Mammographic Breast Research Articles

Breast cancer awareness and knowledge assessment among men and women in Malaysia

The prevalence of breast cancer cases in Malaysia is 1 in every 20 women. Comprehending the risk factors and causation of breast cancer as well as enabling early diagnosis and treatment are important to prevent possible recurrence and fatality. Education on breast cancer plays a pivotal role in raising awareness and overcoming skepticism towards breast examination regimens. The present study aims to compare the awareness and knowledge levels between genders among the local residents of Klang Valley area, Malaysia. A cross-sectional descriptive study was conducted between October 2018 and January 2019, utilising a random convenient sampling technique. Recruitment of participants was undertaken at population-concentrated locations around the Klang Valley area. A total of 440 volunteers, 198 men and 242 women aged 18 years and above, completed the questionnaire via Google link using several electronic gadgets. Results have revealed that the majority of the residents, regardless of gender, have moderate knowledge or awareness with regard to breast cancer (76.5%), breast cancer symptoms (76.8%), and breast cancer risk factors (74.3%). However, female respondents possessed higher knowledge levels than male respondents with regard to breast cancer symptoms (p = 0.005), whereas a significant difference regarding the knowledge on breast cancer risk factors between genders is absent (p = 0.702). In terms of breast cancer screening methods, more females than males possessed sufficient knowledge about breast self-examination and mammography, constituting 50.8% and 68.2% respectively among the female demographic. Nevertheless, we perceived that the reluctance of breast examination may be due to cultural stigma and self-induced fear. This contemporary research certainly demonstrates an insufficiency of knowledge on breast cancer among the general population irrespective of gender, which further emphasises the relevance of literacy and awareness among the public to help conquer cancer.

Diagnostic Accuracy of Mammography and FNAC in Comparison to Gold Standard Histopathological Examination in Carcinoma Breast

Context: Screening and diagnostic efforts for breast cancer are critical because the disease has a high rate of successful outcomes with early identification and treatment. The mammography (MG) and fine needle aspiration cytology (FNAC) are individually effective diagnostic modalities for detection of breast pathologies. Aim: To compare the efficacy of mammography and FNAC in Cancer Breast. Setting & Design: The prospective study conducted on patients admitted for surgery for Breast lump or symptoms of breast malignancy in surgical wards of JLN Medical College, Ajmer and undergoing surgery for same with an aim to evaluate breast lesions using mammography and FNAC independently and in correlation with gold standard histopathology. Results: A total number of 100 cases of breast lump studied. The mammography, FNAC and histopathology results were collected and analysed. In present study, Mammography shows Sensitivity – 93.846, Specificity – 82.857, Positive Predictive value – 91.045, Negative Predictive Value – 87.87and Accuracy – 90. FNAC shows Sensitivity – 93.8, Specificity – 97.14, Positive Predictive value – 98.38, Negative Predictive Value – 89.474 and Accuracy - 95 Conclusion: This study confirms that the Mammography and FNAC have significantly higher sensitivity and NPV in detecting the both benign and malignant lesions of the breast. In the present study, FNAC has more accuracy in predicting breast cancer than mammogram. Association between FNAC and Mammography result was calculated to be.717 Key words: Breast lesions; fine needle aspiration cytology; mammography; histopathological examination. Key message: for successful treatment outcome of carcinoma breast early diagnosis is must.

Breast cancer in dense breasts: comparative diagnostic merits of contrast-enhanced mammography and diffusion-weighted breast MRI

BackgroundThe study was done to compare the value of contrast-enhanced mammography and diffusion-weighted breast MRI in dense breast screening and accurate detection of the breast cancer with correlation of the findings to the histopathological results.The study included 32 female patients having suspicious breast lesions and underwent digital mammography then scheduled for CESM and MRI DW imaging technique. The imaging findings were correlated to the histopathological findings.ResultsThe study was conducted on 40 breast lesions in 32 female patients having dense breasts; they were classified by the digital mammography into ACR C (59.4%) and ACR D (40.6%). By CESM, there were twenty three lesions (57.5%) as mass lesions and thirteen lesions (32.5%) as non-mass lesions. Four lesions (10%) showed no contrast enhancement. According to the lesion characteristics in diffusion-weighted imaging, the breast lesions were classified into thirty three lesions (82.5%) with restricted diffusion and seven lesions (17.5%) with non-restricted diffusion. The study showed a cutoff ADC value to detect the malignant lesions in the dense breasts ≤ 1.1 × 10-3 s/mm2 at b value of 1000 s/mm2 with a sensitivity of 96.77%, specificity of 66.67%, PPV of 96.77%, NPV of 55.55%, and an overall total accuracy of 92.5%.On comparing the diagnostic accuracy of the CESM to that of the DW MRI, the sensitivity of DW MRI (96.77%) was higher than that of CESM (90.32%). The specificity of DW MRI (66.67%) was higher than that of CESM (33.33%). Total accuracy of DW MRI was higher than that of CESM; they were 90% and 77.5%, respectively. Also, PPV and NPV of DW MRI were 90.91 and 85.71% as compared with 82.35 and 50.00% in CESM, respectively. When comparing the sensitivity of CESM to DW MRI in the detection of multiple breast lesions, they were 88.8 and 100%, respectively.ConclusionCESM is a useful technique in identification of hidden lesions in mammographically dense breasts. DW MRI is a fast, unenhanced modality that can be used as a breast cancer screening modality. CESM and DWI demonstrated good overall diagnostic accuracy in dense breast patients; however, DW MRI has a higher diagnostic accuracy than CESM for the detection of malignant breast lesions and their multiplicity.

Dosis glandular promedio en glándula mamaria y dosis de radiación en glándula tiroides y cristalino en mujeres con y sin implantes mamarios durante diferentes modalidades mamográficas

There have always been concerns about the secondary effects of diagnostic methods that use ionizing radiation. During mammography, the parameters to be concerned about are the mean glandular dose and the scatter dose. We evaluated the dose of radiation to the breast, thyroid gland, and lens in digital mammography in women with and without implants, in tomosynthesis in women with and without implants, and in contrast-enhanced mammography. Materials and methodsThe study included 212 women with and without disease who were attended at the Centro Clínico de Estereotaxia, CECLINES, in Caracas, Venezuela, between June 2017 and August 2017; the women were classified into five groups according to the mammographic modality used to evaluate them and whether or not they had implants. The statistical analysis included descriptive statistics for the study population. We used the Mann-Whitney U to compare the mean glandular dose and dose in the thyroid gland and lens between groups. ResultsThe mean glandular dose and the dose of radiation received in the thyroid and lens were within the acceptable range. In a few exceptions, the mean glandular dose per view was slightly higher than 3mGy. The scatter dose to the thyroid gland and the lens during mammography has a very small contribution to the annual dose equivalent. ConclusionThe mean glandular dose and the scatter dose to the thyroid gland and lens delivered during tomosynthesis and 2D mammography in women with implants were higher than those delivered during other mammographic techniques in women without implants.

Comparing the diagnostic efficacy of digital breast tomosynthesis with full-field digital mammography using BI-RADS scoring

BackgroundMammography has been the mainstay for the detection of breast cancer over decades. It has gradually advanced from screen film to full-field digital mammography. Tomosynthesis has evolved as advanced imaging for early diagnosis of breast lesions with a promising role in both diagnostic and screening settings, particularly in dense and treated breasts.ResultsThis study included 90 female patients according to our inclusion criteria. All patients perform full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and were classified according to breast density and age groups. Breast imaging reporting and data system (BI-RADS) scoring was assigned for each case. This was correlated with the final diagnosis; the diagnostic indices of mammography were a sensitivity of 64.44%, a specificity of 77.78%, a positive predictive value (PPV) 74.63%, a negative predictive value (NPV) of 68.63%, and a diagnostic accuracy of 71.11%. Diagnostic indices of DBT were a sensitivity of 100%, a specificity of 97.77%, PPV 97.78%, NPV 100%, and diagnostic accuracy of 97.7%.In patients with dense breasts American College of Radiology (ACR) (c and d), 61% of cases had changed their BIRADS scoring with the addition of tomosynthesis. Yet, in non-dense breast ACR (a and b), 45% of cases had changed BIRADS scoring with the addition of DBT to FFDM.ConclusionDBT is a promising imaging modality offering better detection and characterization of different breast abnormalities, especially in young females, and those with dense breasts with an increase of sensitivity and specificity than FFDM. This leads to a reduction in the recalled cases, negative biopsies, and assessing the efficacy of therapy as it enables improving detection of breast cancer and different breast lesions not visualized by conventional mammography

The Surgical Legacy of Randolph Lee Clark, Jr, MD: First Director and Surgeon-in-Chief of University of Texas MD Anderson Cancer Center II. Surgical Practice and Leadership at University of Texas MD Anderson Cancer Center (1946-1978).

Dr. R. Lee Clark Jr brought a broad-based cancer surgery experience to MD Anderson Hospital for Cancer Research when he became its first Surgeon-in-Chief and full-time salaried physician in 1946. He performed major surgery until 1971 including major head and neck operations, thyroidectomy, mastectomy, radical melanoma and sarcoma surgery, gastric and abdominal-perineal resection, and even hemipelvectomy. He initiated major programs in radiation therapy and mammography breast screening, and organized teams of specialists in a group practice providing multidisciplinary cancer care. Dr. Clark was elected into membership by the James Ewing Society (currently the Society of Surgical Oncology), the Southern Surgical Association, and the American Surgical Association, and was a founding member of the Society of Head and Neck Surgery. The Society of Surgical Oncology honored him with the Lucy Wortham James Award in 1965 and the James Ewing Lecture Award in 1977. Dr. Clark also provided invaluable leadership in the American College of Surgeons, leading a fledgling Committee on Cancer into a robust organization that became the Commission on Cancer. The College of Surgeons honored him with their Distinguished Service Award in 1969. Dr. Clark recruited major surgical leaders and personally designed the new hospital that opened in 1954, described in Time magazine as "the most modern, most ingeniously designed hospital in the U.S." R. Lee Clark, Jr. was an accomplished and busy clinical surgeon, a visionary and charismatic leader, and an organizational genius. Indeed, he was one of the first pioneers in the specialty of surgical oncology.

Clinico-pathological profile and survival outcome among patients with bilateral breast cancer : An Indian perspective

Background: The chance of survival from breast cancer has improved due to early detection and better treatment. Better surgical techniques have contributed to improved quality of life in breast cancer survivor patients. Improved life expectancy after breast cancer treatment and routine use of contralateral breast mammography has led to increased incidence of bilateral breast cancers.The aim of this study is to describe the clinicopathological profile of patients with bilateral breast cancer and to assess the survival outcome of these patients.

Factors associated with breast cancer screening intention in Kathmandu Valley, Nepal.

Breast cancer burden is increasing in low-income countries (LICs). Increasing incidence and delayed presentation of breast cancer are mainly responsible for this burden. Many women do not participate in breast cancer screening despite its effectiveness. Moreover, studies are limited on the barriers associated with low utilization of breast cancer screening in LICs. This study identified breast cancer screening behavior and factors associated with breast cancer screening intention among women in Kathmandu Valley, Nepal. A cross-sectional study was conducted among 500 women living in five municipalities of Kathmandu Valley, Nepal. Data were collected from July to September 2018, using a structured questionnaire. Interviews were conducted among women selected through proportionate random household sampling. This study was conceptualized using the theory of planned behavior, fatalism, perceived susceptibility, and perceived severity. The outcome variables included: the intention to have mammography (MMG) biennially, the intention to have clinical breast examination (CBE) annually, and the intention to perform breast self-examination (BSE) monthly. Analysis was conducted separately for each outcome variable using partial proportional odds model. Out of 500 women, 3.4% had undergone MMG biennially, 7.2% CBE annually, and 14.4% BSE monthly. Women with a positive attitude, high subjective norms, and high perceived behavioral control were more likely to have the intention to undergo all three screening methods. Similarly, women were more likely to have intention to undergo CBE and MMG when they perceived themselves susceptible to breast cancer. Conversely, women were less likely to have intention to undergo CBE when they had high fatalistic beliefs towards breast cancer. Women in this study had poor screening behavior. The practice of breast self-examination was comparatively higher than clinical breast examination and mammography. Multidimensional culturally sensitive interventions are needed to enhance screening intentions. Efforts should be directed to improve attitude, family support, and fatalistic belief towards cancer. Furthermore, the proper availability of screening methods should be ensured while encouraging women to screen before the appearance of symptoms.

EVOLUTION IN BREAST IMAGING

Evolution in breast imaging has dramatically changed and upgraded by wide variety of technologic advances from the early days of direct-exposure film mammography to xeromammography to screen-film mammography to the current era of full-field digital mammography and digital breast tomosynthesis. In early 1950 Mammography has been introduced along with the breast self examination. After two decades thermography and ultrasound examination has been added in the breast imaging . From year 1990 to 2000 drastic technological advances, organized screening, with BI-RAD classification introduced by American College of Radiology Breast Imaging Reporting and Data System have helped to shape the specialty of breast imaging. With the development of digital mammography and tomosynthesis in 2020, breast ultrasonography and breast magnetic resonance imaging, both complementary to mammography, has set new standard in diagnostic accuracy of breast lesions.This paper gives a quick insight to the development of breast imaging and reviews the evolution of breast imaging starting from a historical perspective and progressing to the present day.
 Keywords: Mammography screening, tomosynthesis ,Digital mammography.

Comparison of two-dimensional synthesized mammograms versus original digital mammograms: a quantitative assessment.

This study objectively evaluates the similarity between standard full-field digital mammograms and two-dimensional synthesized digital mammograms (2DSM) in a cohort of women undergoing mammography. Under an institutional review board-approved data collection protocol, we retrospectively analyzed 407 women with digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) examinations performed from September 1, 2014, through February 29, 2016. Both FFDM and 2DSM images were used for the analysis, and 3216 available craniocaudal (CC) and mediolateral oblique (MLO) view mammograms altogether were included in the dataset. We analyzed the mammograms using a fully automated algorithm that computes 152 structural similarity, texture, and mammographic density-based features. We trained and developed two different global mammographic image feature analysis-based breast cancer detection schemes for 2DSM and FFDM images, respectively. The highest structural similarity features were obtained on the coarse Weber Local Descriptor differential excitation texture feature component computed on the CC view images (0.8770) and MLO view images (0.8889). Although the coarse structures are similar, the global mammographic image feature-based cancer detection scheme trained on 2DSM images outperformed the corresponding scheme trained on FFDM images, with area under a receiver operating characteristic curve (AUC) = 0.878 ± 0.034 and 0.756 ± 0.052, respectively. Consequently, further investigation is required to examine whether DBT can replace FFDM as a standalone technique, especially for the development of automated objective-based methods.

Effect of Personalized Breast Cancer Risk Tool on Chemoprevention and Breast Imaging: ENGAGED-2 Trial.

BackgroundLimited evidence exists about how to communicate breast density-informed breast cancer risk to women at elevated risk to motivate cancer prevention.MethodsWe conducted a randomized controlled trial evaluating a web-based intervention incorporating personalized breast cancer risk, information on chemoprevention, and values clarification on chemoprevention uptake vs active control. Eligible women aged 40-69 years with normal mammograms and elevated 5-year breast cancer risk were recruited from Kaiser Permanente Washington from February 2017 to May 2018. Chemoprevention uptake was measured as any prescription for raloxifene or tamoxifen within 12 months from baseline in electronic health record pharmacy data. Secondary outcomes included breast magnetic resonance imaging (MRI), mammography use, self-reported distress, and communication with providers. We calculated unadjusted odds ratios (ORs) using logistic regression models and mean differences using analysis of covariance models with 95% confidence intervals (CIs) with generalized estimating equations.ResultsWe randomly assigned 995 women to the intervention arm (n = 492) or control arm (n = 503). The intervention (vs control) had no effect on chemoprevention uptake (OR = 1.04, 95% CI = 0.07 to 16.62). The intervention increased breast MRI use (OR = 5.65, 95% CI = 1.61 to 19.74) while maintaining annual mammography (OR = 0.98, 95% CI = 0.75 to 1.28). Women in the intervention (vs control) arm had 5.67-times higher odds of having discussed chemoprevention or breast MRI with provider by 6 weeks (OR = 5.67, 95% CI = 2.47 to 13.03) and 2.36-times higher odds by 12 months (OR = 2.36, 95% CI = 1.65 to 3.37). No measurable differences in distress were detected.ConclusionsA web-based, patient-level intervention activated women at elevated 5-year breast cancer risk to engage in clinical discussions about chemoprevention, but uptake remained low.

The effects of educational intervention on breast self-examination and mammography behavior: Application of an integrated model.

BACKGROUND:Breast cancer is the most common type of cancer among women and it is the second leading cause of mortality among cancers in women and a major health issue in developed countries. Although there are simple and effective screening methods, just minority of women use them. Given the high prevalence of breast cancer in Isfahan women and the low prevalence of screening behavior, the present study aimed to determine the impact of theory-based educational intervention on breast self-examination (BSE) behavior and mammography.MATERIALS AND METHODS:The present experimental study was conducted on 93 women referred to comprehensive health centers in Isfahan through convenience sampling, and by this way 46 women were included in the control group and 47 in the intervention group. Data collection was done by a valid and reliable questionnaire. Furthermore, educational interventions were performed for the intervention group in three sessions. Furthermore, the data were completed in the intervention group before, immediately after, and 3 months after intervention and before and 3 months after intervention in the control group. The data were analyzed by SPSS (16); and paired t-test and repeated measure test were used for analysis in the intervention group and also independent t-test and paired t-test were employed to analyze data of the control group.RESULTS:The results showed significant changes in perceived benefit constructs (P = 0.023), knowledge (P < 0.001), self-efficacy (P < 0.001), and behavioral intention regarding BSE (P = 0.035) in the intervention group over time, but changes were not significant in both perceived susceptibility and severity in the intervention group. As far as mammography behavior is concerned, only the perceived benefit construct in the intervention group had significant changes. In terms of the screening behavior, only BSE behavior significantly changed before and after intervention.CONCLUSION:The study showed that theory-based education by applying of constructs such as perceived benefits and self-efficacy and intention for BSE model could promote breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators utilize educational texts based on these constructs to increase their influence on individuals via screening behavior for breast cancer.

Women's Awareness Level on Breast Self-Examination

Aim: The aim of this study was to investigate the level of awareness, regarding the importance of breast self examination (BSE), clinical breast examination (CBE) and mammography, and the effects of education on these issues among patients who applied to family medicine outpatient clinic for follow-up or treatment purposes.Methods: This study was done by establishing a questionnaire form, after review of necessary litetarure, to be applied in patients who applied for follow-up or treatment in a district polyclinic affiliated to the department of family medicine of a tertiary care center in Ankara.Results: A total of 434 women aged between 18-56 years participated in the study. The mean age of the participants was 36.62±9,21 years. Although 258 (59.4%) of the participants reported that they performed BSE. 176 participants (40.6%) stated that they did not perform a BSE. The 38.2% of the participants have undergone a CBE and the 24 % of women expressed that they underwent a mammography.The frequency of BSE, CBE and undergoing mammography has been shown to increase significantly as education level increases. The rates of having a CBE and a mammography were also found to be statistically significantly higher in patients who had a family member with breast cancer.Conclusion: Our results demonstrated that the level of education was important for awareness on the early diagnosis of breast cancer. Thanks to efforts to increase educational level, we can get promising achievements regarding the awareness of both BSE, CBE and mammography performances.

Quadruple Score: A Novel Scoring System for Diagnosing Breast Lump - A Retrospective Pilot Study.

Background:Triple test was a breakthrough in the initial screening of breast cancer due to its high sensitivity, but it has few limitations. To overcome those limitations, we developed a novel quadruple score which included physical examination, ultrasound, mammography, and fine-needle aspiration cytology (FNAC).Aim:The aim of this study was to test the sensitivity, specificity, negative predictive value (NPV), and positive predictive value of a novel quadruple score for the initial screening of breast cancer.Methodology:This retrospective study was conducted on 320 patients having breast lump to the Breast Cancer Outpatient Department of AIIMS, Bhopal. The physical examination findings, breast sonography findings, mammography, and FNAC findings were recorded in the set pro forma, these were later analyzed, and a cumulative scoring was done categorizing patients in the benign, dubious, and malignant category according to the QTS score. These findings were then validated and compared by histopathology.Results:Statistical results show a positive covariance σ suggesting the positive relation between them; also, the correlation coefficient was 0.9996 suggesting a strong linear correlation. On comparing the accuracy of all four variables as physical examination, USG, mammography and FNAC individually and QTS, the accuracy of QTS was highest i.e 99.44%.Conclusion:QTS is accurate and reliable diagnostic approach for evaluation of breast lumps. By using the quadruple scoring system, management of palpable breast lump will become more streamlined, providing a platform for managing discordant results, which can be followed universally.

Mammogram uptake and barriers among Palestinian women attending primary health care in North Palestine

Background Breast cancer affects women's lives worldwide, yet early detection is an effective strategy for reducing mortality. The participation of women in mammography screening is linked to their knowledge, attitudes and perceived barriers. Objectives Our study aims to assess mammography screening uptake and barriers among women attending primary healthcare centres (PHCs) in northern Palestine. Methods Using an interviewer administered questionnaire, we used a cross-sectional study design to determine mammography screening uptake, knowledge and barriers among 357 women attending PHCs in Northern Palestine between December 2018 and March 2019. Results The mean age was 50 years. The majority (69.2%) were considered to have adequate knowledge about breast cancer and mammography screening. Mammography screening uptake among the participants was 37%. Almost 85% of the women had a positive attitude towards breastfeeding as a prophylaxis factor against breast cancer, while the most frequent barrier to mammography screening was that the participants believed they did not have any symptoms (28.6%), followed by 22.1% of them who did not want to know if they had breast cancer. Conclusion The findings of this study highlighted the low mammography uptake among Palestinian women despite the adequate knowledge of those women and the fully accessible and free screening programme. Hence, interventional strategies should be implemented at several levels to enhance mammogram uptake.

How, when, and where information about breast cancer in Brazil is found using Google

Introduction: This article sought to clarify the sources that women seek to find information about breast cancer. Methods: With a data collection from Google Trends, it was possible to list which keywords are most used when the population performs these searches and to know the volume of searches for the words “breast cancer” (câncer de mama), “breast self-exam” (autoexame de mama), and “mammography” (mamografia) from 2009 to 2019. Results: In the search for “breast cancer” (câncer de mama), it was seen that the searches for “breast cancer” (câncer de mama), “breast cancer symptoms” (câncer de mama sintomas), “symptoms of breast cancer” (sintomas de câncer de mama), “what is cancer of breast” (o que é câncer de mama), and “types of breast cancer” (tipos de câncer de mama) are the five most prevalent. Data were also displayed that reflect the importance of the awareness campaign for this type of cancer, the Pink October, since the months of October of the years in question were the ones that had the highest search volume for the keywords “cancer of breast” (câncer de mama), “breast self-examination” (autoexame de mama), and “mammography” (mamografia). In addition, it was noticed that many sites with a greater chance of getting hits due to their being in the first places in the survey did not have the name of the sources from which they had obtained their data and/or the names of the authors, and it was not possible to know the quality of the information published there. Conclusion: It is possible to notice the positive effect that the Pink October campaign has, which can contribute to a greater awareness of the importance of breast self-examination and mammography. In addition, it is necessary to be careful when looking for information in the online environment, since not all sites inform the source and/or the name of the author of the article.

Racial and Ethnic Differences in Preventive Services Use After the Affordable Care Act’s Enhancement of Medicare Benefits

As a consequence of the Affordable Care Act’s enhancements of Medicare benefits, certain recommended clinical preventive services became available to Medicare beneficiaries without cost-sharing. We study the impact of these mandates on racial/ethnic disparities in the use of preventive services among traditional Medicare beneficiaries. We analyze nationally representative data on non-institutionalized Medicare seniors from the 2006-2016 Medical Expenditure Panel Survey (N=27,124). Our preventive services of interest include yearly receipt of cholesterol check, blood pressure test, flu shot, endoscopy, blood stool test, clinical breast examination, mammography and prostate exam. We estimate propensity score weighted difference-in-difference (DID) models to test for differences in preventive services utilization by race/ethnicity. Among traditional Medicare beneficiaries, we do not observe significant change in the use of most preventive services for Blacks and Hispanics compared to their White counterparts. However, Hispanics have significantly increased their use of blood stool tests relative to whites. Overall, we do not find major evidence to support a differential effect of reforms on race/ethnic minorities’ uptake of preventive services following the mandates. Our results suggest that despite an overall benefit trough services expansion and cost-sharing elimination race/ethnic group differences persist. As such, disparities might continue and would require additional interventions. Reduction in disparities is a stated goal of US policy for many decades and achieving equity might require additional work and more varied and targeted interventions.

Distribution of pressure on the breast in mammography using flexible and rigid compression plates: implications on patient handling.

Breast compression in mammography is important but is a source of discomfort and has been linked to screening non-attendance. Reducing compression has little effect on breast thickness, and likely little effect on image quality, due to force being absorbed in the stiff juxta thoracic area instead of in the central breast. To investigate whether a flexible compression plate can redistribute force to the central breast and whether this affects perceived pain. Twenty-eight women recalled from mammography screening were compressed with flexible and rigid plates while retaining force and positioning, 15 in the craniocaudal (CC) view and 13 in the mediolateral oblique (MLO) view. Pressure distribution was continuously measured using pressure sensors. The flexible plate showed greater mean breast pressure in both views: 2.8 versus 2.3 kPa for CC (confidence interval [CI] = 0.2-0.8) and 1.0 versus 0.5 kPa for MLO (CI = 0.2-0.6). The percentage of applied force distributed to the breast was significantly higher with the flexible plate, both on CC (36% vs. 22%, CI = 1-11) and MLO (30% vs. 14%, CI = 4-13). The flexible plate redistributes pressure to the central breast, achieving a better compression, particularly in the MLO view, though much applied force is still applied to the juxta thoracic region.

Mammographic density and its association with molecular subtype of breast cancer.

Background: Breast cancer is the leading cause of death in women globally. The present study aimed to determine the prevalence of different mammographic density of breast parenchyma along with the association with the molecular subtype of breast cancer.&#x0D; Methodology: The present cross-sectional study was conducted among breast cancer females age 40 and above. The study participants' demographic and clinical data, such as age, sex, menstrual status, gravida, parity, and lactation, were collected using a standard questionnaire. The anthropometric parameters were taken by using the standard techniques. Breast physical examination, mammography, and ultrasound were done. The ultrasound did the breast tumor biopsy -guided techniques and histopathology, and immunohistochemistry was used to identify the molecular subtype of breast cancer. The univariate and multivariate statistic was performed on SPSS version 20.0.&#x0D; Results: Most of the patients&lt;50 years were human epidermal growth factor receptor (HER2), estrogen receptor (ER), progesterone receptor (PR) positive, and are overweight too. Similar findings were noted among lactating and multigravida patients. The Grade I tumor and dense breast patients were 100% with HER2 negative and ER, PR positive. Most heterogeneous dense and fibroglandular containing breast patients were ER, PR positive. There is a significant correlation between BMI, microcalcification, and HER2 positive. Most of the triple Negative and Luminal-B were heterogeneous dense.&#x0D; Conclusion: In conclusion, a significant association between the mammographic density parameters and molecular breast cancer subtype, particularly Luminal-A and luminal B, was seen. The ER, PR, and HER-2 have a positive correlation with the physical radiographical and mammodensity parameters.

Abstract PO-152: A systematic review and meta-analysis of the prevalence of breast cancer in Africa: Identifying unanswered questions

Abstract Introduction One major limitation to cancer prevention and control in Africa has been lack of accurate and reliable epidemiological data. To date, there is no publicly available systematic review and meta-analysis on the prevalence of breast cancer in Africa. This data is important to understand the burden of the disease in Africa and identify areas lacking reliable studies. Objective The objective of this review was to examine the prevalence of breast cancer in Africa based on region, subtype, and screening. Methods A systematic search of MEDLINE, EMBASE, PUBMED, ISI Web of Science, BIOSIS, African Journal Online, and Global Health was conducted. We included population-based or hospital-based cancer registry studies on breast cancer conducted on African populations and providing estimates of breast cancer cases or prevalence over a period. A random effect meta-analysis was done to determine the pooled prevalence of breast cancer in Africa based on region, subtype and screening, using Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC. Results Our search of databases yielded 2030 references that were imported into Covidence. A total of 44 studies were included in the review. The overall pooled prevalence of breast cancer in Africa was 0.48% (95% CI: 0.05-0.92). With regards to regional prevalence, the estimated prevalence of breast cancer among women in Sub-Saharan Africa (SSA), 0.68% (-0.03 - 0.1.39) was remarkably higher than that of women in North Africa (NA) 0.16% (95% CI: -0.11-0.42). Also, the overall prevalence of triple negative breast cancer (TNBC) among female breast cancer patients was 29.51% (CI: 23.94-35.08). A sub-group analysis revealed, TNBC was more prevalent in women from SSA 29.51 (CI: 23.94- 35.08, 18 studies) than women from NA 20.17(14.63-25.71, 8 studies). Meta-analysis of African women participation in Breast Self-Examination (BSE) produced a prevalence of 29.57 (CI: 7.90-51.25). This was higher than the prevalence of African women participation in Clinical Breast Examination and mammography, 12.22 (7.58-16.86). Conclusions Though the incidence of breast cancer in Africa is relatively low, the same cannot be said of its prevalence. Also, within Africa, there are clear regional and sub-regional differences in both breast cancer prevalence and the prevalence of TNBC among breast cancer patients. This may be attributed to limited infrastructure needed for breast cancer control and prevention especially within SSA regions. Establishment of robust hospital-based cancer registries in Africa will boost the collection of accurate and complete cancer data that can be used in epidemiological research, patient care improvement, and cancer control which will ultimately lead to the reduction of breast cancer burden in Africa. Citation Format: Livingstone Aduse-Poku, Kurt Fernando, Sabrina I. Fossi, Sylvester Antwi, Haythem Ali, Eleanor Walker, Evelyn M. Jiagge. A systematic review and meta-analysis of the prevalence of breast cancer in Africa: Identifying unanswered questions [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-152.