Imaging In Breast Cancer Patients Research Articles

Optimizing Image Quality with High-Resolution, Deep-Learning-Based Diffusion-Weighted Imaging in Breast Cancer Patients at 1.5 T.

The objective of this study was to evaluate a high-resolution deep-learning (DL)-based diffusion-weighted imaging (DWI) sequence for breast magnetic resonance imaging (MRI) in comparison to a standard DWI sequence (DWIStd) at 1.5 T. It is a prospective study of 38 breast cancer patients, who were scanned with DWIStd and DWIDL. Both DWI sequences were scored for image quality, sharpness, artifacts, contrast, noise, and diagnostic confidence with a Likert-scale from 1 (non-diagnostic) to 5 (excellent). The lesion diameter was evaluated on b 800 DWI, apparent diffusion coefficient (ADC), and the second subtraction (SUB) of the contrast-enhanced T1 VIBE. SNR was also calculated. Statistics included correlation analyses and paired t-tests. High-resolution DWIDL offered significantly superior image quality, sharpness, noise, contrast, and diagnostic confidence (each p < 0.02)). Artifacts were significantly higher in DWIDL by one reader (M = 4.62 vs. 4.36 Likert scale, p < 0.01) without affecting the diagnostic confidence. SNR was higher in DWIDL for b 50 and ADC maps (each p = 0.07). Acquisition time was reduced by 22% in DWIDL. The lesion diameters in DWI b 800DL and Std and ADCDL and Std were respectively 6% lower compared to the 2nd SUB. A DL-based diffusion sequence at 1.5 T in breast MRI offers a higher resolution and a faster acquisition, including only minimally more artefacts without affecting the diagnostic confidence.

The incidence of brain metastases in breast cancer according to molecular subtype and stage: a 10-year single institution analysis.

Breast cancer (BC) is the second most common etiology of brain metastases (BrM). We aimed to examine the incidence of BrM among all BC patients presenting to a large tertiary cancer centre over one decade. We included all BC patients presenting consecutively between 2009 and 2019 and cross referenced that cohort to a radiotherapy database, identifying patients treated for BrM at any time following their initial presentation. Cumulative incidences (CI) of BrM diagnoses were calculated using death as a competing risk and compared using the Fine-Gray method. Overall survival was estimated using the Kaplan Meier method. We identified 12,995 unique patients. The CI of BrM in patients who initially presented with Stage 0-4 disease was 2.1%, 3.7%, 9.4%, 10.6%, and 28.7%, respectively at 10years. For 8,951 patients with available molecular subtype data, 6,470 (72%), 961 (11%), 1,023 (11%), and 497 (6%) had hormone-receptor (HR)-positive/ERBB2-, HR-negative/ERBB2-, HR-positive/ERBB2 + , and HR-negative/ERBB2 + disease, respectively; the CI of BrM in each was 7.6%, 25.3%, 24.1%, and 26.6%, at 10years following BC diagnosis, respectively. Median overall survival (OS) following BC diagnosis and BrM diagnosis was 28years 95% CI [25, 32] and 10months 95% CI [9, 12], respectively. From a large, registry-based study, we observed that patients with ERBB2 + and triple negative BC have the highest incidence of BrM. Our data supports prospective surveillance brain MRI studies. Given advancements in BrM treatment, clinicians should have a low threshold for brain imaging in BC patients with high risk subtypes.

Surveillance Imaging in Breast Cancer Patients Undergoing Breast Conserving Surgery With Chest Wall Perforator Flap Reconstruction

Surveillance Imaging in Breast Cancer Patients Undergoing Breast Conserving Surgery With Chest Wall Perforator Flap Reconstruction

Contact of the Tumor with the Internal Mammary Perforator Vessels as Risk Factor for Internal Mammary Lymph Node Involvement Based on Dynamic Contrast Enhancing MRI Imaging in Breast Cancer Patients

Distant metastasis free and overall survival of high-risk breast cancer patients can be improved with irradiation of the lymphatic system. However, inclusion of internal mammary region (IMN) markedly increases the dose to the heart. Hence, an estimation of the individual risk of subclinical involvement is necessary in order to balance the oncological benefit versus the cardiac toxicity. In randomized studies the risk stratification for IMN involvement is mainly based on the tumor location (medial, central vs. lateral). The aim of this study was to evaluate whether the contact of the tumor with the internal mammary perforator vessels (IMPV) is an additional risk factor for IMN involvement. For this trial we retrospectively examined 104 sets of pre-treatment dynamic contrast enhanced magnetic resonance imaging (DE-MRI) scans of locally advanced breast cancer patients. All patients had ipsilateral clinical suspect lymph nodes in the axillary region and either positive (n = 52) or negative lymph nodes (n = 52) in the internal mammary region. Based on the DE-MRI we assessed the tumor location as well as contact to the internal mammary perforating vessels (IMPV). Contact between tumor and IMPV was classified into either predominant, minor or no contact. Criteria for a predominant IMPV contact was defined as: main vessel contact or contact to multiple (> = 5) side branches. The tumor location of IMN+ patients were medial in 19.2% (10/52), central in 26.9% (14/52), lateral in 28.8% (15/52) and multicentric in 25.0% (13/52) of. In IMN- patients, tumor location was medial in 9.6% (5/52), central in 26.9% (14/52), lateral in 42.3% (22/52) and multicentric in 21.2% (11/52) in IMN- patients. The tumor size ranged from T1-T4 with most patients staged as T2 (48.1% (IMN+) vs. 38.5% IMN-). Most patients had hormone receptor positive / Her2neu negative disease (36.5% (IMN+) vs. 46.2% (IMN-). 100 % of tumors in IMN+ patients had contact with IMPV: in 94.2% (49/52) criteria for predominant IMPV contact was fulfilled; in the remaining 3 cases (5.8%) the tumor had minor IMPV contact. In IMN- patients however, 36/52 of cases (69.2%) had direct IMPV contact. Predominant contact was found in only 23.1% (12/52), minor IMPV contact in 46.2% (24/52). Predominant contact of the tumor with IMPV appears to be a potential risk factor for IMN involvement in breast cancer patients and could be used for stratification for IMN-irradiation in future trials.

3D Surface Imaging in Reducing Setup Error for Prone Whole Breast Radiotherapy

For patients undergoing whole breast radiotherapy, treatment in the prone position allows for reduced dose to critical organs such as the heart and lungs. However, this treatment position comes with greater challenges in reproducibility and setup error given the unstable position. Our objective was to investigate the benefit of using 3D surface imaging to reduce daily setup errors for these patients. We performed a retrospective review of consecutive breast patients receiving prone breast radiotherapy at our institution. All patients were positioned initially using setup tattoos and twice a week, the positioning was adjusted using the aid of a motion tracking system. Then, a daily kilovoltage (kV) cone beam computed tomography (CBCT) image was acquired and positioning was adjusted to setup the breast and chest wall. Shifts in each translational direction were recorded and the three-dimensional vector displacement was calculated. For each patient the average displacements on days where a motion tracking system was used were compared to days whereas motion tracking system was not used. Patients were classified into significant benefit (more than 4 mm improvement), small benefit (0-4 mm improvement) or increased error (increased shifts on days a motion tracking system was used). Patient demographics were collected including stage, BMI, weight, heigh, age, ethnicity. Comparisons were made using t-tests. A total of 40 patients with stage T0-2N0 breast cancer were included. The median age was 64 and 60% of patients had left sided breast cancer. A total of 665 daily CBCT scans were analyzed, and the median daily vector displacement was 7.2 mm (1-21 mm). The median displacement on treatments where a motion tracking system was used (41% of treatments) was 6.1 mm versus 8.1 mm when not used (p<.0001). The use of a motion tracking system significantly reduced the occurrence of shifts more than 1 cm (12% vs. 33%, p < .0001) and 5 mm (65% vs. 83% p < .0001). For individual patients, 28% showed a significant improvement, 55% showed small improvement, 17% showed increased error. The median BMI was 27, weight was 71 kg, and neither was associated with an improvement in the use of Align RT (p > .05). However, patients in the small improvement group had a higher BMI than patients in the other two groups 29 vs. 25 (p = .01). A similar association was seen for weight (p < .05). No association was found for the benefit of a motion tracking system for height, age, stage or ethnicity. The use of 3D surface imaging for breast cancer patients receiving prone whole breast radiotherapy on average significantly reduced setup errors. For patients with higher BMI there was a consistent small reduction in setup error when compared to using setup marks alone. For patients with lower BMI, caution should be exercised as there was more variation with some patients demonstrating a large benefit and other patients having an increased setup error with the use of surface imaging. Further research is needed to investigate on the optimal use of this technology.

Sistem Temu Kembali Citra Termal Kanker Payudara Pada Citra Rekam Medis

Medical record images (Medical Imaging) in the form of the thermal images can be able to detect of of breast cancer as early detector for the patient. The technic process is by utilizing the thermal image of an existing breast cancer patient, the thermal image of the new patient can be searched by the similarities the image of the old patient. In order to get the exactly results, required an accurate system to find the thermal imaging of breast cancer patients in the thermal image database. This study aims to build a Content Based Imaged Retrieval (CBIR) system for thermal images of breast cancer patients based on thermal images have been diagnosed by specialist doctors. This system with using a combination of color histogram features and dominant color descriptors. To determine the similarity between the query image and the dataset image with using of two methods that is measuring the Euclidean Distance and the Minkowski Distance. The results of this research show from testing the combination between the two features, the F-measure evaluation value obtained from the top 10 retrieval was in the healthy image category of 0.07 and 0.09 in the cancer image category. From the conducting testing process result, the concluded is the most appropriate feature in carrying out the breast thermal image retrieval process is using a combination of dominant color descriptor features and color histograms.

Challenges in Cardiovascular Imaging in Women with Breast Cancer.

Cardiovascular imaging in breast cancer patients is paramount for the surveillance of cancer therapy-related cardiac dysfunction (CTRCD); however, it comes with specific limitations. PURPOSE OF REVIEW: This review aims to describe the unique challenges faced in cardiovascular imaging of breast cancer patients, discuss evidence to support the utility of various imaging modalities, and provide solutions for improvement in imaging this unique population. RECENT FINDINGS: Updated clinical society guidelines have introduced more unifying surveillance of CTRCD, although there remains a lack of a universally accepted definition. Traditional and novel multi-modality imaging can be used to detect CTRCD and myocarditis in breast cancer patients. Cardiovascular imaging in breast cancer patients is difficult due to reconstructive surgery. Although echocardiography with myocardial strain is the cornerstone, multi-modality imaging can be used to evaluate for CTRCD and myocarditis. Novel imaging techniques to improve the diagnosis of cardiotoxicities in breast cancer patients are needed.

Retracted: Role of Posttreatment Nursing Based on Functional Magnetic Resonance Imaging in Breast Cancer Patients with Lymphedema.

[This retracts the article DOI: 10.1155/2022/5224288.].

Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients.

In this study, we investigated the prognostic implications of focal breast edema on preoperative breast magnetic resonance imaging (MRI) in patients with breast cancer. Data of 899 patients with breast cancer at a single institution were retrospectively analyzed. The patients were divided into an edema-positive group (EPG) and an edema-negative group (ENG) based on the presence of peritumoral, prepectoral, or subcutaneous edema. Two radiologists evaluated the presence or absence of focal edema and its subtypes on preoperative breast MRI. Clinicopathologic characteristics and survival outcomes were compared between the two groups and among the three subtypes using Pearson's χ² test, Kaplan-Meier estimator, and Cox proportional hazards model. There were 399 (44.4%) and 500 (55.6%) patients in the EPG and ENG, respectively. The EPG showed significantly higher rates of axillary lymph node metastasis (55.6% vs. 19.2%, p < 0.001) and lymphovascular invasion (LVI) (57.9% vs. 12.6%, p < 0.001) than the ENG. Patients in the EPG showed significantly worse overall survival (OS) rate (log-rank p < 0.001; hazard ratio [HR], 4.83; 95% confidence interval [CI], 2.56-9.11) and recurrence-free survival rate (log-rank p < 0.001; HR, 3.00; 95% CI, 1.94-4.63) than those in the ENG. After adjusting for other variables, focal breast edema remained a significant factor affecting the OS rate, regardless of the edema type. Specifically, the presence of subcutaneous edema emerged as the strongest predictor for OS with the highest HR (p < 0.001; HR, 9.10; 95% CI, 3.05-27.15). Focal breast edema on preoperative breast MRI implies a higher possibility of LVI and axillary lymph node metastasis, which can lead to a poor prognosis. A detailed description of focal breast edema, especially subcutaneous edema, on preoperative breast MRI may provide prognostic predictions. More intensive surveillance is required for patients with breast cancer and focal preoperative breast edema.

Synthesis, characterization, and radiosynthesis of fluorine-18-AVT-011 as a Pgp chemoresistance imaging marker

P-glycoprotein (Pgp) is the most studied ATP-binding cassette (ABC) efflux transporter and contributes to chemoresistance. A few tracers have been developed to detect the in-vivo status of chemoresistance using positron emission tomography (PET) imaging. In our study, we have synthesized labeled AVT-011 with fluorine-18 (18F) followed by in-vitro and in-vivo analysis. Tosylate AVT-011 precursor was synthesized and characterized by 1H-NMR and 13C-NMR. AVT-011 was labeled with 18F using the nucleophilic substitution method, and a standard set of quality control was performed. The specificity for Pgp was tested in U87MG cells with and without an inhibitor (tariquidar). The biodistribution and in-vivo stability were tested in the small animals (mice). The biodistribution data of [18F]-AVT-011 was extracted from the PET-CT imaging of breast cancer patients (n = 6). The precursor was synthesized with 36 ± 4% yield and 97 ± 2% purity. The labeling was more than 95% with a 42 ± 2% yield, as evaluated by Radio-HPLC. The cell-binding assay showed a specificity of the tracer for Pgp as the uptake increased by twice after blocking the Pgp receptors. The radiotracer showed a hepatorenal excretion pathway for clearance in an animal study. The uptake was higher in the liver, lungs, spleen, and heart at 15 min and decreased at 60 min. The patients' distribution showed similar uptake patterns as observed in the small animals. [18F]AVT-011 was characterized successfully with high radiochemical purity and yield. The in-vitro and in-vivo studies proved its specificity for Pgp and safe for patient use.

Study of Linear Energy Transfer Effect on Rib Fracture in Breast Patients Receiving Pencil-Beam-Scanning Proton Therapy

<h3>Purpose/Objective(s)</h3> To study the linear energy transfer (LET) effect upon rib fracture (RF) in breast cancer patients treated with pencil-beam scanning proton therapy (PBS) using dose-linear energy transfer volume histogram (DLVH). <h3>Materials/Methods</h3> After IRB approval, we retrospectively identified RF cases detected after workup of chest wall pain or incidentally on imaging in breast cancer patients treated with PBS to the breast/chest wall and regional nodes from 2015-2020. Control patients were selected to match the RF patients 2:1 considering prescription dose, boost location, reconstruction status, laterality, chest wall thickness, and treatment year. For all plans, a chest wall was contoured, incorporating ribs and intercostal muscles within the 50% prescription isodose line. Both dose and LET were calculated using a planning tool dose engine. DLVH was generated for each patient, using dose and LET as the two axes. The DLVH index, <i>V</i>(<i>d, l</i>), defined as <i>V</i>(% for normalized volume or cc for absolute volume) of the structure with a dose of at least <i>d</i> Gy[RBE] and an LET of at least <i>l</i> keV/µm, was calculated for all combinations of <i>d</i> and <i>l</i>. Conditional logistic regression model was used to establish the relation of <i>V</i>(<i>d, l</i>) and the observed RF at each combination of <i>d</i> and <i>l</i>. The derived <i>p values</i> constitute a <i>p value</i> map in the 2D dose and LET plane. Concordance and its standard error (se) maps were generated to evaluate the performances for all DLVH indices. A correlation coefficient map was obtained to determine the correlation between the featured DLVH indices. <h3>Results</h3> Eight RF cases were identified, and 16 controls were matched. Of RF patients, seven were treated with post-mastectomy (PMRT) and one was treated with post-lumpectomy radiotherapy. Six RF patients treated with PMRT received a dose of 50 Gy[RBE] in 25 fractions to the chest wall and regional lymph nodes; of these, four received a simultaneous integrated boost (SIB) of 56.25 Gy[RBE] to the chest wall (n=2) or axillary nodes (n=2), and one received a sequential boost of 14 Gy[RBE] in 7 fractions to the chest wall. One RF patient that received PMRT was treated with 40.05 Gy[RBE] in fifteen fractions to the chest wall and regional lymphatics. The post-lumpectomy patient received 50 Gy[RBE] in 25 fractions to the whole breast and regional nodes with a SIB of 56.25 Gy[RBE] to the lumpectomy cavity. Two characteristics correlated with RF (<i>p</i><0.2): 1) Smaller <i>V</i>(50-54 Gy[RBE], 0-4.4keV/µm) of the RF patients with a maximum concordance of 0.813 (se 0.114); 2) Larger <i>V</i>(0-36 Gy[RBE], 5.2-6.8keV/µm) of the RF patients with a maximum concordance of 0.875 (se 0.119) compared with controls. These two features were independent from each other with a weak negative correlation (-0.185). <h3>Conclusion</h3> The increase of high LET in moderate dose regions of the chest wall from constraining the adjacent heart and lung dose during PBS treatment planning may result in increased risk of RF.

Satisfaction survey on a preoperative explanation method using three-dimensional breast imaging for breast cancer patients considering breast-conserving surgery.

Although one of the essential factors in surgical shared decision-making is the body image, the breast morphology after breast-conserving surgery is particularly difficult to explain in a uniform manner due to large individual differences. Patients with breast cancer eligible for breast-conserving surgery (BCS) were recruited between June 2020 and October 2021. We surveyed the patients' satisfaction with our method of explaining the likely breast morphology after BCS using three-dimensional (3D) breast imaging in the form of a questionnaire. A total of 162 patients were enrolled, and 137 (84.6%) answered the questionnaire. One hundred and sixteen patients (84.6%) answered that they were very satisfied or satisfied with our explanation method, and 100 (73.0%) patients were very satisfied or satisfied with the 3D breast imaging. Some patients answered that 3D breast imaging helped them prepare for BCS, or on the contrary, made them choose mastectomy with breast reconstruction because the deformation likely with BCS was considered unacceptable. Only a few patients who underwent BCS felt that their postoperative morphology was more deformed than the preoperatively imagined one. Our results suggest that our preoperative explanation method using 3D breast imaging was useful for shared decision-making.

Application of a Novel 68Ga-HER2 Affibody PET/CT Imaging in Breast Cancer Patients.

BackgroundBreast cancer is a heterogeneous disease, and the human epidermal growth factor receptor 2 (HER2) expression may vary considerably between primary and metastatic lesions, or even within a single lesion. Repeated biopsies cannot always be performed. In this feasibility trial, we assessed whether a novel 68Ga-NOTA-MAL-MZHER2 (68Ga-HER2) affibody PET/CT could determine the HER2 status of each lesion if there was a clinical need for it.Methods 68Ga-HER2 affibody PET/CT was performed in breast cancer patients if HER2 status remained unclear after standard examinations (including bone scan, 18F-FDG PET/CT, CT, and feasible biopsy). All available images for each patient were evaluated through an independent review of two committee-certified radiologists with nuclear medicine expertise. In case of discrepancy, adjudication by a third radiologist was performed as needed. All radiologists were blinded to the clinical information.ResultsTwenty-four patients were enrolled. 68Ga-HER2 affibody PET/CT was requested by physicians due to the following reasons: 6 with multiple primary cancers, 13 with metastases not amenable to biopsy or repeated biopsy, 6 with inconsistent HER2 status between primary and metastatic lesions, and 4 with different HER2 status within different metastases. The final PET report revealed that the 68Ga-HER2 affibody tumor uptake was considered positive in 16 patients, negative in 7 patients, and equivocal in one patient. The heterogeneity of 68Ga-HER2 affibody uptake was observed, with a maximal 8.5-fold difference within one patient and a maximal 11-fold difference between patients. 68Ga-HER2 affibody PET/CT demonstrated a high diagnostic accuracy in differentiating HER2-enriched breast cancer, with a sensitivity of 91.7% and a specificity of 84.6%, regardless of prior lines of anti-HER2 therapies.Conclusion 68Ga-HER2 affibody PET/CT imaging could provide valuable information on HER2 expression of each tumor in the body of patients, which may help in personalized clinical decision-making. Its value is now under systemic assessment.

Image processing improvements afford second-generation handheld optoacoustic imaging of breast cancer patients

BackgroundSince the initial breast transillumination almost a century ago, breast cancer imaging using light has been considered in different implementations aiming to improve diagnostics, minimize the number of available biopsies, or monitor treatment. However, due to strong photon scattering, conventional optical imaging yields low resolution images, challenging quantification and interpretation. Optoacoustic imaging addresses the scattering limitation and yields high-resolution visualization of optical contrast, offering great potential value for breast cancer imaging. Nevertheless, the image quality of experimental systems remains limited due to a number of factors, including signal attenuation with depth and partial view angle and motion effects, particularly in multi-wavelength measurements. MethodsWe developed data analytics methods to improve the accuracy of handheld optoacoustic breast cancer imaging, yielding second-generation optoacoustic imaging performance operating in tandem with ultrasonography. ResultsWe produced the most advanced images yet with handheld optoacoustic examinations of the human breast and breast cancer, in terms of resolution and contrast. Using these advances, we examined optoacoustic markers of malignancy, including vasculature abnormalities, hypoxia, and inflammation, on images obtained from breast cancer patients. ConclusionsWe achieved a new level of quality for optoacoustic images from a handheld examination of the human breast, advancing the diagnostic and theranostic potential of the hybrid optoacoustic-ultrasound (OPUS) examination over routine ultrasonography.

Evaluation of left atrial remodeling using cardiovascular magnetic resonance imaging in breast cancer patients treated with adjuvant trastuzumab.

We evaluated left atrial (LA) remodeling using cardiac MRI (CMR) in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer during and after trastuzumab therapy. In this prospective 2-center longitudinal study, 41 women with HER2-positive breast cancer received adjuvant trastuzumab for 12months, in addition to standard chemotherapy. Serial CMRs were performed at baseline, 6, 12, and 18months after initiation of trastuzumab. LA volumes were measured by a blinded reader. Linear mixed model was used to evaluate longitudinal changes. Of 41 women (mean age 52 ± 11 [SD] years; 56% received anthracycline), one patient experienced trastuzumab-induced cardiotoxicity (TIC) for which trastuzumab was interrupted for one cycle. Mean baseline left ventricular ejection fraction (LVEF) was 68.0 ± 5.9% and LA ejection fraction (LAEF) was 66.0 ± 6.6%. Compared to baseline, LAEF decreased significantly at 6months (62.7 ± 5.7%, p = 0.027) and 12months (62.2 ± 6.1%, p = 0.003), while indexed LA minimum volume (LAmin) significantly increased at 12months (11.6 ± 4.9ml/m2 vs 13.8 ± 4.5ml/m2, p = 0.002). At 18months, all changes from baseline were no longer significant. From baseline to 6months, change in LAEF correlated with change in LVEF (Spearman's r = 0.41, p = 0.014). No significant interactions (all p > 0.10) were detected between time and anthracycline use for LA parameters. Among trastuzumab-treated patients with low incidence of TIC, we observed a small but significant decline in LAEF and increase in LAmin that persisted for the duration of therapy and recovered 6months after therapy cessation. These findings suggest that trastuzumab has concurrent detrimental effects on atrial and ventricular remodeling. • In trastuzumab-treated breast cancer patients evaluated by cardiac MRI, left atrial ejection fraction declined and minimum volume increased during treatment and recovered to baseline after trastuzumab cessation. • Changes in left atrial ejection fraction correlated with changes in left ventricular ejection fraction in the first 6months of trastuzumab treatment. • Trastuzumab therapy is associated with concurrent detrimental effects on left atrial and ventricular remodeling.

Time to treatment and hospital visits for patients undergoing neoadjuvant chemotherapy for breast cancer in a single payer system.

Neoadjuvant chemotherapy (NAC) requires coordination of various services to ensure timely and accurate delivery of care. This can result in multiple hospital visits and extend time to treatment (TTT). The primary purpose of our study was to evaluate time to NAC for patients at a regional cancer centre. Healthcare resource use in the form of hospital visits before NAC was also evaluated. A retrospective chart analysis of patients with invasive breast cancer who underwent NAC between 1 January 2012 and 31 December 2018 was performed. Overall, 286 patients underwent NAC. Median TTT was 22 days (range: 2-105). Median number of visits between first consultation and NAC was 5 (range: 0-12). Majority of additional visits were for diagnostic imaging/interventions, with a median number of 4 visits (range: 0-10). Each additional hospital visit increased time to NAC treatment by 14%. Women undergoing NAC require multiple visits before initiating treatment-the majority of these visits are for diagnostic imaging. These results support the need for the coordination of multidisciplinary care and diagnostic imaging for breast cancer patients undergoing NAC to reduce hospital visits, improve the patient experience, and reduce TTT.

Role of Posttreatment Nursing Based on Functional Magnetic Resonance Imaging in Breast Cancer Patients with Lymphedema.

Breast cancer is the tumor disease with the highest incidence in women, especially lymphedema after treatment, which seriously affects the quality of life of women. In order to improve the nursing quality of breast cancer patients, medical staff uses functional magnetic resonance imaging (fMRI) to intervene in breast cancer patients, which greatly improves the recovery speed of patients. In this paper, functional magnetic resonance imaging based on the image registration method is proposed and applied to the follow-up of patients with breast cancer lymphedema after treatment. The powerful imaging effect allows doctors to timely and accurately judge the condition of the patient's lesions after treatment, which is conducive to nursing care. The experimental results of this paper show that the total number of serious patients in group A before the experiment is 25, accounting for 83.3%. After the experiment, the total number of severe cases was 24, accounting for 80%, indicating that the nursing measures of group A did not have a great effect. The total number of severe cases in group B before the experiment was 27, accounting for 90%. The total number of severe cases after the experiment was 10, accounting for 33.3%. The effect after the experiment was significantly higher than that before the experiment, indicating that the nursing program of group B played a great role.

Diagnostic performance of breast imaging with ultrasonography, magnetic resonance and mammography in the assessment of residual tumor after neoadjuvant chemotherapy in breast cancer patients

Background/Aim: Following the administration of neoadjuvant chemotherapy (NAC), a complete pathological response (pCR) is seen at rates of up to 50-70% in breast cancer patients, especially in triple-negative (TNBC) and HER-2 enriched subgroups and related to increased pCR rates, studies to predict the pathological response with preoperative evaluation are ongoing. The aim of this study was to investigate the correlation of preoperative imaging in breast cancer patients receiving NAC with the pathological response. Methods: The study, organized as a retrospective cohort study, included 129 breast patients who underwent surgery after NAC between April 2014 and February 2020. The demographic data of the patients, the clinical and radiological findings before and after NAC, operation findings, and the histopathological evaluation results were collected retrospectively from the patient files. The radiological images of the patients were examined by separating into groups of patients with ultrasonography (US), magnetic resonance imaging (MRI), US+MRI, and mammography (MG)+US. The NAC response on preoperative breast US and MG was evaluated according to the RECIST-1.1 system, and the NAC response on MRI with the Goorts et al grading system. In the histopathological examination of operation material, the Miller Payne grading system for breast tissue was used in the determination of NAC response. Results: The mean age of the patients in the study was 49.17 (11.00) years. The vast majority of the patients (87.6%) were diagnosed with invasive ductal cancer, with 27.13% in luminal A, 35.65% in luminal B, 31.0% in HER-2 enriched, and 6.2% in TNBC subgroups. A statistically significant correlation was determined between the pathological response and the US+MRI, MRI, and US+MG groups, with agreement at a moderate level (Kappa: 0.653, P<0.001; Kappa:0.443, P<0.001; Kappa:0.481, P=0.005, respectively). Within all the groups, the group with the highest sensitivity and accuracy were seen to be the patients evaluated with US+MRI (66.67%, 90.91%, respectively). Conclusion: The results of this study demonstrated that there is a correlation between the pathological response and US+MRI, MRI, and US+MG evaluation after NAC. The US+MRI group was found to have the highest sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. When possible, the use of these two imaging methods together in the preoperative evaluation of patients is a successful method in the prediction of pathological response.

Imaging Evaluation of the Axilla-A National Survey of Clinical Practice Among Radiologists.

To assess awareness and implementation of the American College of Surgeons Oncology Group Z0011 trial findings, approaches to axillary nodal imaging, and to identify differences in practice based on respondent characteristics. An online survey was distributed to members of the Society of Breast Imaging. Questions regarded demographics, evaluation approaches, and impact of the Z0011 trial. Poisson regression with robust standard errors to regression was used to generate multivariable-adjusted relative risks and 95% confidence intervals (CIs) for associations. The response rate was 21.7% (430/2007). The majority (295/430, 68.6%) reported always performing axillary US in patients with a BI-RADS 4B, 4C, or 5 breast mass. Most respondents (299/430, 69.5%) were familiar with the findings of the Z0011 trial. Radiologists in academic practice were 0.67 (95% CI: 0.54-0.83) times less likely than private practice radiologists to perform axillary US in all masses and 1.31 (95% CI: 1.13-1.52) times more likely to be very familiar with the trial. Frequency of axillary US showed no association with time spent in breast imaging, years in practice, or presence of dedicated breast surgeons. Increased time in breast imaging and presence of dedicated breast surgeons was strongly associated with familiarity with the trial. No association was observed with years in practice. Most respondents (291/430, 67.7%) made little or no change to their practice based on trial findings. There is wide variability in approaches to axillary nodal evaluation, demonstrating a need for improved education and guidelines for axillary imaging in breast cancer patients.

Heterogeneity of estrogen receptor based on 18F-FES PET imaging in breast cancer patients

Heterogeneity of estrogen receptor based on 18F-FES PET imaging in breast cancer patients