Benign Breast Disease Research Articles

Shear-Wave Elastography Gradient Analysis of Newly Diagnosed Breast Tumours: A Critical Analysis.

A better understanding of the peritumoral stroma changes due to tumour invasion using non-invasive diagnostic methods may improve the differentiation between benign and malignant breast lesions. This study aimed to assess the correlation between breast lesion differentiation and intra- and peritumoral shear-wave elastography (SWE) gradients. A total of 135 patients with newly diagnosed breast lesions were included. Intratumoral, subsurface, and three consecutive peritumoral SWE value measurements (with three repetitions) were performed. Intratumoral, interface, and peritumoral gradients (Gradient 1 and Gradient 2) were calculated using averaged SWE values. Statistical analysis included descriptive statistics and an ordinary one-way ANOVA to compare overall and individual gradients among Breast Imaging-Reporting and Data System (BI-RADS) 2, 3, and 5 groups. Malignant tumours showed higher average SWE velocity values at the tumour centre (BI-RADS 2/3: 4.1 ± 1.8 m/s vs. BI-RADS 5: 4.9 ± 2.0 m/s, p = 0.04) and the first peritumoral area (BI-RADS 2/3: 3.4 ± 1.8 m/s vs. BI-RADS 5: 4.3 ± 1.8 m/s, p = 0.003). No significant difference was found between intratumoral gradients (0.03 ± 0.32 m/s vs. 0.0 ± 0.28 m/s; p > 0.999) or gradients across the tumour-tissue interface (-0.17 ± 0.18 m/s vs. -0.13 ± 0.35 m/s; p = 0.202). However, the first peritumoral gradient (-0.16 ± 0.24 m/s vs. -0.35 ± 0.31 m/s; p < 0.0001) and the second peritumoral gradient (-0.11 ± 0.18 m/s vs. -0.22 ± 0.28 m/s; p = 0.037) were significantly steeper in malignant tumours. The AUC was best for PTG1 (0.7358) and PTG2 (0.7039). A threshold value for peritumoral SWI PT1 above 3.76 m/s and for PTG1 below -0.238 m/s·mm-1 indicated malignancy in 90.6% of cases. Evaluating the peritumoral SWE gradient may improve the diagnostic pre-test probability, as malignant tumours showed a significantly steeper curve of the elasticity values in the peritumoral stroma compared to the linear regression with a relatively flat curve of benign lesions.

The application of methylene blue location technique in deep-seated benign breast tumor resection under endoscopy: a retrospective, single-institution analysis.

Endoscopic curative excision of benign breast diseases (BBDs) can preserve the cosmetic appearance of the breast. However, endoscopic surgery is not feasible, and some challenges still need to be addressed. Traditional line marker localization methods cannot visualize tumors, and the exploration of deep tumors may lead to certain risks of accidental injury. This study aimed to investigate the value of the methylene blue location (MBL) technique in endoscopic resection of deep-seated benign breast tumors. A total of 217 patients with benign deep breast tumors admitted to the Sixth Affiliated Hospital of Sun Yat-sen University between November 2017 and June 2023 met the inclusion criteria. Among them, 107 patients underwent endoscopic resection with a MBL, in which methylene blue was injected to guide the tumor resection endoscopically, whereas 110 patients underwent endoscopic resection with a skin mark location (SML), in which the tumor was located by a marking line on the skin. We compared patient characteristics, surgery-related data, complications, and cosmetic outcomes between the two groups. Endoscopic breast tumor resection was successfully performed in 217 patients, none of whom had undergone open surgery. The mean operation time was significantly different between the MBL and SML groups (45.70±12.508 and 49.59±10.997 min, respectively; P=0.008<0.05), and blood loss in the MBL group was significantly reduced compared with that in the SML group (11.07±5.665 and 13.83±7.918 mL, respectively; P=0.004<0.05). There were no significant differences in drainage volume, length of hospital stay, or postoperative complications between the MBL and SML groups (P>0.05). The postoperative cosmetic outcomes of the patients were noteworthy, with no statistically significant differences between the two groups. The methylene blue positioning technique is safe and effective for the endoscopic treatment of deep breast tumors. It shortens operation time, reduces surgical complications, and is worthy of clinical promotion.

Clinical effectiveness of transaxillary single-port endoscopic surgery in the treatment of breast benign tumor.

Benign breast lumps affect 10% of women in their lifetimes. Endoscopic surgery could be an alternative surgical technique for benign breast tumors because it is performed through small wounds hidden in inconspicuous areas. The aim of this study was to explore the safety and esthetic effects of endoscopic surgery in the treatment of benign breast disease. This retrospective cohort study analyzed 363 patients with benign breast tumors from August 2021 to December 2023 in the Sixth Affiliated Hospital of Sun Yat-Sen University, of whom 118 underwent transaxillary single-port endoscopic surgery and 245 underwent traditional open surgery. Clinicopathologic characteristics, surgery type, hospital stay, and complications were analyzed to assess the effectiveness of the procedure for benign breast tumors. Breast tumor resection was successfully performed in 363 patients by endoscopic surgery or traditional open surgery. Endoscopic procedures demonstrated longer durations of surgery (98.54±35.17min vs. 70.28±26.06min, p<0.01) and postoperative drainage (64.30±34.92mL vs.18.49±19.86mL, p<0.01), but there was less blood loss. The nipple-areolar complex of the patients who underwent endoscopic resection was significantly more sensitive than the traditional open surgery group. Patients in the endoscopic group reported higher satisfaction with surgical outcome (13.10±1.97 vs. 12.63±1.90, p<0.01). And there was a significant difference in the wound scar and cosmetic outcome total score between the two groups. Transaxillary single-port endoscopic surgery is effective and safe and improves postoperative nipple-areolar sensation and cosmetic outcome, as compared to the conventional technique.

Value of fractional-order calculus (FROC) model diffusion-weighted imaging combined with simultaneous multi-slice (SMS) acceleration technology for evaluating benign and malignant breast lesions

BackgroundThis study explores the diagnostic value of combining fractional-order calculus (FROC) diffusion-weighted model with simultaneous multi-slice (SMS) acceleration technology in distinguishing benign and malignant breast lesions.Methods178 lesions (73 benign, 105 malignant) underwent magnetic resonance imaging with diffusion-weighted imaging using multiple b-values (14 b-values, highest 3000 s/mm2). Independent samples t-test or Mann-Whitney U test compared image quality scores, FROC model parameters (D,, ), and ADC values between two groups. Multivariate logistic regression analysis identified independent variables and constructed nomograms. Model discrimination ability was assessed with receiver operating characteristic (ROC) curve and calibration chart. Spearman correlation analysis and Bland-Altman plot evaluated parameter correlation and consistency.ResultsMalignant lesions exhibited lower D, and ADC values than benign lesions (P < 0.05), with higher values (P < 0.05). In SSEPI-DWI and SMS-SSEPI-DWI sequences, the AUC and diagnostic accuracy of D value are maximal, with D value demonstrating the highest diagnostic sensitivity, while value exhibits the highest specificity. The D and combined model had the highest AUC and accuracy. D and ADC values showed high correlation between sequences, and moderate. Bland-Altman plot demonstrated unbiased parameter values.ConclusionSMS-SSEPI-DWI FROC model provides good image quality and lesion characteristic values within an acceptable time. It shows consistent diagnostic performance compared to SSEPI-DWI, particularly in D and values, and significantly reduces scanning time.

Effects of Melatonin Supplementation on Clinical Symptoms and Paraclinical Outcomes in Women Diagnosed With Fibrocystic Breast Disease: An Interventional Study

Fibrocystic breast disease is the most common benign breast disease in women, and it is necessary to investigate the most effective treatment method to reduce its symptoms. Therefore, the study was conducted to investigate the effect of melatonin supplementation on clinical symptoms and paraclinical outcomes in women diagnosed with fibrocystic breast disease. Investigating the Effects of melatonin supplementation on clinical symptoms and paraclinical outcomes in women diagnosed with fibrocystic breast disease. The present study is a controlled intervention-placebo treatment conducted on women suffering from fibrocystic breast disease aged 18-40. This interventional study was conducted on 66 patients (33 in the intervention group and 33 in the control group). Melatonin supplement of 3 mg was administered to the intervention group and a placebo to the control group for 12 weeks. Patient information, symptoms, and paraclinical outcomes were recorded at the beginning of the study before the intervention and 12 weeks after the intervention. After collecting the data, we analyzed it using SPSS version 16 software and appropriate statistical tests. The findings of this study showed that melatonin administration in patients with fibrocystic breast disease reduced anxiety, depression, improved sleep quality, increased TAC (Total Antioxidant Capacity), and decreased MDA (Malondialdehyde). However, both study groups did not have statistically significant differences in the average pain and hs-CRP before and after the intervention. According to the findings of the study and the identification of the positive effect of melatonin on laboratory indicators and symptoms in patients with fibrocystic breast disease, it is recommended to prescribe melatonin in addition to standard treatment to witness a better and faster recovery, and in this way, the quality of life of patients can be increased.

Thromboelastogram and coagulation function index: relevance for female breast cancer.

Screening and postoperative intervention of breast tumors are critical for the effective diagnosis and treatment of disease development, and reliable diagnostic/screening methods become a key link. Thromboelastogram (TEG), routine platelet (PLT) count, and the coagulation function indicators in patients with different breast diseases were determined and analyzed to explore their predictive value in secondary bleeding disorders. A total of 131 patients with breast diseases, admitted to Jiangsu University Affiliated Hospital from January 2019 to December 2022, were selected as the research subjects. The detection items were analyzed using the receiver operating curve (ROC) after grouping for secondary bleeding disorders of patients with breast cancer. The reaction (R) and the coagulation (K) times were lower in the malignant breast disease group, while the coagulation angle (α), maximum amplitude (MA), coagulation index (CI), fibrinogen (FIB), and D-dimer (D-D) were higher than those in the benign breast disease group. The t-tests proved that the MA and FIB values were statistically significant (p < 0.05) in the benign and malignant breast disease groups. The R and K in patients with breast diseases were positively correlated with the activated partial thromboplastin time (aPTT) and D-D, but were negatively correlated with PLT. The α angle was negatively correlated with aPTT and D-D, but was positively correlated with PLT. The MA for PLT function was positively correlated with FIB and PLT. CI was negatively correlated with aPTT, thrombin time (TT), and D-D, but was positively correlated with PLT. ROC curve analysis showed that the CI and α angle had a significant predictive value, whereas the correlation of the other indicators was relatively low. Coagulation tests showed significant differences in patients with breast cancer, differing from those with benign breast diseases. TEG combined with conventional coagulation indicators is potentially valuable for the prediction of secondary bleeding disorders in patients with breast cancer.

Risk factors for breast cancer subtypes by race and ethnicity: A scoping review.

Breast cancer is comprised of distinct molecular subtypes. Studies have reported differences in risk factor associations with breast cancer subtypes, especially by tumor estrogen receptor (ER) status, but their consistency across racial and ethnic populations has not been comprehensively evaluated. We conducted a qualitative, scoping literature review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis, extension for Scoping Reviews to investigate consistencies in associations between 18 breast cancer risk factors (reproductive, anthropometric, lifestyle, and medical history) and risk of ER-defined subtypes in women who self-identify as Asian, Black or African American, Hispanic or Latina, or White. We reviewed publications between January 1, 1990 and July 1, 2022. Etiologic heterogeneity evidence (convincing, suggestive, none, or inconclusive) was determined by expert consensus. Publications per risk factor ranged from 14 (benign breast disease history) to 66 (parity). Publications were most abundant for White women, followed by Asian, Black or African American, and Hispanic or Latina women. Etiologic heterogeneity evidence was strongest for parity, followed by age at first birth, post-menopausal BMI, oral contraceptive use, and estrogen-only and combined menopausal hormone therapy. Evidence was limited for other risk factors. Findings were consistent across racial and ethnic groups, although the strength of evidence varied. The literature supports etiologic heterogeneity by ER for some established risk factors that are consistent across race and ethnicity groups. However, in non-White populations evidence is limited. Larger, more comparable data in diverse populations is needed to better characterize breast cancer etiologic heterogeneity.

Differentiating between benign and malignant breast lesions using dual-energy CT-based model: development and validation

ObjectivesTo develop and validate a dual-energy CT (DECT)-based model for noninvasively differentiating between benign and malignant breast lesions detected on DECT.Materials and methodsThis study prospectively enrolled patients with suspected breast cancer who underwent dual-phase contrast-enhanced DECT from July 2022 to July 2023. Breast lesions were randomly divided into the training and test cohorts at a ratio of 7:3. Clinical characteristics, DECT-based morphological features, and DECT quantitative parameters were collected. Univariate analyses and multivariate logistic regression were performed to determine independent predictors of benign and malignant breast lesions. An individualized model was constructed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic ability of the model, whose calibration and clinical usefulness were assessed by calibration curve and decision curve analysis.ResultsThis study included 200 patients (mean age, 49.9 ± 11.9 years; age range, 22–83 years) with 222 breast lesions. Age, lesion shape, and the effective atomic number (Zeff) in the venous phase were significant independent predictors of breast lesions (all p < 0.05). The discriminative power of the model incorporating these three factors was high, with AUCs of 0.844 (95%CI 0.764–0.925) and 0.791 (95% CI 0.647–0.935) in the training and test cohorts, respectively. The constructed model showed a preferable fitting (all p > 0.05 by the Hosmer-Lemeshow test) and provided enhanced net benefits than simple default strategies within a wide range of threshold probabilities in both cohorts.ConclusionThe DECT-based model showed a favorable diagnostic performance for noninvasive differentiation between benign and malignant breast lesions detected on DECT.Critical relevance statementThe combination of clinical and morphological characteristics and DECT-derived parameter have the potential to identify benign and malignant breast lesions and it may be useful for incidental breast lesions on DECT to decide if further work-up is needed.Key PointsIt is important to characterize incidental breast lesions on DECT for patient management.DECT-based model can differentiate benign and malignant breast lesions with good performance.DECT-based model is a potential tool for distinguishing breast lesions detected on DECT.Graphical

Combination of IVIM with DCE-MRI for diagnostic and prognostic evaluation of breast cancer

PurposeTo identify the most effective combination of DCE-MRI (Ktrans,Kep) and IVIM (D,f) and analyze the correlations of these parameters with prognostic indicators (ER, PR, and HER2, Ki-67 index, axillary lymph node (ALN) and tumor size) to improve the diagnostic and prognostic efficiency in breast cancer. MethodsThis is a prospective study. We performed T1WI, T2WI, IVIM, DCE-MRI at 3 T MRI examinations on benign and malignant breast lesions that met the inclusion criteria. We also collected pathological results of corresponding lesions, including ER, PR, and HER2, Ki-67 index, axillary lymph node (ALN) and tumor size. The diagnostic efficacy of DCE-MRI, IVIM imaging, and their combination for benign and malignant breast lesions was assessed. Correlations between the DCE-MRI and IVIM parameters and prognostic indicators were assessed. ResultsOverall,59 female patients with 62 lesions (22 benign lesions and 40 malignant lesions) were included in this study. The malignant group showed significantly lower D values (p < 0.05) and significantly higher Ktrans, Kep, and f values (p < 0.05). The AUC values of DCE, IVIM, DCE + IVIM were 0.828, 0.882, 0.901. Ktrans, Kep, D and f values were correlated with the pathological grade (p < 0.05); Ktrans was negatively correlated with ER expression (r = −0.519, p < 0.05); Kep was correlated with PR expression and the Ki-67 index (r = −0.489, 0.330, p < 0.05); the DCE and IVIM parameters showed no significant correlations with the HER2 and ALN (p > 0.05). Tumor diameter was correlated with the Kep, D and f values (r = 0.246, −0.278, 0.293; p < 0.05). ConclusionIVIM and DCE-MRI allowed differential diagnosis of benign and malignant breast lesions, and their combination showed significantly better diagnostic efficiency. DCE- and IVIM-derived parameters showed correlations with some prognostic factors for breast cancer.

Cross-sectional study of hepatitis B virus infection in female breast cancer patients in China for the first time diagnosed.

The correlation between breast cancer and hepatitis B virus (HBV) remains inconclusive. This study aims to explore the serological status of HBV infection and past infection in different age groups of female breast cancer patients, patients with benign breast diseases, and individuals undergoing routine physical examinations. Serum data on HBV serological markers were collected and analyzed from 6072 female breast cancer patients first diagnosed from September 2012 to July 2020 at the First Affiliated Hospital of Chongqing Medical University, along with 4019 women with benign breast diseases and 54,740 healthy females undergoing routine physical examinations in the same period. The data were stratified by age for comparison between groups. The prevalence of HBV infection and past infection in the breast cancer group (7.9%, 55.1%) was higher than that in the benign breast disease group (6.5%, 39.1%) and the healthy females group(5.0%, 17.6%);the rate of only HBV surface antibody positivity (HBsAb ( +)) in the breast cancer group (10.3%) was lower than that in the benign breast disease group (26.9%) and the healthy females group (49.2%), with significant differences between the three groups (p < 0.05). Stratified by age, the prevalence of HBV infection in the breast cancer group (8%, 8.9%) and benign breast disease group (7.75%, 8.1%)was higher than that in the healthy females group (4.5%, 6.3%) in the 30-39 and 40-49 age group, respectively. The past infection rate of HBV in the breast cancer group (24.8%, 45.0%) was higher than that in the benign breast disease group (16.1%, 35.4%) in the ≤ 29 and 30-39 age group, respectively.. The past infection rate of HBV in the breast cancer group was higher than that in the healthy females group in all age groups, while the rate of only HBsAb ( +) in the breast cancer group was lower than that in the benign breast disease group and the routine physical examination group in all age groups. Breast cancer women and women with benign breast diseases have higher rates of hepatitis B virus infection and previous infections, with more significant differences among middle-aged women. Breast cancer women and women with benign breast diseases have lower rates of only HBsAb ( +) for HBV.

Breast cancer screening patterns and associated factors in Iranian women over 40 years

Screening is a key component of breast cancer early detection programs that canconsiderably reduce relevant mortality rates. The purpose of this study was to determinethe breast cancer screening behavioral patterns and associated factors in women over40 years of age. In this descriptive‑analytical cross‑sectional study, 372 over 40 years of agewomen visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling.The data were collected using the sociodemographic characteristics questionnaire, breastcancer perception scale, health literacy for Iranian adults scale, and the Breast CancerScreening Behavior Checklist. The obtained data were analyzed in SPSS version 16 usingdescriptive statistics (frequency, percentage, mean, and standard deviation) and inferentialstatistics (univariate and multivariate logistic regression analyses). In total, 68.3% of allparticipants performed breast self‑examination (BSE) (9.9% regularly, once per month),60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year),51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwentsonography (3.8% regularly, twice per year). The findings also showed that women withbenign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21;P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography(OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderatebreast cancer perception scores were more likely to perform BSE than women with highbreast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women whohad a history of benign breast disease were more likely to perform screening behaviors thanothers (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 weremore likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE(OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participationof women in regular breast cancer screening, it is suggested that health care providershighlight the need for screening at the specified intervals in their training programs. Inaddition, health authorities are recommended to use reminder systems to remind women,especially those over 40 years of age, of the best time for breast screening. Moreover, healthcare providers must seek to improve breast cancer knowledge, attitudes, and perceptionsof women who visit health centers, which are the first level of contact with the healthcaresystem for the general population.

Understanding Benign Breast Disease and Subsequent Breast Cancer in Hispanic White Females: A Step Closer to Evidence-Based Management.

Although Hispanic White (HW) females have a lower incidence of breast cancer than non-Hispanic White (NHW) females, breast cancer risk is unclear for HW females after benign breast disease (BBD). We compared BBD characteristics and subsequent breast cancer risk among HW and NHW females in New Mexico using a population-based collection of benign breast biopsies (1996-2007). BBD was categorized as nonproliferative disease (NPD), proliferative disease without atypia (PDWA), or atypical hyperplasia (AH). Breast cancer risk was assessed as absolute risk (AR) using cumulative incidence and RR by comparing the number of breast cancer events in BBDs to non-BBD. This study included 3,684 HW and 6,587 NHW females with BBD. HW females had similar proportions of NPD (58.6% vs. 54.3%), PDWA (21.4% vs. 23.5%), and AH (3.6% vs. 3.3%) as NHW females. Breast cancer risk among all females with BBD was higher than population-based expected rates (RR, 1.87) and was similar for HW and NHW subgroups (RR = 1.99 vs. 1.84). As expected, breast cancer risk increased with increasing BBD severity, both overall [RR, 1.81 (NPD), 1.85 (PDWA), and 3.10 (AH)] and in the HW and NHW subgroups. Adjusted AR of breast cancer at 5 years also increased with the severity of BBD (HW vs. NHW; NPD: 1.4% vs. 2.1%; PDWA: 1.5% vs. 2.7%; AH: 6% vs. 4.8%). We found similar breast cancer RRs and ARs in HW and NHW. Risk counseling should ensure that HW females receive breast cancer clinical management warranted by their similar absolute risks. The present population-based provides evidence for the clinical management of HW females with BBD for the prevention of breast cancer.

Evaluating cell type deconvolution in FFPE breast tissue: application to benign breast disease

Abstract Transcriptome profiling using RNA sequencing (RNA-seq) of bulk formalin-fixed paraffin-embedded (FFPE) tissue blocks is a standard method in biomedical research. However, when used on tissues with diverse cell type compositions, it yields averaged gene expression profiles, complicating biomarker identification due to variations in cell proportions. To address the need for optimized strategies for defining individual cell type compositions from bulk FFPE samples, we constructed single-cell RNA-seq reference data for breast tissue and tested cell type deconvolution methods. Initial simulation experiments showed similar performances across multiple commonly used deconvolution methods. However, the introduction of FFPE artifacts significantly impacted their performances, with a root mean squared error (RMSE) ranging between 0.04 and 0.17. Scaden, a deep learning-based method, consistently outperformed the others, demonstrating robustness against FFPE artifacts. Testing these methods on our 62-sample RNA-seq benign breast disease cohort in which cell type composition was estimated using digital pathology approaches, we found that pre-filtering of the reference data enhanced the accuracy of most methods, realizing up to a 32% reduction in RMSE. To support further research efforts in this domain, we introduce SCdeconR, an R package designed for streamlined cell type deconvolution assessments and downstream analyses.

A "C" triad: cirrhosis and cholangitis due to Caroli disease.

Abstract Caroli disease (CD) is a rare congenital pathology of probable autosomal recessive inheritance, it is part of the fibrocystic liver diseases and is included in group V of the Todani classification. It is characterized by saccular or cystic dilations of the intrahepatic bile ducts, sometimes associated with congenital liver fibrosis, and is then called Caroli syndrome (CS). The usual clinical manifestation is recurrent abdominal pain secondary to intrahepatic or vesicular stones, and acute cholangitis crises with the consequent formation of intrahepatic abscesses.

The Association between Vitamin D Deficiency and Fibrocystic Breast Disorder.

The role of deficiency of vitamin D in a wide range of human cancer, including breast cancer, has been proven, but its role in benign breast diseases remains unknown. This study aimed to determine the prevalence of vitamin D deficiency in patients with fibrocystic breast (FB) disease. First, the hospital prevalence of fibrocystic breast was determined by a crosssectional study. Then, patients were divided into two groups by a case-control study; women with confirmed fibrocystic breasts based on breast pain, physical examination, and ultrasonography were included as a case group (N=48), and age-matched women without fibrocystic breasts were also included as a control group (N=48). After recording the demographic and gynecological characteristics and exposure to the sun, gynecological records, and family history of fibrocystic breast, the blood sample was taken to determine vitamin D. Data were analyzed by Stata software. The result indicated that the studied groups had significant differences in regards to weight, breast pain, the severity of breast pain, breast heaviness, family history of fibrocystic breast, history of breast disease, caffeine consumption, and exposure to sunlight (p <0.05), but did not show significant differences based on age, occupation, education, gynecological history, diabetes mellitus, hypertension, obesity and hypothyroidism, vegetable, fast food, and dairy products consumption. The frequency of vitamin D deficiency in the case group was 45.8%, and in the control group, it was 20.8%, and there was a statistically significant difference (p <0.05). Vitamin D deficiency is more common in women with fibrocystic breast disease and may play a role in the development of the disease.

Assessing Urinary 8-OHdG: A Comparative Analysis between Benign Breast Diseases and Healthy Participants

Background: Benign breast problems account for a considerable share of diagnoses for breast diseases, which is a major global health concern. The study investigates the correlation between urinary 8-OHdG levels and benign breast illnesses, aiming to identify oxidative stress variations, aid in developing targeted therapies and personalized healthcare plans. Methods: This comparative study evaluated urinary 8-OHdG levels in patients with clinically suspected breast lump cases at Bangabandhu Sheikh Mujib Medical University, Dhaka. The sample included 30 healthy individuals and 30 patients with benign breast disorders. Important variables included oestrogen replacement medication, alcohol intake, age of menarche, menopause, obesity, and urinary 8-OHdG levels. Results: The study analysed 60 participants with benign breast diseases, revealing significant differences in age distribution, menarche age, BMI categories, demographic and reproductive factors, and urine 8-OHdG levels. Multiple logistic regression analysis revealed significant associations between urinary 8-OHdG concentrations and factors like age, OCP consumption history, marital status, age of menarche, breast feeding history, menopausal status, family history of breast cancer, and histopathological grading. However, body mass index and number of parities did not show significant associations with urinary 8-OHdG concentrations.

Comparison of the Ultrasonography Features of the Breast in Women with Fibroadenoma and Those with Other Breast Lumps.

Fibroadenoma (FA) is documented as the most common benign breast disease typically presenting as a lump. A wide variety of other diseases including breast cancer can similarly present as lumps hence the need for further differentiation. Ultrasonography plays a vital role in the evaluation and treatment of breast lumps with histological analysis as the gold standard. This study compared the physical and sonographic features of the breast in women with FA and women with breast lumps due to other diseases. This is a single-centre comparative study. Clinical and sonographic breast evaluations of the recruited patients with lumps were done and reported using the American College of Radiology Breast Imaging Reporting and Data System score. The lumps were biopsied, and histological diagnosis was documented. Clinical and imaging features of the breasts of women with FA were then compared with those of women with lumps from other breast diseases, and collated data were analysed using SPSS Statistical version 23.0. Data from 118 subjects (59 in each group) were used for this study. There was a significant difference in the physical and sonographic appearance of FA concerning the patient's age, parity, change in lesion size, perilesional architecture, echogenicity, borders, capsule and background breast density. No FA was found in women with less dense breasts. The sonographic features of breasts showed some differences from the corresponding features of FA and other breast lesions. This has the potential to increase the efficiency of pre-operative diagnosis of FA and could be further applied in developing diagnostic criteria for FA in our environment.

The diagnostic accuracy of conventional breast ultrasound in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

Breast cancer is a prominent worldwide health issue, with difficulties in detection worsened by the presence of dense breast tissue. Ultrasound and other alternative diagnostic methods have demonstrated potential to enhance detection rates, especially in situations involving thick breast tissue. Objective: To evaluate how well conventional breast ultrasonography can accurately differentiate between benign and malignant tumors, using histopathology as the most reliable method of comparison. Methods: A cross-sectional study was conducted at a tertiary care hospital to evaluate 185 female patients with breast lesions using sonographic examination. Demographic information, ultrasonography results and histopathological data were gathered and examined using SPSS version 26.0. Calculations were performed to determine the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Results: The study demonstrated that conventional breast ultrasound has a high diagnostic accuracy rate, with ratings of 91.07%, 83.57%, 89.47%, 85.92%, and 88.11% for sensitivity, specificity, positive predictive value and negative predictive value, respectively. Statistically significant differences in diagnostic accuracy were observed when stratification was performed based on age, duration of disease, parity, and history of breastfeeding. Conclusions: The findings indicated that ultrasound is highly effective in differentiating between benign and malignant breast lesions, with substantial diagnostic precision. However, false positives remain a concern, necessitating ongoing research for optimizing ultrasound efficacy, especially in high-risk cohorts.

High cure rate and satisfaction in patients with periductal mastitis via the latissimus dorsi myocutaneous flap technique: a retrospective study.

Periductal mastitis (PDM) is a complex benign breast disease with a prolonged course and a high probability of recurrence after treatment. There is a variety of available treatments for PDM, but none of these options have been widely accepted. A standard strategy has been especially difficult to establish in patients with PDM accompanied by large tumors or large skin ruptures, as these seriously affect the appearance of the breasts after surgeries, which can lead to feelings of lower self-esteem among patients. Therefore, finding a reliable volume replacement has become a focus of our research efforts. With the widespread use of latissimus dorsi in breast reconstruction, we attempted to use the latissimus muscle (skin) flap for stage I repair in patients with large-defect PDM. Our study is the first of its kind to evaluate the clinical effect and patient satisfaction of the latissimus dorsi myocutaneous flap (LDMF) technique in PDM. Thirty-two patients with PDM and more than about 20% loss of breast volume admitted to the Department of Breast Surgery of Shanxi Bethune Hospital from March 2017 to July 2021 were enrolled. After lesion removal, the LDMF technique was applied to these patients for immediate completion of breast contour revision. All patients were periodically followed up to assess the efficacy of the procedure and their satisfaction with the breasts' shape. Three patients (9.4%) developed dorsal effusion after removal of the back drain; six patients (18.8%) developed mild limitation of the activity of the affected upper limb; and three patients (9.4%) experienced local recurrence of inflammation after the operation, all of whom underwent a second operation. The cure rate of the patients treated with LDMF was 90.6%, the overall satisfaction rate of the patients was 96.9%, and doctor's evaluation of satisfaction was 90.6%. In patients with poor results after anti-infective and local treatment and those with more than 20% defect volume following lesion removal, the LDMF technique yields a high cure rate and good patient satisfaction.

The impact of cotrimoxazole in idiopathic granulomatous mastitis treatment

Introduction and importanceIdiopathic granulomatous mastitis (IGM) is a benign inflammatory breast disease, commonly presented with a sensitive breast lump and developing scars. Currently, there is no definitive treatment for IGM but Antibiotics, steroids, immunosuppressive drugs or a surgical treatments are the usual options. This case series aimed to evaluate the effectiveness of cotrimoxazole in treatment of IGM as there is no clinical consensus on the best and most widely acknowledged therapeutic management for IGM. Case presentationAll IGM patients were treated by Cotrimoxazole (800 mg BD for one week), and they were assessed at a month, 3 months, and 6 months after that. The primary outcome was an improvement in presenting complaints and symptoms such as palpable mass, bulging, pain, erythema and hypersensitivity of breast skin, breast discharge and fluctuation. The secondary outcome was the refractory rate within 6 months. Number of 20 patients were included. At the baseline, participants exhibited various symptoms such as bulging, pain and erythema (100 %), breast discharge (80 %), and fluctuation (30 %). After the intervention, there was a significant decrease in the prevalence of symptoms over the study period. The prevalence of bulging and pain, erythema, discharge, and fluctuation symptoms were decreasedto 5 %, 0 %, and 0 %, respectively. The refractory rate of IGM within six months of cotrimoxazole treatment was estimated 30 %. Clinical discussionIn this study, the treatment approach did not involve corticosteroids and invasive procedures and the recurrence rate of IGM within the six months was lower than in similar studies that employed steroids alone or any more invasive treatments. Additionally, our study showed a high healing rate with resolution of inflammation, pain, discharge, and fluctuation. These results suggest that cotrimoxazole may be a more favorable option than high-dose corticosteroids and a comparable alternative to low-dose corticosteroids regarding recurrence rates. ConclusionCotrimoxazole may be an effective treatment option for idiopathic granulomatous mastitis. However, further research is needed on different treatment options.