International Journal of Breast Cancer最新文献

Objective: This study is aimed at comparing the forward IMRT (F-IMRT) and VMAT techniques in the adjuvant treatment of left-sided breast cancer using hypofractionated radiation over 1 week with deep inspiration breath hold (DIBH) via the Elekta Active Breathing Coordinator (ABC) system. Materials and Methods: Treatment plans for 26 patients receiving 26 Gy in five fractions (5.2 Gy/fraction), followed by a 10-Gy electron boost in five fractions, were analyzed. The boost phase was excluded from the comparison. F-IMRT and VMAT plans were evaluated for dose to 95% of the volume, conformity index (CI), mean left lung dose (MLLD), left lung V8 Gy, mean heart dose (MHD), heart V1.5Gy and V7Gy, mean right breast dose (MRBD), and mean right lung dose (MRLD). Statistical analysis was conducted using the Wilcoxon signed-rank test. Results: PTV coverage was similar in F-IMRT and VMAT arms (95.83% vs. 95.38%), but CI was significantly improved with VMAT (1.31 vs. 1.04). F-IMRT significantly reduced MLLD (4.55 Gy vs. 5.95 Gy) and left lung V8Gy (18.78% vs. 25.87%) when compared to VMAT. MHD was lower with F-IMRT (1.79Gy vs. 2.47Gy), with significantly reduced heart V1.5Gy (21.6% vs. 54.4%) when compared to VMAT, with V7Gy not different (5.04% vs. 5.79%) between F-IMRT and VMAT. F-IMRT also resulted in lower MRBD (0.62 Gy vs. 2.4 Gy) and MRLD (0.38 Gy vs. 1.8 Gy) when compared to VMAT. Conclusion: F-IMRT provides comparable target coverage to VMAT while significantly reducing radiation exposure to the heart, lungs, and contralateral breast for left-sided breast cancer treatment with DIBH and hypofractionation over 1 week. Given its dosimetric advantages, F-IMRT should be the preferred technique to enhance patient safety and minimize long-term toxicities.

Molecular subtype is a crucial prognostic factor for bilateral breast cancer and plays a key role in guiding treatment decisions. Several studies have confirmed that the expression patterns of hormone receptor and human epidermal growth factor receptor 2 are generally consistent in synchronous bilateral primary breast cancer. Discordance in the receptor expression status is commonly associated with poorer prognosis in synchronous bilateral breast cancer. However, there is currently limited literature reporting such cases. This article presents a case of synchronous bilateral primary breast cancer with discordant molecular subtypes and reviews relevant literature.

Background: In Ghana, the incidence of breast cancer is increasing with disproportionately high mortality rates. Awareness about the disease process is critical for achieving early diagnosis of breast cancer in countries without a national screening program. Targeting adolescents in school will help to inculcate good health seeking behaviors with widespread reach. This study assessed the baseline knowledge in high school males and females as an important first step to inform the development of appropriate educational interventions to address identified gaps in student knowledge about breast cancer. Methodology: A multisite cross-sectional study was carried out in 14 high schools in two regions in southern Ghana to assess the baseline student knowledge of breast cancer. Self-administered questionnaires were used covering the following four domains: (1) general breast cancer knowledge, (2) breast cancer symptoms, (3) risk factors for breast cancer, and (4) breast self-examination/screening for breast cancer. For each domain of knowledge tested, the total score was categorized as adequate knowledge (≥ 50% of questions answered correctly) or inadequate knowledge (< 50% of questions answered correctly). Logistic regression was used to determine factors associated with each of the knowledge domains. Stata 14.0 was used for the statistical analysis, and a p < 0.05 was considered statistically significant. Results: Nine thousand seven hundred sixty-seven students from 10 coeducational and 4 girls-only schools participated with 68% of respondents being female. The mean student age was 16.9 ± 1.2 years. Eighty-four percent of the students demonstrated adequate general knowledge on breast cancer and 54% demonstrated adequate knowledge of breast cancer symptoms. However, only 34% and 21%, respectively, received a score of adequate knowledge in regard to breast cancer risk factors and BSE/breast cancer screening. After combining all domain scores to evaluate overall breast cancer knowledge, less than half (47%) of the students received an adequate breast cancer knowledge score. Females and the girls-only schools had statistically significant adequate levels of knowledge of breast cancer. Conclusion: The overall knowledge of breast cancer among senior high school students in southern Ghana is inadequate especially on knowledge of breast cancer risk factors, breast self-examination, and breast cancer screening. Breast cancer educational activities should be incorporated into the national school health curriculum in senior high schools across the country to ameliorate this knowledge gap, with special emphasis on risk factors and breast self-examination. Adolescent males should be included in breast cancer education.

Purpose: The purpose was to investigate the impact of breast density notification on anxiety using the State and Trait Anxiety Inventory (STAI) tool in South Australian women undergoing breast cancer screening. Methods: A survey-based cross-sectional mixed method study was conducted in women attending breast cancer screening at the Queen Elizabeth Hospital Breast/Endocrine outpatient department (n = 100). The women had participated in a previous study assessing their general knowledge of breast density and had indicated they wanted to know their own breast density. Breast density was assessed using Volpara software, and the participants were notified by letter. The STAI tool was administered with an additional question asking how participants felt after being told their breast density. State and trait anxiety levels were compared between those receiving notification of dense breasts and those notified of nondense breasts. Results: State anxiety scores were not different between women notified they had dense breasts (n = 34, mean state anxiety ± SD; 36.65 ± 13.03) and those who had nondense breasts (n = 66, 35.17 ± 13.60, p = 0.51). Severe trait anxiety was observed in 8 of 34 (23%) and 13 of 66 (20%) women in the dense and nondense groups, respectively, and there were no significant differences. Qualitative analysis of 122 coded responses revealed the majority of reactions to breast density notification were positive or neutral, with 17% being negative. Conclusion: Notification of dense breasts was not associated with elevated anxiety when compared to the notification of nondense breasts. Breast density notification approaches need to be considerate of the significant proportion of women with severe underlying anxiety.

Background: Research suggests that fear of cancer could be a significant predictor influencing participation in cancer screening. However, no tools have been validated to measure breast cancer fear among women in Bangladesh, while the Breast Cancer Fear Scale (BCFS) has been extensively examined in Western contexts. Thus, this study intends to validate the Bangla version of the BCFS among female university students aged (> 18) years, given the urgent need for a culturally relevant tool to evaluate fear associated with breast cancer screening practices in this population. Methods: This cross-sectional study was conducted in 2023 among female university students in Bangladesh. Participants were aged > 18 years, able to read Bangla, and had no personal or familial history of cancer or chronic illnesses. Data were collected via an online survey using a random sampling method, resulting in 456 eligible participants after data cleaning. The BCFS was translated into Bangla following the standard forward-backward translation process. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to evaluate the structure of the scale factor. Internal consistency, test-retest reliability, and convergent validity were also assessed. Results: The results showed that the mean age of the participants was 22.91 (SD: 1.12). The Bangla version of the BCFS showed a single-factor structure, high internal consistency (Cronbach's α = 0.939), and good test-retest reliability (r = 0.53, p < 0.001). The CFA results are consistent with the EFA findings, confirming that the scale is a good fit for the one-factor structure. The loadings range from 0.679 (Fear1) to 0.920 (Fear4) in the total sample, indicating that the items are significant indicators of the latent construct. The BCFS demonstrated an acceptable model fit, with RMSEA values below the 0.08 cutoff and SRMR values well below the 0.05 threshold across all samples. Additionally, the GFI, AGFI, NFI, TLI, and CFI values were all above the recommended thresholds, indicating a high fit for the model. Conclusions: The Bangla version of the BCFS has proven to be a powerful and reliable tool for gauging the multifaceted nature of breast cancer fear among Bangladeshi women, particularly female university students. This culturally tailored instrument holds the potential to shed light on the psychological barriers that hinder breast cancer screening.

Breast cancer stands as the utmost prevalent malignancy in women, impacting the epithelial tissue of the breast and often displaying resistance to effective treatment due to its diverse molecular and histological features. Current treatment modalities may exhibit decreasing efficacy over time and can lead to disease progression. The mitochondria, a crucial organelle responsible for cellular metabolism and energy supply, stand highly sensitive to both heat and reactive oxygen species, presenting an assuring target for photodynamic and photothermal therapies (PTTs) in cancer cure. The employment of nanodrug carriers for combination deliveries holds promise in addressing challenges related to drug degradation and off-target toxicity. By circumventing the reticuloendothelial system, nanocarriers bolster the drug's bioavailability at the intended site and ensure controlled codelivery of multiple drugs, thereby maintaining the normal pharmacokinetic features and the regular pharmacodynamic characteristics of different therapeutic mechanisms. The precision and efficacy of this innovative technology have revolutionized drug delivery, substantially enhancing treatment effectiveness. In the pursuit of targeting mitochondrial modifications in cancer cells, various combination therapies such as photodynamic therapy (PDT), PTT, and chemodynamic therapy (CDT) have been explored. These therapies have improved the efficiency of mitochondria-targeted cancer treatment due to their advantageous properties of minimal toxicity, noninvasiveness, reduced drug resistance, and a safer profile. Our review article provides an exhaustive overview of alterations in the mitochondrial environment in BC, their impact on BC development, potential mitochondrial targets for BC treatment, nanotherapeutic approaches for targeting mitochondria, and the limitations of these approaches.

Purpose: Breast cancer patients are subjected to many hardships during chemotherapy which negatively affects the patient's quality of life. The current study was conducted to identify aspects with low scores and produce untoward effects on the quality of life. Results: The results of the study showed that the social functioning domain achieved high quality of life mean score of 76.68 ± 32.94 while emotional functioning attained 38.18 ± 29.61. The most apparent symptoms detected were insomnia and fatigue followed by pain and loss of appetite. Regarding EORTC-BR45, higher score and better quality of life were observed in the body image domain with a mean score of 60.72 ± 37.19, while the future perspective domain achieved low quality of life of 35.41 ± 42.9, and the most obvious symptom for patients was upset by hair loss. Conclusion: The results of the study showed the impact of chemotherapy on the lives of patients and highlighted the aspects that need greater focus by healthcare providers in Jordan. In addition to providing treatment, emotional and psychological support are necessary to improve the quality of life for these women.

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.