International Journal of Breast Cancer最新文献

Purpose: This study is aimed at generating consensus among women who had ductal carcinoma in situ (DCIS) and healthcare professionals on how to improve communication about low-risk forms of DCIS and reduce affected women's diagnosis-related confusion and anxiety. Methods: We conducted a two-round online Delphi survey with affected women and professionals from across Canada. They rated items sourced from prior research and key informant interviews on a 7-point Likert scale. We retained items rated 6 or 7 by ≥ 80% of panelists. Results: Thirty-seven panelists (17 women, 20 professionals) completed Round 1 and 94.6% of those completed Round 2. Of 42 items rated, 18 were retained, 13 discarded, and 11 did not achieve consensus to retain or discard. Women and professionals agreed on 3 language approaches (use plain language, distinguish DCIS from invasive breast cancer, specify the risk of recurrence and spread) and 9 other strategies to help discuss DCIS (e.g., use visual aids, provide or refer women to culturally tailored DCIS-specific information, ensure physicians can access interpreters). Based on rating and comments, women were more enthusiastic than professionals about referring to abnormal cells rather than DCIS and scheduling longer or follow-up visits to address concerns. To disseminate these findings, panelists recommended public awareness campaigns for women and continuing education and professional society endorsement for physicians. Conclusion: These findings address gaps in prior research that recommended changing the DCIS label, but had not fully explored label preferences, or identified other ways to improve and support communication about DCIS.

Skin cancer is among the most prevalent types of cancer worldwide, and early detection is crucial for improving treatment outcomes and patient survival rates. Traditional diagnostic methods, often reliant on visual examination and manual evaluation, can be subjective and time-consuming, leading to variability in accuracy. Recent developments in machine learning, particularly using pretrained models and fine-tuning techniques, offer promising advancements in automating and improving skin cancer classification. This paper explores the application of a two-phase model using the HAM10000 dataset, which comprises a wide range of skin lesion images. The first phase employs transfer learning with frozen layers, followed by fine-tuning all layers in the second phase to adapt the models more specifically to the dataset. I evaluate nine pretrained models, including VGG16, VGG19, InceptionV3, Xception (extreme inception), and DenseNet121, assessing their performance based on accuracy, precision, recall, and F1 score metrics. The VGG16 model, after fine-tuning, achieved the highest test set accuracy of 99.3%, highlighting its potential for highly accurate skin cancer classification. This study provides important insights for clinicians and researchers, demonstrating the efficacy of advanced machine learning models in enhancing diagnostic accuracy and supporting clinical decision-making in dermatology.

Background/Purpose: During the coronavirus disease 2019 (COVID-19) outbreak, reactive lymphadenopathy after vaccination is a major concern in breast sonography, especially for patients with a history of breast cancer. The state-of-the-art literature on clinical and sonographic findings either examines a small volume of cases or limited types of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. This study is aimed at providing vast clinical information to facilitate breast sonographic examination for participants who underwent recent SARS-CoV-2 vaccination. Methods: Among different SARS-CoV-2 vaccines in the Asian Taiwanese population, reactive axillary lymphadenopathy was investigated through breast sonographic findings and clinical data analysis. The sample included participants with recent vaccination by different brands approved in Taiwan, such as the AstraZeneca ChAdOx1 (AZ) vaccine, Moderna mRNA-1273 (Moderna) vaccine, and Pfizer-BioNTech BNT162b2 (BNT) vaccine. Results: A total of 291 participants received the AZ vaccine, 154 received the BNT vaccine, 222 received the Moderna vaccine, and 422 were nonvaccinated during the study period. The incidence rate for axillary reactive lymphadenopathy was 10.9, 21.3, 21.4, and 0.6, respectively. No incidence of malignancy was reported during the 6-month follow-up period. The AZ vaccine, which is a virus-vector vaccine reported a lower incidence rate than mRNA vaccines. We also found lymphadenopathy may last for more than 1 month after vaccination in this study. Conclusion: The study results provide additional supporting information for the management suggested by the recently updated revision of the Society of Breast Imaging guideline pertaining to lymphadenopathy diagnosis of SARS-CoV-2 vaccine-related ipsilateral lymphadenopathy and screening of mammograms.

Background: This study evaluates the effects of hydroxytyrosol (HT), a component of olive oil, on mammographic breast density reduction. We explored effects of HT on Wnt β-catenin and other pathways involved in cancer stem cell renewal, DNA repair, cell proliferation, and differentiation. Methods: Twenty-five milligrams per day oral dose of HT was given for 12 months in pre- and postmenopausal women at increased risk of breast cancer. Out of 51 patients enrolled, 41 completed the study. The annualized percent decrease in maximum mammographic volumetric breast density (max VBD%) between baseline (BL) and end of treatment (EOT) was analyzed. RNA sequencing (RNA-Seq) and multiplex analysis was performed on the breast biopsies to compare the BL with EOT samples. Results: Max VBD% showed a nonsignificant change; however, in women 60 years or older, the max VBD% decrease was significant (3.7%, p = 0.0391), especially in those with high BL mammographic density. Using RNA-Seq, 3330 unique transcripts were identified (p < 0.05). Mitotic telophase/cytokinesis and DNA damage were upregulated, whereas Wnt, Notch, and oxidative stress-induced senescence pathways were downregulated (p < 0.05). These pathways were confirmed by NanoString nCounter where significant decrease in proliferative genes (RELA and CDK4) and Wnt pathway (R-HSA-195721 and R-HAS-201681) was observed (p < 0.05). Conclusions: HT reduced breast density only in women over 60 years, especially in those with high BL breast density. HT also reduced proliferation and affected the Wnt signaling pathway. This study lays the foundation for future larger studies in exploring a natural compound with well tolerability and overall nontoxic profile for chemoprevention of breast cancer. Trial Registration: ClinicalTrials.gov identifier: NCT02068092.

Objectives: This study is aimed at evaluating the effectiveness of TachoSil in controlling lymphatic leakage in breast cancer patients undergoing axillary dissection. By examining its ability to reduce postsurgical lymphatic drainage, the study will assess its impact on complications like seroma formation, recovery time, and overall patient outcomes, including quality of life and reduced healthcare costs. Methods: Breast cancer patients treated in the Department of Surgical Oncology at King Abdulaziz Medical City were enrolled to receive either TachoSil or undergo drain placement after axillary dissection. Repeated measures multivariate analysis of variance (MANOVA) was used to observe the difference in lymphatic drainage volume over time considering other covariates, such as age, sex, family history, neoadjuvant chemotherapy (NAC), and stage. Results: The TachoSil group showed significantly lower lymphatic drainage volumes at 24 h (106.5 ± 11.3) than the control group (141.7 ± 13.0) (p < 0.001). There were no significant differences in lymphatic drainage volume at 3 days (p = 0.176) and 7 days (p = 0.091). However, at 10 days, the TachoSil group exhibited significantly lower lymphatic drainage volume (19.9 ± 6.1) than the control group (44.5 ± 9.2) (p < 0.001). Repeated measures MANOVA showed a statistically significant difference in lymphatic drainage over time, with a moderate effect (p < 0.001). Conclusion: The findings suggest that TachoSil sealant effectively reduces early postoperative lymphatic drainage volume and maintains lower drainage rates up to 10 days following axillary dissection in breast cancer patients. The use of TachoSil sealant may have potential benefits in reducing the incidence of complications associated with lymphatic drainage and improving patient outcomes.

Purpose: Previous studies have demonstrated that many healthcare workers in low- and middle-income countries (LMICs) lack the appropriate training and knowledge to recognize and diagnose breast cancer at an early stage. As a result, women in LMICs are frequently diagnosed with late-stage breast cancer (Stage III/IV) with a poor prognosis. Materials and Methods: We hosted a 1-day breast cancer educational conference directed towards healthcare workers in Honduras. We conducted pre- and postcourse (1-2 months later) assessments that evaluated knowledge of screening, diagnosis, and treatment of breast cancer. Breast cancer specialists at the University of Minnesota and Honduras developed a 12-question assessment tool in Spanish. Results: A total of 157 people attended the course, and 86 completed the precourse knowledge assessment. The overall percentage of correct responses was 70% in the precourse assessment. Postcourse knowledge assessments were completed by 94 participants. The overall percentage of correct responses was 80% in the postcourse assessment and was significantly higher than precourse assessment scores (p < 0.0001). For the individual domains of screening, diagnosis, and treatment, the postcourse knowledge assessment scores were significantly improved as compared with the precourse scores (p < 0.0001). Conclusion: In this study, we found that a 1-day, in-person breast cancer educational course directed towards healthcare workers in Honduras resulted in improved breast cancer knowledge assessment scores. Future research and implementation strategies will include training healthcare workers throughout Honduras and determining the impact of these educational interventions on the late-stage presentation of breast cancer.

The intricate terrain of breast cancer (BC) in India is examined in this review, which also looks at screening techniques, geographical differences, epidemiological trends, and obstacles to early diagnosis. BC has a major impact in India, especially on women. The research examines data from 2014 to 2024 and finds that, although overall cancer rates are declining, there has been a noticeable increase in BC cases. While obstacles including late-stage diagnosis and restricted access to treatment contribute to lower survival rates in India compared to Western countries, regional variations underscore the need for customized screening measures. The analysis of screening methods highlights the particular difficulties that Indian women encounter, such as the limitations of mammography in a country whose breast density is higher. The review presents cutting-edge technologies like breast exams and computer-aided detection and examines alternative techniques like ultrasonography. The importance of healthcare spending on screening uptake is highlighted by the regional inequality discussion, and mobile screening camps have emerged as a workable way to get around access and cost issues. The relevance of patient education and awareness in the Indian context is emphasized in the review's conclusion. The lack of adequate health resources and sociocultural obstacles, such as the fear of cancer, highlight the necessity of early detection campaigns and thorough education programs. With a knowledge of the difficulties and achievements in BC screening procedures, this narrative review hopes to make a significant contribution to the larger conversation about managing BC in the particular setting of India.

Introduction: Cancer is a genetic disease that affects people worldwide, and breast cancer is the most common cancer in women. Studies have been conducted on molecular parameters to predict tumor behavior and develop therapeutic strategies. Telomeres, which are at the end of chromosomes, have been studied for their relationship with breast cancer, but more research is needed to understand their role in the disease. Circulating-free DNA (cfDNA) is DNA that is free in the bloodstream and is considered a promising target for early cancer detection, treatment response monitoring, and prognosis assessment. This study is aimed at comparing cfDNA telomere length of breast cancer patients and healthy individuals and analyzing the impact of neoadjuvant chemotherapy on telomere length in cfDNA. Materials and Methods: Blood samples were collected from 33 breast cancer patients undergoing neoadjuvant chemotherapy before and after treatment. The quantitative PCR method is used to measure the average telomere lengths. Results: This study found that the telomere length of cfDNA in breast cancer patients before and after treatment is significantly shorter than in the control group. Neoadjuvant chemotherapy is found to shorten the cfDNA telomere length, especially in the treatment-responsive group. Conclusion: Our study suggests that telomere length in cfDNA may be a useful biomarker for predicting therapy response and possible reoccurrence of the disease in breast cancer patients.

Purpose: This study is aimed at investigating the 10-year outcomes of intraoperative radiotherapy (IORT) in Mexican women with early breast cancer (EBC) treated at the Centro Medico ABC, Mexico City. Methods: A cohort study included women with early-stage invasive ductal carcinoma aged ≥ 45 years without prior oncologic treatment, tumor size ≤ 3.5 cm, cN0M0, positive hormone receptors, margins ≥ 2 mm, negative sentinel lymph nodes, and no extensive lymphovascular invasion. IORT was administered at 20 Gy for 20-30 min after a lumpectomy. Follow-up extended over 10 years and included clinical examinations every 6 months for the first 18 months, followed by annual mammograms and conventional examinations. Patients out of the criteria were excluded from this study because they were referred for additional surgery and/or whole-breast radiation therapy. Results: The study involved 238 patients with an average age of 61.1 years. The mean tumor size was 12 mm, and the percentages of lymphatic invasion, positive hormone receptors, and HER2/neu overexpression were 12.6%, 90.8%, and 2.1%, respectively. The median follow-up was 66.6 months (range: 1-126 months), and the overall survival and mastectomy-free rate reached 95.7% and 90%, respectively. Thirteen patients showed side effects; four recurrences were recorded, of which 50% were out-field relapses. The 5-year Kaplan-Meier probability of local relapses, mastectomy-free, and overall survival reached 97.5%, 100%, and 98%, respectively. Conclusions: This is the first 10-year report about the effect of IORT on Mexican women with EBC in the early stages. Strict adherence to the selection criteria in this study resulted in low rates of side effects, mortality, and local recurrences, demonstrating that IORT is an effective treatment alternative for patients with EBC. Studies with a longer follow-up period should be performed, as recurrences can occur in the long term.

Objective: Early detection through screening could improve breast cancer (BC) outcomes in sub-Saharan Africa (SSA). We explored women's preferences for BC-related mobile health text messaging, described the development of a mobile-health text messaging platform, and examined the enablers and barriers to BC screening. Methods: A concurrent mixed-method study of women aged 40-59 years was conducted. Four essential actions were carried out: (i) a baseline survey of 130 women, (ii) five focus group discussions (FGDs), (iii) a stakeholder meeting with BC research and clinical treatment specialists, and (iv) text message pretesting. The survey and FGD findings were used to create a culturally appropriate SMS platform for BC screening. Results: Thirty-five text messages were developed and evaluated with the following communication goals in mind: 15 addressed BC awareness, six emphasized the importance of early detection, five alleviated anxieties as a barrier to BC screening, seven encouraged women to prioritize their health, and three indicated screening locations and costs. The majority (92.6%) of survey respondents who had heard of mammography (54/130) said screening was necessary. Fear of the screening procedure, receiving a positive diagnosis, and other testing-related worries (40.7%) were identified as potential barriers to BC screening, along with low income (18.5%), a lack of BC-related indicators (9.3%), insufficient breast awareness education (9.3%), and time restrictions (7.4%). The presence of BC-related symptoms (27.8%), breast awareness education (24.1%), and doctor's advice (16.7%) were all potential facilitators of BC screening uptake. The majority of FGD participants favored brief texts, with 42.3% preferring one text message per day. Conclusion: Several factors limit women from accessing BC screening services; nevertheless, specific barriers such as a lack of BC education, time constraints, and disease fears can be successfully targeted through SMS messaging interventions to encourage women to use BC screening programs.