Regular Mammography Research Articles

Predictive Analysis of Breast Cancer from Full-Field Digital Mammography Images using Residual Network

Breast cancer has been a significant contributor to cancer-related mortality, but advancements in early detection through regular mammography and improvements in treatment modalities have contributed to declining mortality rates in several regions. This study presents a novel approach to cancer diagnosis utilizing Full-Field Digital Mammography images through predictive analysis methods. By using predictive analytic techniques and mammography images, this study offers a novel way to cancer detection. The research involves the application of deep learning techniques to extract valuable insights from cancer images captured by mammography devices. The CBIS-DDSM (Curated Breast Imaging Subset of Digital Database for Screening Mammography) dataset including images from patients with varying types and stages of cancer, is collected and pre-processed to ensure uniformity and quality. Relevant features, including color, texture, and shape characteristics, are extracted, and a rigorous feature selection process is employed to identify discriminative markers. The Residual Network (ResNet) model is selected and trained on the dataset, with a focus on classification accuracy and robust predictive performance. Validation metrics, such as accuracy, IoU (Intersection over Union) score, dice score, and ROC (Receiver Operating Characteristic) curve are employed to evaluate the model’s efficiency. After analysis, the proposed method had the best degree of mass lesion detection accuracy, at 99.24%. This research contributes to the advancement of non-invasive and efficient diagnostic tools, potentially enhancing early detection and intervention in cancer patients. The proposed method not only demonstrates promising results in terms of diagnostic accuracy but also emphasizes interpretability, seamless integration into clinical workflows, and adherence to ethical standards.

Abstract A015: Small area-estimation for low mammography screening: Geographic and racial disparities in mammography screening, 2015 – 2022

Abstract Background: Mammography screening is associated with at least a 20% reduction in breast cancer mortality. However, there are racial/ethnic differences in breast cancer mortality. For example, non-Hispanic Black (NHB) women are significantly more likely to die of breast cancer than non-Hispanic White (NHW) women. Few studies have reported small-area estimates for mammography screening among the entire US population; differences by race were either not examined or resulted in mixed findings. The American Cancer Society (ACS) and the United States Preventive Services Taskforce (USPSTF) recommend regular mammography screening from age 40 through 74 years. The current study aims to identify areas of up-to-date mammography screening and to elucidate whether mammography screening varied by geographical location, race, or ethnicity. Methods: Mammography screening within the past 12 months was retrieved from the 2015-2022 Behavioral Risk Factor Surveillance System data. The study population consisted of adult women aged 40 and older residing within the United States. 2020 US census tract population estimates were used to generate gender (all women), race/ethnicity (NHB, NHW, non-Hispanic Asian, and Hispanic/Latina), income, and age group weights for each US census tract. Synthetic estimates of mammography screening uptake at the census tract were conducted using our novel PARIS model (Probability of mammography screening within the past year, given age, race/ethnicity, income, and state) using a multilevel logistic regression model. Regional differences in mammography screening by US Census Bureau regions and divisions were examined. Results: Up-to-date mammography among all women in the sample was 55.98% (SD = 2.07; F (3, 72429) = 2886.81, p < .0001). Mammography screening examined by race indicated the greatest screening rates among non-Hispanic Black women (M = 60.78, SD = 3.11) and least among Asian women (M = 48.68, SD = 3.15). Among four US Census Bureau regions, the West region had the lowest rates of mammography screening among women (M = 54.74, SD = 1.85) while the South region had the highest rates (M = 56.55, SD = 2.18; F(3, 72429) = 2886.81, p < .0001). After further parsing geographical units, the West Pacific region, among the 9 US Census Bureau divisions, had the lowest mammography screening (M = 54.53, SD = 1.81) while the East South Central division had the highest rates of mammography screening (M = 56.94, SD = 2.10; F(8, 72429) = 1360.60, p < .0001).Conclusion: Using novel geospatial methods, the current study elucidated significant differences in mammography screening by race and place. These results suggest that Black women and women living in the South have higher up-to-date mammography screening compared to other women. Thus, the existing inequities in breast cancer outcomes may be explained by differences in the cancer care continuum (delays in follow-up care, treatment, and breast cancer survival). Further examination of the interplay between screening uptake, late-stage diagnosis, and death is needed. Citation Format: Sydney P. Howard, Justin X. Moore, Elinita Pollard, Ryan Johnson, Lovoria Williams, Adebola Adegboyega, Jie Chen, Jorge Cortes, Aimee James. Small area-estimation for low mammography screening: Geographic and racial disparities in mammography screening, 2015 – 2022 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A015.

Clinical breast exam contribution to breast cancer diagnosis in BRCA mutation carriers vs. average to intermediate risk women

PurposeThe contribution of clinical breast exam (CBE) to breast cancer diagnosis in average risk women undergoing regular screening mammography is minimal. To evaluate the role of CBE in high-risk women, we compared BC diagnosis by CBE in BRCA mutation carriers undergoing regular BC surveillance to average to intermediate risk women undergoing regular breast cancer screening.MethodsA retrospective chart review of all consecutive screening visits of BRCA mutation carriers (January 2012–October 2022) and average to intermediate risk women (November 2016–December 2022) was completed. Women with histologically confirmed BC diagnosis were included. Additional CBE yield for BC diagnosis, defined as the percentage of all BC cases detected by CBE alone, was assessed in both groups.ResultsOverall, 12,997 CBEs were performed in 1,328 BRCA mutation carriers in whom 134 BCs were diagnosed. In 7,949 average to intermediate risk women who underwent 15,518 CBEs, 87 BCs were diagnosed. CBE contributed to BC diagnosis in 3 (2%) BRCA mutation carriers and 3 (4%) non-carriers. In both groups, over 4,000 CBEs were needed in order to diagnose one cancer. In all 3 BRCA mutation carriers BC was palpated during the surveillance round that did not include MRI. In the average to intermediate risk group, 2 of 3 cancers diagnosed following CBE findings were in a different location from the palpable finding.ConclusionsThe contribution of CBE to BC diagnosis is marginal for all women including BRCA mutation carriers. In BRCA mutation carriers, CBE appears redundant during the MRI surveillance round.

Arterial Calcification Disappearance in Breast Imaging: A Key Indicator for Transition to Invasive Ductal Carcinoma.

A woman in her 70s, initially suspected of having fibroadenoma due to a well-defined mass in her breast, underwent regular mammography and ultrasound screenings. Over several years, no appreciable alterations in the mass were observed, maintaining the fibroadenoma diagnosis. However, in the fourth year, an ultrasound indicated slight enlargement and peripheral irregularities in the mass, even though the mammography images at that time showed no alterations. Interestingly, mammography images over time showed the gradual disappearance of previously observed arterial calcification around the mass. Pathological examination eventually identified the mass as invasive ductal carcinoma. Although the patient had breast tissue arterial calcification typical of atherosclerosis, none was present around the tumor-associated arteries. This case highlights the importance of monitoring arterial calcification changes in mammography, suggesting that they are crucial indicators in breast cancer diagnosis, beyond observing size and shape alterations.

Rhode Island (RI) Women's Breast Cancer Mammography Use Prior to and After Cancer Diagnosis: Linkage of RI Cancer Registry Data With RI All-Payer Claims Database.

A limitation of the central cancer registries to examine associations between mammography use and cancer diagnosis is their lack of cancer screening history. To fill this measurement gap, Rhode Island Cancer Registry (RICR) breast cancer (BC) records were linked to Rhode Island-all-payer claims database (RI-APCD) to study Rhode Island (RI) women's regular mammography use and identify its predictors. From the linked 2011-2019 data, we identified 4 study cohorts: (1) women who ever received mammography by Women's Cancer Screening Program (WCSP) and were diagnosed with BC ("WCSP-BC" cohort: n = 149), (2) women diagnosed with BC outside of WCSP (BC-control cohort: n = 4304), (3) women with a history of mammography use at WCSP but no BC diagnosis (n = 6513), and (4) general RI women with no BC diagnosis (n = 15 121). Logistic regressions were conducted to identify predictors of regular mammography use. The linkage for RI-APCD and RICR for our study had a high matching rate of 82%. Mammography use prior to BC diagnosis was not different between the WCSP-BC cohort and the BC-control cohort (58% vs 57%). Women in the BC-control cohort who had mammography in 2 years prior to their cancer diagnosis were more likely of being diagnosed at an early-stage disease. Among BC-control group, women with no anxiety/depression or with no preventive examinations were less likely of regular mammography use. Among women with no BC, a lower proportion of women with a history of screening at WCSP had regular mammography use, compared with the general RI women (38% vs 66%). RI-APCD data linkage with RICR provides excellent opportunities to examine regular mammography use among RI women and compare their outcomes to the general women population in the state. We identified opportunities for improving their mammography use. A measurement gap in the central cancer registries can be effectively reduced by utilizing statewide claims database.

A randomized controlled trial of a tailored navigation intervention to promote breast and cervical cancer screening among intergenerational Southeast Asian women

BackgroundCancer is the leading cause of death for Southeast Asian women in the U.S. Southeast Asian women have significantly high rates of breast and cervical cancers, yet are least likely to obtain regular mammography and Pap testing of all racial/ethnic groups in the U.S. ObjectivesThe purpose of this study is to compare a tailored navigation intervention delivered by bilingual and bicultural Community Health Advisors to information and reminder only to increase age-appropriate breast and cervical cancer screening completion among Southeast Asian women. MethodsThe Southeast Asian Women's Health Project study will enroll 232 Cambodian, Filipino, Lao, and Vietnamese women who are not up to date with their breast and cervical cancer screenings. Women randomized to navigation will receive the intervention for 10 weeks. Women in the information group will be mailed information on mammography and Pap testing only. All participants will be contacted post-enrollment to assess screening completion. DiscussionWe will examine intervention efficacy, predictors of each intervention group, and the influence of intergenerational exchange of breast and cervical cancer screening information between mothers and daughters. We will disseminate study results locally to the community, nationally at conferences, and through peer-reviewed journals.

Association between breast diseases and symptomatic uterine fibroids by using South Korean National Health Insurance database

Both the uterus and breasts have sex hormone dependence, yet there are few studies on the association between breast disease and uterine fibroids (UFs). The purpose of this study was to investigate the incidence of benign breast disease (BBD), carcinoma in situ (CIS), and breast cancer (BC) in women treated for UFs compared to women who were not treated for UFs. This retrospective cohort study used national health insurance data from January 1st, 2011, to December 31st, 2020. We selected women between 20 and 50 years old who (1) were treated for UFs (UF group) or (2) visited medical institutions for personal health screening tests without UFs (control group). We analyzed independent variables such as age, socioeconomic status (SES), region, Charlson comorbidity index (CCI), delivery status, menopausal status, menopausal hormone therapy (MHT), endometriosis, hypertension (HTN), diabetes mellitus (DM), and dyslipidemia based on the first date of uterine myomectomy in the UF group and the first visiting date for health screening in the non-UF group. There were 190,583 and 439,940 participants in the UF and control groups, respectively. Compared with those of the control group, the RRs of BBD, CIS, and BC were increased in the UF group. The hazard ratios (HRs) of BBD, CIS, and BC in the UF group were 1.335 (95% confidence interval (CI) 1.299–1.372), 1.796 (95% CI 1.542–2.092), and 1.3 (95% CI 1.198–1.41), respectively. When we analyzed the risk of BC according to age at inclusion, UFs group had the increased risk of BCs in all age groups in comparison with control group. Women with low SES (HR 0.514, 95% CI 0.36–0.734) and living in rural areas (HR 0.889, 95% CI 0.822–0.962) had a lower risk of BC. Our study showed that women with UFs had a higher risk of BBD, CIS, and BC than those without UFs. This result suggests that women with UFs should be more conscious of BC than those without UFs. Therefore, doctors should consider recommending regular breast self-exams, mammography, or ultrasound for the early detection of BC in women with UFs.

Artificial intelligence for breast cancer detection in screening mammography in Sweden: a prospective, population-based, paired-reader, non-inferiority study

Artificial intelligence (AI) as an independent reader of screening mammograms has shown promise, but there are few prospective studies. Our aim was to conduct a prospective clinical trial to examine how AI affects cancer detection and false positive findings in a real-world setting. ScreenTrustCAD was a prospective, population-based, paired-reader, non-inferiority study done at the Capio Sankt Göran Hospital in Stockholm, Sweden. Consecutive women without breast implants aged 40-74 years participating in population-based screening in the geographical uptake area of the study hospital were included. The primary outcome was screen-detected breast cancer within 3 months of mammography, and the primary analysis was to assess non-inferiority (non-inferiority margin of 0·15 relative reduction in breast cancer diagnoses) of double reading by one radiologist plus AI compared with standard-of-care double reading by two radiologists. We also assessed single reading by AI alone and triple reading by two radiologists plus AI compared with standard-of-care double reading by two radiologists. This study is registered with ClinicalTrials.gov, NCT04778670. From April 1, 2021, to June 9, 2022, 58 344 women aged 40-74 years underwent regular mammography screening, of whom 55 581 were included in the study. 269 (0·5%) women were diagnosed with screen-detected breast cancer based on an initial positive read: double reading by one radiologist plus AI was non-inferior for cancer detection compared with double reading by two radiologists (261 [0·5%] vs 250 [0·4%] detected cases; relative proportion 1·04 [95% CI 1·00-1·09]). Single reading by AI (246 [0·4%] vs 250 [0·4%] detected cases; relative proportion 0·98 [0·93-1·04]) and triple reading by two radiologists plus AI (269 [0·5%] vs 250 [0·4%] detected cases; relative proportion 1·08 [1·04-1·11]) were also non-inferior to double reading by two radiologists. Replacing one radiologist with AI for independent reading of screening mammograms resulted in a 4% higher non-inferior cancer detection rate compared with radiologist double reading. Our study suggests that AI in the study setting has potential for controlled implementation, which would include risk management and real-world follow-up of performance. Swedish Research Council, Swedish Cancer Society, Region Stockholm, and Lunit.

Barriers to Using Breast Cancer Screening Methods Among Adult Females in Jeddah, Saudi Arabia: A Cross-Sectional Study.

Introduction Breast cancer (BC) is one of the most common cancers worldwide and it considerably increases morbidity and mortality globally. Screening methods, such as self-examination, clinical examination, and mammography, can help in early detection and treatment, which will help in improving survival rates and reducing mortality. While regular screening of the breast is essential to detect the earliest stages of breast cancer, not all women adhere to regular breast screening. Methods A cross-sectional study was conducted in Jeddah, Saudi Arabia, between December 2021 to July 2022. using an online self-administered questionnaire. The total number of responses (n = 328), Data was analyzed using SPSS 25. Results In this study, out of the 328 respondents, 18.9% reported undergoing regular mammography, 14.3% reported having regular clinical breast examinations, and 38.1% reported practicing regular breast self-examinations.. In addition, the participants' most known warning signs of BC were a lump under their armpit (69.1%). the most perceived barrier to breast self-examination (BSE) was Doing a breast examination will make her worry about what is wrong with her breast (47%). whereas the most barrier to clinical breast examination (CBE) was embarrassment (45.9%). On the other hand, the main barriers that prevented women from having mammograms were embarrassment (36%) and pain (32.6%). Conclusion The most perceived barrier to BSE was women's concern, while embarrassment and painful procedures were significant barriers to performing mammography and CBE. Therefore, adult females in Jeddah need educational programs to improve their knowledge and increase public awareness of breast cancer screening for early detection.

Comparative accuracy of sonography, mammography and the BI-RADS characterization of breast masses among adult women at Mulago Hospital, Uganda

Background Breast cancer is common among Ugandan women and mortality rate is significantly high. Uganda, like many low-income countries, has no national regular mammography screening programme, a gold standard in breast cancer imaging. Breast ultrasound and Breast Imaging Reporting and Data System (BI-RADS) classification is thus being promoted as a supplemental evaluation tool for breast masses. However, studies on the comparative accuracy of breast sonography, mammography and BI-RADS from low-income settings are limited. This study aimed to determine the accuracy of breast ultrasound, mammography and BI-RADS classification against histology in the evaluation of breast masses among adult women. Methods This was a cross-sectional study conducted at Mulago National Referral Hospital involving women with breast masses. The women underwent breast ultrasound, mammography and needle biopsy for histological analysis. The breast lesions were also evaluated against the BI-RADS characterization criteria. Results Overall, 212 breast masses were evaluated and included in the analysis. Of these, 50% (106) were benign and 50% (106) were malignant. The sensitivity for ultrasound and mammography separately was 68.5% and 72.5% respectively. The sensitivity for ultrasound and mammography combined was 85%. BI-RADS 5 category had the highest sensitivity at 59.9% while the highest specificity was noted among BI-RADS 3 and 5 at 100%. The highest accuracy was noted in the BI-RADS 5 category at 79.9%. Conclusions Findings from this study demonstrate that combining ultrasound and mammography could have a higher sensitivity and diagnostic accuracy than when these imaging modalities are used independently. In addition, the BI-RADS reporting classification has an optimum positive predictive value and should be promoted to standardize breast imaging reporting.

Rurality Impacts Mammography Screening Adherence Among Mid-life Women in the Kansas Region.

The gold standard for breast cancer screening and prevention is regular mammography; thus, understanding what impacts adherence to this standard is essential in limiting cancer-associated costs. We assessed the impact of various understudied sociodemographic factors of interest on adherence to the receipt of regular mammograms. A total = 14,553 mammography-related claims from = 6,336 female Kansas aged between 45 and 54 were utilized from insurance claim databases furnished by multiple providers. Adherence to regular mammography was quantified continuously via a compliance ratio, used to capture the number of eligible years in which at least one mammogram was received, as well as categorically. The relationship between race, ethnicity, rurality, insurance (public/private), screening facility type, and distance to nearest screening facility with both continuous and categorically defined compliance were individually assessed via Kruskal-Wallis one-way ANOVAs, chi-squared tests, multiple linear regression models, and multiple logistic regression, as appropriate. Findings from these individual models were used to inform the construction of a basic, multifaceted prediction model. Model results demonstrated that all factors race and ethnicity had at least some bearing on compliance with screening guidelines among mid-life female Kansans. The strongest signal was observed in the rurality variable, which demonstrated a significant relationship with compliance regardless of how it was defined. Understudied factors that are associated with regular mammography adherence, such as rurality and distance to nearest facility, may serve as important considerations when developing intervention strategies for ensuring that female patients stick to prescribed screening regimens.

Barriers and Facilitators to Breast Cancer Screening for Women With Severe Mental Illness.

Women with severe mental illness (SMI) are diagnosed with breast cancer at later stages, with greater mortality rates than the general population. Although breast cancer screening is an acknowledged strategy for early breast cancer detection, women with SMI are 32% to 50% less likely to have regular mammography screenings, yet the specific factors related to the disparity in this population have not been determined. The purpose of this study was to identify the barriers and facilitators toward breast cancer screening in women diagnosed with SMI. In collaboration with a community-based mental health services agency, women aged 40 and older, diagnosed with SMI, and treated at that agency, were identified and asked if they were willing to participate. Fifteen women agreed to be interviewed. An interpretive descriptive approach was utilized to analyze the qualitative data. The themes elicited included barriers and facilitators to screening. Barriers found were: Psychiatric Symptoms, Fear, Distrust in the Health care System, and Not my Priority. Among the facilitators were Support, Good Health care Experiences, Make it Easy, Integrated Care, and Self-Care. Unique to this study was the understanding by participants that physical health needed to be integrated into their mental health care services through direct support and education, primarily because the process of recovery from mental illness itself entailed the increasing ability for self-care, encompassing a focus on both mental and physical health needs and preventive care.

Evaluation of Arab Cultural Barriers That Influence Muslim Arab Iraqi Women's Breast Cancer Screening Behavior.

Little is known about Iraqi women's practice towards breast cancer screening (BCS), breast self-examination (BSE), clinical breast examination (CBE) and mammography, and the influence of Arab culture. The aim of this study was to assess women's behavior towards BCS, and to explain the influence of specific Arab culture barriers. This descriptive study was carried out with 1,066 women. Three structured questionnaires were used in the data collection. Descriptive statistics and multivariable logistic regression were used for data evaluation. Many Iraqi women did not practice regular BSE, CBE, and mammography. The most common reason was "not having a breast complaint". Specific Arab cultural barriers such as exposure [odds ratio (OR) = 0.545; 95% confidence interval (CI) = 0.440 to 0.674; p<0.001], environment (OR = 0.571; 95% CI = 0.464 to 0.703; p<0.001) and uneasiness barriers (OR = 0.736; 95% CI = 0.557 to 0.974; p=0.032) were predictors for BSE while exposure (OR = 0.553; 95% CI = 0.447 to 0.684; p<0.001), and environment barriers (OR = 0.585; 95% CI = 0.474 to 0.772; p<0.001) was predictor for CBE. Additionally, exposure (OR = 0.324; 95% CI = 0.251 to 0.419; p<0.001), environment (OR = 0.636; 95% CI = 0.500 to 0.809; p<0.001), and uneasiness barriers (OR = 0.644; 95% CI = 0.464 to 0.893; p = 0.008) were predictors for mammography screening of Iraqi women. Arab specific cultural barriers may be one of the key obstacles to BSC uptake in Iraq. Health education, including cultural education, may have the potential to increase BCS awareness and down-staging of the disease at presentation.

Factors Affecting Women's Participation in Breast Cancer Screening in Turkey.

Background:Breast cancer is the most frequent cancer type in Turkey and the rest of the world. Regular mammography screening leads to a significant decrease in breast cancer mortality rates. The aim of this study is to analyze the factors that affect Turkish women’s participation in screening. Methods:This qualitative research design is grounded in a phenomenological approach. Fifteen women were selected using a purposive sampling method and participated in in-depth interviews. Interview data was analyzed using thematic content analysis. Results:The breast has a special meaning for participants which is heavily associated with feminity. Breast cancer causes fear because of its potential to undermine women’s sense of feminity. Women’s knowledge about the screening services and the mammography procedure is insufficient with only one third of women obtaining information about screening from healthcare workers. Individual and social factors that affect women’s participation in screening are women’s roles in the family, knowledge and awareness of breast cancer and screening, fear of cancer, anxiety about getting a mammogram, need for spouse-family support, and concerns for privacy. Organizational factors that affect participation are accessibility of breast cancer screening services, guidance given by and communication with healthcare professionals. Conclusion:Women should be better informed about breast cancer and screening services by healthcare professionals. Accessibility of mammography screening should be increased by expanding mobile services. National and institutional policies should be implemented to overcome women’s anxiety and socio-cultural barriers to increase participation in screening.

Investigation of breast cancer screening among the women of Khorramabad (west of Iran): A cross-sectional study

Abstract. Breast cancer is the most common women's cancer that more than 90% of the patients can be treated or even cured through early diagnosis. So we intend to investigate the status of breast cancer screening in Khorramabad, a city in the west of Iran. In the present cross-sectional study, the study population included 457 number of 20 to 65 year old women referring to the health centers of Khorramabad during the second half of 2015 to receive health care services. The sampling method was multistage random-cluster. A multi-part questionnaire were used. Fisher exact test, chi-square and independent t tests were used to analyze the data. The regular self-breast exam (SBE) had been carried out by 12.3% of the women, visiting doctors for regular clinical breast exam (CBE) had been done by 6% of the respondents and regular mammography every one to two years had been performed by 2.4% of the women. A statistically significant relationship was seen between occupation (P = 0.001), regular consumption of contraceptive pills (P = 0.032), history of breastfeeding, history of breast cancer in the first degree relatives (P = 0.001), and a history of cancer in the second degree (P = 0.005) relatives, and the regular SBE. Planning to enhance the women's awareness about breast cancer and the methods of early diagnosis and designing educational programs can be an important step to reduce deaths and disabilities caused by this disease among the women in such deprived cities.

Barriers to breast cancer screening in Iranian females: a review article

Breast cancer is one of the most common malignancies among females in Iran. Screening and detection in the early stages can increase the likelihood of breast cancer treatment and prognosis, thereby decreasing the mortality rate and promoting patient survival. However, mass screening programs for breast cancer are still confronted by predominant barriers in Iran. We tried to review and recognize the barriers to breast cancer screening and early detection in Iranian females as the main research question. We searched all available databases, and screened manuscripts for eligibility according to our inclusion/exclusion criteria. The search strategy was based on the following keywords: Breast, Malignancy, Cancer, Screening, Early Detection, Mammography, Iran, and Barrier. Responsible authors performed a literature review and compiled the results into a report. Various perceived barriers at different levels (individual, intrapersonal, health systems, and community) play influential and pivotal roles in women’s decisions to participate in breast cancer screening programs to facilitate early detection. Lack of awareness, neglect, procrastination, embarrassment, religious beliefs, and lack of primary health workers awareness and recommendation were cited as perceived barriers in screening procedures in Iran. There are still barriers in performing mammography at population levels in five major dimensions including availability, accessibility, cost, fears, and acceptability. However, the rate of regular mammography utilization in Iran is low compared with other countries and needs increasing through informing women. Many perceived barriers can affect women’s willingness and self-efficacy in screening procedures and one of the most effective ways of overcoming these barriers is to increase women’s awareness.

Predictive Factors of the Regular Mammography Screening among Korean Chinese Women in Korea

Predictive Factors of the Regular Mammography Screening among Korean Chinese Women in Korea

Unusual presentation of dermal microcalcifications on mammography images: A case report

Introduction. Calcifications and microcalcifications are mineral deposits in the breast tissue. Breast calcifications are a common mammographic finding, present on over 80% of images, and they are usually benign. Characteristics such as size, shape, number, distribution pattern, location, density, and other findings help determine the pathology. Dermal calcifications of the breast are superficial and benign calcifications that are usually found on the sebaceous glands of the skin. In some cases, calcifications can be the first marker of underlying cancer development. They may be associated with the presence of ductal carcinoma in situ or even invasive ductal carcinoma that has spread to the surrounding breast tissue. By correct identification of benign calcifications as such, unnecessary interventions and use of limited resources can be avoided. Case Report. A 66-year-old female patient presented for a regular mammography check-up. On the previous mammographic examination, she was categorized as bilateral breast imaging reporting and data system 1. The new mammography images showed numerous newly formed grouped microcalcifications at the junction of the lower quadrants of the right breast, and a stereotactic vacuum-assisted biopsy was indicated. During the biopsy attempt, the image guided biopsy program did not detect any calcifications in the parenchyma or in any projection and therefore it did not allow the biopsy procedure to continue after several attempts. Examination of the right breast skin revealed lesions treated by the patient for a few weeks; a repeat mammogram was performed and it was observed that the calcifications were of dermal origin. Conclusion. Dermal calcifications are mostly tiny, about the size of skin pores, single or clustered, and often have a calcified rim surrounding a lucent center. However, dermal calcifications deserve a special attention, because they sometimes lack a lucent center and simulate grouped intraparenchymal calcifications that require careful monitoring or biopsy.

Breast Density and Risk of Interval Cancers: The Effect of Annual Versus Biennial Screening Mammography Policies in Canada

Regular screening mammography reduces breast cancer mortality. However, in women with dense breasts, the performance of screening mammography is reduced, which is reflected in higher interval cancer rates (ICR). In Canada, population-based screening mammography programs generally screen women biennially; however, some provinces and territories offer annual mammography for women with dense breast tissue routinely and/or on recommendation of the radiologist. This study compared the ICRs in those breast screening programs with a policy of annual vs. those with biennial screening for women with dense breasts. Among 148,575 women with dense breasts screened between 2008 to 2010, there were 288 invasive interval breast cancers; screening programs with policies offering annual screening for women with dense breasts had fewer interval cancers 63/70,814 (ICR 0.89/1000, 95% CI: 0.67-1.11) compared with those with policies of usual biennial screening 225/77,761 (ICR 1.45 /1000 (annualized), 95% CI: 1.19-1.72) i.e. 63% higher (p = 0.0016). In screening programs where radiologists’ screening recommendations were able to be analyzed, a total of 76,103 women were screened, with 87 interval cancers; the ICR was lower for recommended annual (65/69,650, ICR 0.93/1000, 95% CI: 0.71, 1.16) versus recommended biennial screening (22/6,453, ICR 1.70/1000 (annualized), 95%CI: 0.70, 2.71)(p = 0.0605). Screening program policies of annual as compared with biennial screening in women with dense breasts had the greatest impact on reducing interval cancer rates. We review our results in the context of current dense breast notification in Canada.

English

BACKGROUND Breast cancer is the most common cancer in women worldwide and has surpassed cervical cancer in India. As a result of regular mammography screening programs and public awareness, early-stage breast cancer with better prognosis has occurred. Immunohistochemistry (IHC) is now a common practice in tumour evaluation which are of importance in diagnosis as well as for deciding the treatment and of prediction of prognosis in breast cancer. The present study was undertaken in view of correlating the histopathology of the tumour and IHC profile with respect to oestrogen receptor (ER), progesterone receptor (PR) and HER2 / neu. METHODS The study is a cross-sectional prospective analysis of patients with primary carcinoma of breast who are undergoing surgery over a period of 2 years from September 2017 to August 2019. All specimens were processed and stained with haematoxylin and eosin and immunohistochemistry was done for oestrogen and progesterone receptors and HER 2neu. RESULTS A total of 20 cases of breast carcinoma specimens were studied, whose age ranged from 24 - 72 years of age. All the 20 cases occurred in females. Infiltrating duct carcinoma was the most histological subtype noted in this study comprising 85 % (17 / 20) of cases. In the study 50 % (10/20) of the cases showed ER / PR positivity with negative HER2 / neu while 15 % (3/15) of cases were negative for ER / PR and HER2 / neu and only one case showed positivity for all three markers. 10 cases (50 %) had lymph node metastases in this study. CONCLUSIONS Breast cancer is the most commonly diagnosed malignancy in Indian women and is also the leading cause of cancer death in women worldwide. Assessment of receptor (ER, PR and HER – 2 / neu) status along with histopathological grading and staging will guide the clinicians to impart a correct treatment protocols to the patients. It will also be of great help in assessing the prognosis. KEYWORDS Breast Cancer, Histopathology, Immunohistochemistry