Treatment Of Breast Disease Research Articles

Past and present of endoscopic surgery and robotic surgery in treatment of breast diseases

To review the research progress related to endoscopic surgery and robotic surgery for breast diseases, aiming to provide references for clinical practice. The recent domestic and international literature on endoscopic surgery and robotic surgery for breast diseases was reviewed, then the challenges in their development, the innovative evolution of endoscopic surgery combined with clinical practice by our team, and its clinical applications were summarized. Traditional endoscopic surgery, despite its advantages such as minimal invasiveness, good cosmetic outcomes, and high patient's satisfaction, has been limited in its development due to specific difficulties in establishing the operative field. Our team innovatively proposed the "reverse sequence method" and the Huaxi Hole 1 theory and methods, cleverly altering the surgical procedure sequence, adding small operative orifices to transform single-port operations into multi-port ones, effectively overcoming the challenges restricting the advancement of endoscopic surgery in the field of breast diseases, thereby enabling further proliferation of endoscopic procedures. In terms of breast endoscopic reconstruction surgery, the parachute patch technique has broadened the indications for reconstruction surgery, benefiting patients with a certain degree of breast ptosis; and the postoperative adjustment concept, through early intervention in the post-reconstruction breast shape, has further refined the reconstruction procedure. Robot-assisted surgery derived from endoscopic surgery theory has further enhanced the precision and stability of surgeries, reducing surgical risks; however, excessive time and economic costs are urgent issues that must be addressed. Through theoretical innovations, endoscopic surgery has been applied in the excision and reconstruction of breast lesions, while robotic surgery shows promising applications in autologous breast reconstruction, especially in the latissimus dorsi reconstruction field. Nevertheless, the lack of high-level large-sample, multi-center randomized controlled clinical trials to confirm its surgical safety, oncological safety, and postoperative cosmetic outcomes is an important direction for future research.

An integrated approach to the prevention and treatment of mastitis in cattle

This article presents the results of research on the effectiveness of preventive and therapeutic measures for mastitis in cattle. In modern conditions, in the farms of the Smolensk region, the disease of large cattle (cows) with mastitis is an urgent problem. In this regard, the subject of our research was the work on the search and application of new most effective means for the prevention and treatment of breast disease in lactating cows. The object of research was cattle. The work was carried out in the conditions of a farm in the Smolensk region. In order to implement a comprehensive approach to the diagnosis, prevention and therapy of cattle in the household, the situation was first studied by suit.

The application of mammography imaging in the diagnosis and prediction of breast diseases

Breast diseases pose a significant threat to women’s health, so early detection and treatment are extremely important. In this context, early disease identification has become crucial in the diagnosis and treatment of breast diseases. This paper begins by outlining the pivotal role of mammography in the early diagnosis of breast cancer, comparing the structural similarities and differences between normal and diseased breast tissues. This comparison underscores the primary role of mammography in the diagnosis and treatment of breast diseases. Additionally, our paper provides an overview of fundamental concepts related to breast cancer detection, diagnosis, and prediction systems. It delves into the latest research developments in auxiliary diagnostic detection, examination, and risk prediction systems associated with breast cancer. Our objective is to offer a comprehensive understanding of the role of computer-aided detection, diagnosis, and prediction systems in breast diseases, fostering further development and application. This work aims to explore and drive innovation in the field, enhance early detection rates of breast diseases, and guide readers towards novel directions, thus contributing to female healthcare management.

Comparative Evaluation of Contrast-Enhanced Spectral Mammography and Digital Breast Tomosynthesis for Diagnosing and Treating Breast Cancer.

BACKGROUND The aim of this study was to evaluate the efficacy of contrast-enhanced spectral mammography (CESM) and digital breast tomosynthesis (DBT) in the diagnosis and chemotherapy of breast cancer. MATERIAL AND METHODS We retrospectively analyzed data on 125 lesions of 115 patients with breast diseases in Lanzhou First People's Hospital from January 2020 to June 2022. Patients were examined by digital breast tomographic fusion and contrast-enhanced spectral mammography after chemotherapy. We compared the diagnostic accuracy of the 2 imaging techniques, and the diagnostic efficacy was evaluated with ROC curves. RESULTS There were significant differences in the type and degree of CESM enhancement between benign and malignant lesions. Malignant lesions mostly showed moderate to severe enhancement, while benign lesions mostly showed mild to moderate enhancement. There was no significant difference in DBT manifestations between benign and malignant lesions. After neoadjuvant chemotherapy, 88 patients had pathological remission, and the remission rate was 70.40%. Thirty-seven patients did not respond (nonresponse rate: 29.60%). The accuracy of CESM lesion size assessment was 84.00% (105/125), with high consistency. The accuracy of DBT lesion size assessment was 68.00% (85/125), and the consistency was poor. BI-RADS 4B was the truncation point. CESM had significantly higher sensitivity, specificity, accuracy, positive predictive value, and negative predictive value than DBT. In premenopausal patients and patients aged less than 50 years, the diagnostic efficacy of DBT and CESM was significantly different. CONCLUSIONS The diagnostic efficacy of CESM was significantly better than DBT in premenopausal women and patients under age 50. Diagnosis and treatment of breast diseases may be enhanced by the use of CESM.

LMA-Net: A lesion morphology aware network for medical image segmentation towards breast tumors

Breast tumor segmentation plays a critical role in the diagnosis and treatment of breast diseases. Current breast tumor segmentation methods are mainly deep learning (DL) based methods, which exacted the contrast information between tumors and backgrounds, and produced tumor candidates. However, all these methods were developed based on traditional standard convolutions, which may not be able to model various tumor shapes and extract pure information of tumors (the extracted information usually contain non-tumor information). Besides, the loss functions used in these methods mainly aimed to minimize the intra-class distances, while ignoring the influence of inter-class distances upon segmentation. In this paper, we propose a novel lesion morphology aware network to segment breast tumors in 2D magnetic resonance images (MRI). The proposed network employs a hierarchical structure that contains two stages: breast segmentation stage and tumor segmentation stage. In the tumor segmentation stage, we devise a tumor morphology aware network to incorporate pure tumor characteristics, which facilitates contrastive information extraction. Further, we propose a hybrid intra- and inter-class distance optimization loss to supervise the network, which can minimize intra-class distances meanwhile maximizing inter-class distances, hence reducing the potential false positive/negative pixels in segmentation results. Verified on a clinical 2D MRI breast tumor dataset, our proposed method achieves eminent segmentation results and outperforms state-of-the-art methods, implying that the proposed method has a good prospect for clinical use.

National study on use of artificial intelligence in breast disease and cancer.

The aim of this study was to examine the thoughts, reservations, approaches and perspectives on the future of artificial intelligence (AI) held by physicians specializing in breast healthcare in our country. Our survey was sent to the members of the Federation of Turkish Breast Disease Associations (MHDF) by e-mail. The survey investigates the attitudes towards the use of AI in breast disease and cancer, including demographic characteristics of the participants, their daily practice and approaches, and their stance on the future. The questionnaire was sent to a total of 1,890 people via e-mail. 108 (40.1 %) participants believed that the use of AI in breast disease would improve their field of expertise moderately, 103 (38.3 %) expected this improvement to be considerable. 169 (70.3 %) respondents identified 'rapid diagnosis' as the most important advantage of AI. 123 (45.7 %) participants considered concerns about potential medical errors and liability issues to be the most worrying aspects of AI. According to our study, the use of AI technology in the diagnosis and treatment of breast disease and cancer seems to be beneficial for both physicians and patients. However, physicians have some concerns about possible medical errors and liability issues that AI might cause (Tab. 1, Ref. 25).

Clinical case: pregnancy-associated breast cancer

This article presents a clinical case of pregnancy-associated breast cancer. We have analyzed the features of the diagnostic algorithm, considered the radiological manifestations and presented the main literature sources about this pathology.Pregnancy-associated breast cancer is breast cancer that occurs during pregnancy or within the first year after a baby birth. It is most often diagnosed only after first clinical symptoms, the most characteristic of which is a feeling of compaction in the breast, less often bloody discharge from the nipple, pain, breast deformation and baby's refusal to breastfeed.Radiological signs of pregnancy-associated breast cancer are not pathognomonic and may mimic benign changes associated with pregnancy and lactation at early stage: lactation adenoma, mastitis, abscess, galactocele, fibroadenoma. Uncertainty of physicians about the harm of radiological methods of examination for pregnant women and the fetus and, consequently, incorrect diagnostic algorithms can delay the early detection of pathology, establish an accurate diagnosis and worsen the prognosis for the patient.Compliance with a sequential diagnostic algorithm using sonographic diagnostics, X-ray mammography with digital breast tomosynthesis, magnetic resonance imaging in accordance with the diagnostic categories of the BI-RADS scale allows you to verify breast tumors. Diagnosis should be consistent with American College Radiology guidelines.In case of detection of suspicious breast pathology in a pregnant woman or woman in labor, a doctor of any specialty should refer the patient to specialized specialists in the diagnosis and treatment of breast diseases. Adherence to the correct algorithms for the appointment, conduct and interpretation of radiological studies, taking into account changes in the breast structure, will allow timely diagnosis, proper treatment and save the lives and health of childbearing aged women.

The Importance of Clinical Data for the Diagnosis of Breast Tumours in North Afghanistan.

Background This study was performed in knowledge of the increasing gap between breast disease treatment in countries with restricted resources and developed countries with increasingly sophisticated examination methods. Methods The authors present the analysis of a breast disease register consisting of diagnostic cases from Mazar e Sharif and Herat in 2018 and 2019. The study comprises a total of 567 cases, which were presented to experts via telemedicine for final diagnosis. 62 cases (10.9%) were excluded due to inacceptable data or insufficient image quality. These data provided by daily diagnostic classification were used for the built-up of a profile for each frequent breast disease and a breast cancer register. All images and cases were seen by at least 3 independent experts. The diagnoses were made in 60% of cases by cytology of fine needle aspiration and in 40% by histological images. Results For each entity of breast diseases (e.g., fibroadenoma), a profile of context variables was constructed allowing to assist medical decisions, as “wait and see,” elective surgery or immediate surgical intervention with R0 (complete) resection. These “profiles” could be described for fibroadenoma, mastitis, galactocele, fibrous-cystic disease, and invasive breast cancer. Conclusions The presented preliminary data set could serve as a cost-effective basis for a North Afghan breast cancer registry, with option to extent to a national model. These preliminary data are transformed in profiles of breast diseases, which are used by the local physicians in charge of breast disease patients. Each new case can be compared by the local treating physician with the profile of all preceded cases with the same diagnosis.

173P Quality indicators of treatment of breast cancer in Bulgaria

Bulgaria is one of the countries with the lowest breast cancer (BC) survival in Europe. We investigated the impact of the adherence to EUSOMA recommendations for diagnosis and treatment of breast diseases on treatment outcomes.

Diagnosis of breast diseases in a certified breast center

The beginning of the 21st century has seen immense improvements in the quality of diagnosis and treatment of breast cancer due to several, simultaneous developments. In particular, the introduction of acertification program from the German Cancer Society based on levelIII guidelines has enhanced the transparency and quality of treatment of breast diseases for all actors. As a result, patients have benefited from intensified cooperation especially between core disciplines in breast disease, gynecology, pathology, and radiology. The standardized and synoptic reading of multiple diagnostic modalities has enabled precise sampling of histologic specimen, which has improved prognosis and the successful individualization of therapy. In this article the benefits of breast cancer diagnosis and therapy in a certified breast center are illustrated using four case examples.

The treatment proposal for the patients with breast diseases in the central epidemic area of 2019 coronavirus disease

Currently, the epidemic of 2019 coronavirus disease (COVID-19) is still ongoing. Its characteristics include high contagiousness, herd susceptibility and clinical phenotype diversity, which have a severe influence on people's daily life and rountine therapy for other diseases. Breast dieases are clinical common diseases. In the central epidemic area of COVID-19, the clinical specialists of breast diseases should consider all of the following factors comprehensively: the prevention of COVID-19, the diagnosis and treatment of breast diseases and the accessibility of medical resources. Besides, we should select the appropriate therapy and optimize treatment process so as to prevent the propagation and cross infection of COVID-19 as well as manage the breast diseases without delay. Therefore, we carried out some management proposals of the patients with breast diseases in the central epidemic area during the epidemic of COVID-19 on the basis of conventional treatment guidelines and clinical experiences. The suggestions and corrections from colleagues will be welcomed.

Catechins- a natural blessing in Breast cancer treatment

Breast malignant growth is a typical disease in female. There were an expected 1.7 million new cases (25% of all tumors in female) and 0.5 million malignant growth passings (15% of all disease deaths in female) in 2012 [1]. In spite of the fact that there have been incredible advances in the treatment of breast disease, mortality from breast malignant growth is still high and it is the subsequent driving reason for disease related passing among female in the United States [2].

Feasibility and safety of image-guided vacuum-assisted breast biopsy: A PRISMA-compliant systematic review and meta-analysis of 20 000 population from 36 longitudinal studies.

Breast cancer is a serious disease in women. We estimated the global technical success rate and complication rates of percutaneous vacuum-assisted breast biopsy (VABB). PubMed, Embase, Web of Science, and Scopus databases were retrieved up to July 2018 to find studies in which technical success rate and complication rates of VABB were available. Pooled rates were calculated according to location mode (ultrasonography [US] or mammography) and needle type (8- or 11-gauge Mammotome probes). Of the 36 articles with 20 868 cases, we found the pooled technical success rate 0.9999(0.9997, 1.0000) (I2 = 17.1%, P = .187) and low complication risks including haematoma 0.1092(0.0748, 0.1437) (I2 = 98.3%, P < .001), pain 0.0738(0.0334, 0.1141) (I2 = 95.9%, P < .001), vasovagal reflex 0.0281(0.0035, 0.0527) (I2 = 92.5%, P < .001), and infection 0.0027(-0.0019, 0.0073) (I2 = 49.8%, P = .113). In this systematic review and meta-analysis, the pooled data suggested that VABB with US or mammography could be promising for diagnosis and treatment of breast disease. Further studies were necessary to identify strategies for these findings.

Consensus statements and operation guidelines on breast lesions and lymph nodes biopsy guided by ultrasound

With the advancement of clinical concepts and techniques in diagnosis and treatment of breast diseases, pathological evaluation of breast lesions and regional lymph nodes using tissue biopsy has been widely recognized in clinical practice. In order to standardize biopsy techniques of breast lesions and lymph nodes guided by ultrasound in application, Chinese Association of Breast Surgery organized domestic experts going into deep discussion, reiterating indications and contraindications in clinical operation and finally pointing out concrete suggestions on the operation guidelines.

Screening for the anti-inflammation quality markers of Xiaojin Pills based on HPLC-MS/MS method, COX-2 inhibition test and protein interaction network

Nowadays, breast disorders seriously affect women’s health in an increasing number. In China, Xiaojin Pills are commonly used in the treatment of breast diseases. Doctors have concluded that the combined use of Xiaojin Pills with conventional therapy can significantly improve the efficacy with fewer side effects. However, the prescription of Xiaojin Pills is complicated and their quality control methods cannot completely ensure the quality of Xiaojin Pills. On the basis of its mechanism, our study combined chemical evaluation and biological evaluation to identify the anti-inflammatory markers of Xiaojin Pills. In this manuscript, 13 compounds in Xiaojin Pills were quantified. At the same time, the cyclooxygenase-2 inhibition rates of different Xiaojin Pills were measured and the possible markers were screened by spectrum-effect relationship. Further, anti-inflammatory activities of markers were verified and protein interaction network was analyzed, identifying the components of Protocatechuate, Beta-Boswellic acid and Levistilide A as the anti-inflammatory quality markers of Xiaojin Pills. We hope our studies can provide a scientific theoretical basis for accurately quality control of Xiaojin Pills and reasonable suggestions for pharmaceutical companies and new ideas for the quality control of other medicines.

Prevalence of breast-related symptoms, health care seeking behaviour and diagnostic needs among women in Burkina Faso

BackgroundThe prevalence of breast cancer has been increasing in sub-Saharan Africa over the last few years. Patients often present with late stage disease, resulting in a high mortality rate. This study aims to estimate the prevalence of breast -related symptoms in the female population of Burkina Faso. The findings can be used to advise on adequate diagnostic health services for breast symptoms to ensure early detection and down-staging of breast cancer.MethodsA cross-sectional, population based study of 996 women was conducted to investigate the proportion of women with breast-related symptoms. A semi-structured questionnaire was used to collect sociodemographic data, information about breast cancer knowledge and details about breast-related symptoms, health care seeking and medical care. Breast-related symptoms were categorised as currently present/not currently present to estimate the current prevalence of women requiring a diagnostic service.ResultsAmong the 996 women, 120 reported having had a breast-related symptom in their life. Only 36 women sought medical advice and eight women had diagnostic confirmation by histological or imaging techniques. Current breast-related symptoms were reported by 33 women (3.3% of the sample). An extrapolation to Burkina Faso’s female population suggests that 184,562 women are in current need of diagnostic services due to any breast-related symptoms.ConclusionsImaging techniques at the community and referral level are needed in order to triage women with breast-related symptoms. Specialised services need to be strengthened to ensure appropriate diagnosis and treatment of breast diseases. Education campaigns among the general population and among health care professionals are required to increase awareness of breast cancer and improve prompt health care seeking and referral.

Clinicopathological Analysis of Ultrasound-guided Vacuum-assisted Breast Biopsy for the Diagnosis and Treatment of Breast Disease.

To evaluate the usefulness and safety of vacuum-assisted breast biopsy (VABB) for breast lesion diagnosis and treatment. Clinical and histopathological data of 8,748 patients, who underwent 11,221 VABB procedures were analyzed. Most patients (58.2%) were <40 years old. Most lesions (39.6%) were 0.6-1.0 cm in diameter while 3.2% were ≥3.0 cm; fibroadenomas were the most common (46.6%). Eight (14% of 57) cases of atypical ductal hyperplasia were underestimated. The positive predictive values (PPVs) of breast imaging reporting and data system (BI-RADS) ultrasound category were 0.6%, 3.4%, 34.8%, 66.2%, and 93.8% for category 3, 4a, 4b, 4c, and 5 lesions, respectively. The mean number of core specimens was 9.5±8.8; the mean procedure time was 3.4±2.7 min. No residual lesions were found in 94.4% of the 7,480 patients. VABB could replace ultrasound-guided core biopsy and surgical excisional biopsy for the diagnosis of breast disease and the treatment of benign breast lesions.

P3 Breast Magnetic Resonance Imaging outcomes and utility of multidisciplinary discussion

Background & purpose: Breast Magnetic Resonance Imaging (MRI) has a role in diagnosis and treatment of breast disease, which may be limited by reduced sensitivity, high false positive rate and high cost(1). A multidisciplinary meeting (MDM) discussion around complex cases requiring MRI may have a positive impact as it does for breast cancer cases(2).

A step-by-step review on patient-specific biomechanical finite element models for breast MRI to x-ray mammography registration.

Breast magnetic resonance imaging (MRI) and x-ray mammography are two image modalities widely used for the early detection and diagnosis of breast diseases in women. The combination of these modalities leads to a more accurate diagnosis and treatment of breast diseases. The aim of this paper is to review the registration between breast MRI and x-ray mammographic images using patient-specific finite element-based biomechanical models. Specifically, a biomechanical model is obtained from the patient's MRI volume and is subsequently used to mimic the mammographic acquisition. Due to the different patient positioning and movement restrictions applied in each image modality, the finite element analysis provides a realistic physics-based approach to perform the breast deformation. In contrast with other reviews, we do not only expose the overall process of compression and registration but we also include main ideas, describe challenges, and provide an overview of the used software in each step of the process. Extracting an accurate description from the MR images and preserving the stability during the finite element analysis require an accurate knowledge about the algorithms used, as well as the software and underlying physics. The wide perspective offered makes the paper suitable not only for expert researchers but also for graduate students and clinicians. We also include several medical applications in the paper, with the aim to fill the gap between the engineering and clinical performance.

SAFE trial: an ongoing randomized clinical study to assess the role of cardiotoxicity prevention in breast cancer patients treated with anthracyclines with or without trastuzumab.

Over the years, thanks to the addition of new generation systemic agents, as well as the use of more advanced and precise radiotherapy techniques, it was able to obtain a high curability rate for breast cancer. Anthracyclines play a key role in the treatment of breast disease, with a well-known benefit on disease-free survival of patients with positive nodal status. Trastuzumab have shown a significant outcome advantage after 1-year administration in case of HER2-positive disease. Unfortunately, significant increase in cardiotoxicity has been observed after anthracyclines and trastuzumab therapies. Even though the cardiology and oncology community strongly recommend a cardiotoxicity prevention strategy for this subset of patients, there is still no consensus on the optimal patient's approach. We aimed to review the published and ongoing researches on cardioprevention strategies and to present the SAFE trial (CT registry ID: NCT2236806; EudraCT number: 2015-000914-23). It is a randomized phase 3, four-arm, single-blind, placebo-controlled study that aims to evaluate the effect of bisoprolol, ramipril or both drugs, compared to placebo, on subclinical heart damage evaluated by speckle tracking cardiac ultrasound in non-metastatic breast cancer patients.