impact on improving patient care. In recent years, the confluence of quantum science and diagnostic imaging has opened new avenues for BC diagnosis. The present state of quantum imaging-based BC diagnosis sensors is examined in this article, along with potential future developments with the help of artificial intelligence.

TRIM28 promotes tumor growth and metastasis in breast cancer by targeting the BRD7 protein for ubiquitination and degradation.

Bromodomain-containing protein 7 (BRD7) is downregulated and functions as a tumor suppressor in many types of cancers including breast cancer, and the dysregulation of BRD7 expression is closely related to the development and progression of breast cancer. Whereas little attention has been focused on the regulation of BRD7 protein levels in breast cancer, which needs to be further elucidated. The protein stability of BRD7 in breast cancer cells and BRD7 protein level in breast cancer tissues was examined by Western Blotting. The potential E3 ubiquitin ligase proteins that interact with the BRD7 was screened by coimmunoprecipitation combined with mass spectrometry analysis in MDA-MB-231 cells. We proved the interaction between BRD7 and tripartite motif containing 28 (TRIM28) through Co-Immunoprecipitation (Co-IP) and immunofluorescence assays. Co-IP and ubiquitination assay were used to explore the specific binding domain between BRD7 and TRIM28 and the ubiquitination site of BRD7. The effects of TRIM28 on the BRD7 protein stability and ubiquitination level was investigated by qPCR, Western Blot and Co-IP assay. CCK-8 and clone formation assays were carried out to assess the effect of TRIM28 on proliferation ability of breast cancer ells. Transwell assay and wound healing assay were used to investigate the effect of TRIM28 on breast cancer cell invasion and migration. Flow cytometry was used to detect the effect of TRIM28 on cell cycle and apoptosis of breast cancer cells. In addition, we confirmed effect of TRIM28 on tumor growth and metastasis by xenograft and metastatic mouse models. We designed some recovery assays to explore the role of recovery BRD7 in TRIM28-mediated promotion of malignant progression of breast cancer in vivo and in vitro. Finally, the clinical significance of TRIM28 and BRD7 was proved by immunohistochemistry. In this study, we demonstrated that BRD7 was an unstable protein and might be regulated by ubiquitination in breast cancer; furthermore, we found that the Coiled-Coil region of TRIM28 could directly bind to N-terminal of BRD7, and TRIM28 mediates BRD7 ubiquitination and degradation dependent on K21 by acting as a potential E3 ubiquitin ligase. Moreover, TRIM28 promoted cell proliferation, migration, invasion, xenograft tumor growth and metastasis, thus playing an oncogenic role in breast cancer. Furthermore, the restoration of BRD7 expression in breast cancer significantly reversed the promotional effects of TRIM28 on malignant progression both in vitro and in vivo. In addition, TRIM28 was highly expressed in the biopsy tissues of breast cancer, and its expression was negatively correlated with BRD7 expression and positively correlated with TNM stage and poor prognosis of BC patients. Our findings provide a novel mechanism by which TRIM28 significantly facilitates BRD7 ubiquitination and degradation, thus promoting breast cancer malignant progression. Targeting the TRIM28/BRD7 axis might be a novel potential strategy for the clinical diagnosis and treatment of breast cancer.

Contraception use and changes in young women with newly diagnosed breast cancer

To evaluate contraception use and change among young women with early breast cancer. Secondary analysis of a cluster randomized trial. Multi-institutional. Patients with newly diagnosed breast cancer age ≤45 years enrolled from 54 US oncology practices. Sites were randomly assigned to the Young Women's Intervention, an educational intervention for young women with newly diagnosed breast cancer and their oncologists addressing issues specific to this population, including contraception, or a contact-time control physical activity intervention. Participants completed surveys in follow-up, including a 3-month survey regarding contraceptive practices before and after diagnosis. Outcomes of interest included young women's contraceptive use and methods before breast cancer diagnosis and 3 months after study enrollment. Logistic regression models assessed factors associated with use of less than highly effective contraceptive methods categorized according to World Health Organization effectiveness tiers and changes in contraceptive methods. Of 312 women included, 258 (83%) reported contraceptive use before breast cancer diagnosis, and 275 (88%) reported contraceptive use after diagnosis. Use of highly effective methods (e.g., vasectomy, non-hormonal intrauterine devices) increased from 39% before diagnosis to 52% after diagnosis. Use of moderately effective methods (e.g., hormonal methods) decreased from 22% before diagnosis to 3% after diagnosis. Use of less effective methods (e.g., condoms, withdrawal) increased from 22% before diagnosis to 34% after diagnosis. On multivariable analysis, factors associated with using less than highly effective contraception after diagnosis included desire for additional children (odds ratio [OR], 6.33; 95% confidence interval [CI], 3.76-10.66) and discussing contraception with a provider (OR, 1.96; 95% CI, 1.12-3.40). After breast cancer diagnosis, 207 patients (66%) reported no change in contraceptive methods. On multivariable analysis, factors associated with contraceptive method change after diagnosis included age <35 years (OR, 2.96; 95% CI, 1.57-5.58) and provider discussion (OR, 3.59; 95% CI, 1.91-6.78). There was no association in either analysis with study arm. Although most patients used contraception after breast cancer diagnosis, nearly half reported using less than highly effective contraceptive methods with higher failure rates, highlighting the need for early and improved contraceptive counseling for young women with breast cancer. NCT01647607.

Meta-analysis and systematic review of the diagnostic value of contrast-enhanced spectral mammography for the detection of breast cancer

ObjectiveThe objective is to evaluate the diagnostic effectiveness of contrast-enhanced spectral mammography (CESM) in the diagnosis of breast cancer.DesignData sourcesPubMed, Embase and Cochrane libraries up to 18 June 2022.Eligibility criteria...

The Role of Spiritual Well-Being and Religious Coping in Psychiatric Morbidities Associated with Breast Cancer Patients: A Cross-Sectional Analysis

Background: Spirituality and religious resources support and enhance both overall and emotional well-being during adversity such as diagnosis of breast cancer. Breast cancer patients are at higher risk of developing severe anxiety, depression, and potential mood disorders. Aim: The aim is to assess, compare, and correlate spiritual well-being and religious coping in patients with breast cancer with and without psychiatric disorders (anxiety and depression). Materials and Methodology: Recently diagnosed 90 treatment-naïve breast cancer patients were selected in adherence to the inclusion and exclusion criteria. Hospital Anxiety and Depression Scale (HADS), Spiritual Assessment Scale, and Brief Religious Coping Scale were applied to the sample population. The study population was divided into two groups depending on scores of HADS, those having psychiatric disorders, and those who did not have. The data were analyzed using Mann‒Whitney test and Pearson’s correlation coefficient in the SPSS version 21. Results: More than half (61.1%) of the females suffered from psychiatric disorders after diagnosis of breast cancer. About 50% and 38.9% of the study population developed significant emotional distress, leading to the diagnosis of cases of anxiety and depression, respectively. Females suffering from psychiatric disorders have significantly lower spirituality, positive religious coping, and significantly higher negative religious coping than females without any psychiatric disorder. Total spirituality score (P = 0.034) is making a significant contribution toward predicting depression. Negative religious coping is making a significant contribution toward predicting both anxiety (P = 0.008) and depression (P = 0.045). Conclusion: The study suggests that spirituality and religion-based coping facilitates adaptive psychological adjustment to cancer and decreases the prevalence of anxiety and depression.

Perceptions of delayed alopecia among breast cancer survivors

BackgroundRetrospective studies suggest that some breast cancer survivors report treatment-associated hair loss or thinning years after their diagnosis. This study investigates frequency and perceptions of alopecia persisting 6 years after patients’ breast cancer diagnoses. MethodsBreast cancer survivors participating in the Mayo Clinic Breast Disease Registry (MCBDR) were mailed a survey 6 years after diagnosis. They were asked about their degree of bother from hair thinning and hair loss and mental health was explored. ResultsA total of 969 of 1476 participants (65.7%) responded to the survey. Of these, 755 patients were eligible for inclusion and had stage I-III breast cancer. Respondents' median age was 65.6 years (35-95 years). Chemotherapy (± endocrine therapy) was administered to 216 (29%) participants, and 342 (45%) received only endocrine therapy. Nearly half (345, 46%) of respondents reported hair loss and over half (431, 57%) reported hair thinning. Moderate to extreme bother from hair loss was reported by 27% of chemotherapy recipients, by 18% of endocrine therapy only recipients, and by 14% of patients who received neither. Moderate to extreme bother from hair thinning was reported by 31% of chemotherapy recipients, by 21% of endocrine therapy-only recipients, and by 19% of those who had received neither. Hair growth product usage was reported by 31% of chemotherapy recipients and 14% of endocrine therapy-only recipients. ConclusionsHair loss and thinning are frequently reported as persistently bothersome symptoms by breast cancer survivors. Future investigations into the incidence, predictors, and treatment of therapy-associated alopecia are needed.Micro Abstract: Chronic alopecia related to breast cancer treatment is a distressing symptom. In our cohort study of breast cancer survivors 6 years after diagnosis, 46% reported hair loss and 57% reported hair thinning. Moderate to extreme bother from hair loss and thinning was common, especially post-chemotherapy, and 19% of respondents used hair regrowth products. These findings emphasize the need for addressing persistent treatment-associated alopecia.

745. A CASE OF ESOPHAGEAL METASTATIC STRICTURE 9 YEARS AFTER BREAST CANCER SURGERY

Abstract Background Oesophageal metastasis of breast cancer is relatively rare. In this report, we describe our experience of a case in which dysphagia was the main complaint, leading to the diagnosis of esophageal metastasis. Method A 63-year-old woman who had undergone partial mastectomy and sentinel lymph node removal in 20xx with a diagnosis of breast cancer presented 9 years after surgery with dysphagia. The postoperative pathological diagnosis of breast cancer was invasive ductal carcinoma, T2, N0, M0, ly1. She had previously received chemotherapy for recurrent bone metastases and mediastinal lymph node metastases 7 years post-operatively, and RT and chemotherapy for a diagnosis of SVC syndrome due to mediastinal lymph nodes 8 years post-operatively. In the present case, upper gastrointestinal endoscopy showed oesophageal stricture and biopsy showed ER+ and PgR- from oesophageal mucosa. Radiotherapy and chemotherapy were administered for the diagnosis of oesophageal metastasis of breast cancer, and the patient's symptoms improved. Conclusion In the case of oesophageal stricture with dysphagia after breast cancer surgery, it is essential to consider oesophageal metastases of breast cancer as a differential, although rare, in addition to benign and primary disease.

Assessment of the contribution of the ADC value to the Kaiser score in the differential diagnosis of breast lesions with non-mass enhancement morphology on MRI

PurposeTo investigate the effectiveness of diffusion-weighted imaging (DWI) as a supplementary tool to the Kaiser score (KS) in diagnosing breast cancer in non-mass enhancement (NME) lesions using breast magnetic resonance imaging (MRI). MethodsThis single-center, retrospective study analyzed 360 cases with NME on MRI images. Two breast radiologists independently evaluated each lesion using the Kaiser score (KS) and apparent diffusion coefficient (ADC) values, without knowledge of the pathological outcomes. NME lesions with a KS above 4 and an ADC value below 1.3 × 10-3mm2/s were classified as malignant. Inter-rater reliability was determined using Cohen’s Kappa (κ) statistics. The diagnostic performance of KS, DWI, and their combination was assessed by calculating sensitivity, specificity, and the area under the curve (AUC), and the results were compared across the benign and malignant groups. ResultsThe diagnostic performance of KS surpassed that of DWI in predicting the malignancy of NMEs (p = 0.003). The sensitivity of KS alone was 93 %; however, when ADC data was incorporated, the sensitivity decreased to 86 %, with no significant difference observed (p = 0.060). The specificity of the combined KS and ADC (94 %) was significantly higher than that of KS alone (89 %) and DWI alone (73 %) (p < 0.001). ConclusionOur findings indicated that although the combination of KS and ADC increased specificity and reduced unnecessary biopsies, the resulting decrease in sensitivity was unacceptable. Therefore, KS alone is superior to the KS-ADC combination in detecting malignancy in NME lesions.

Advancements in Biotechnology and Stem Cell Therapies for Breast Cancer Patients.

This comprehensive review article examines the integration of biotechnology and stem cell therapy in breast cancer diagnosis and treatment. It discusses the use of biotechnological tools such as liquid biopsies, genomic profiling, and imaging technologies for accurate diagnosis and monitoring of treatment response. Stem cell-based approaches, their role in modeling breast cancer progression, and their potential for breast reconstruction post-mastectomy are explored. The review highlights the importance of personalized treatment strategies that combine biotechnological tools and stem cell therapies. Ethical considerations, challenges in clinical translation, and regulatory frameworks are also addressed. The article concludes by emphasizing the potential of integrating biotechnology and stem cell therapy to improve breast cancer outcomes, highlighting the need for continued research and collaboration in this field.

Discussion of Emotions Among Newly Diagnosed Non-Hispanic White and Chinese American Patients With Breast Cancer and Their Oncologists.

This qualitative study analyzed how Chinese American (CA) and non-Hispanic White (NHW) breast cancer patients and their oncologists communicated about patients' emotional concerns. Data included twenty-four recordings of clinical encounters between oncologists and four CA and eight NHW women with a new breast cancer diagnosis between 2013 and 2015. Using an interactional sociolinguistics approach to discourse analysis, we examined how CA and NHW patients and their oncologists initiated conversations about patients' emotions. We also categorized oncologists' responses by whether oncologists turned toward, turned away, or remained neutral to patients' emotions. When bringing up emotions with oncologists, NHW patients brought up social and personal life topics, whereas CA patients only brought up biomedical topics. We also observed that oncologists initiated discussions about emotions with only English-speaking patients of both racial groups. There were no observed differences in how oncologists remained neutral to or turned away from both CA and NHW patients' emotional expressions. When oncologists turned away from patients' emotions, they did so to solve administrative or biomedical problems. In conclusion, the findings suggest that CA patients' racial backgrounds and the language spoken during the encounters may influence how patients and oncologists initiate discussion about patients' emotions. Furthermore, the findings suggest that oncologists remain neutral and turn away from CA and NHW patients' emotions in similar ways. This study provides preliminary data for more comprehensive investigations of Asian American cancer patients' actual communication with their providers regarding emotions and treatment decisions to facilitate patient-provider communication quality.

1569P Secondary delay in breast cancer diagnosis and role of rural medical practitioners: A cause and cure finding study

1569P Secondary delay in breast cancer diagnosis and role of rural medical practitioners: A cause and cure finding study