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Depression and Anxiety Symptoms Before and After Breast-Cancer Diagnosis Among Young Women in the Northern Finland Birth Cohort 1966. 1966 年北芬兰出生队列中年轻女性诊断乳腺癌前后的抑郁和焦虑症状》(Northern Finland Birth Cohort 1966.
IF 1.3 Q4 ONCOLOGY Pub Date : 2024-09-26 DOI: 10.4274/ejbh.galenos.2024.2024-7-1
Anniina Tastula, Arja Jukkola, Anni-Emilia Alakokkare, Tanja Nordström, Peeter Karihtala, Jouko Miettunen, Sami Räsänen

Objective: The aim of the study was to explore depressive, anxiety, and mental-health related somatic symptoms among young breast-cancer survivors by considering symptoms before and after cancer onset.

Materials and methods: The study sample included females from the prospective Northern Finland Birth Cohort 1966. Symptoms were assessed with the Hopkins Symptom Checklist-25 at the age of 31 and 46 years. We studied both subscales of depressive, anxiety, and somatic symptoms and single symptoms in secondary analyses.

Results: Thirty-one cases and 3.077 controls were included. Females diagnosed with breast cancer 3-8 years before the 46-year follow-up had increased depressive (p = 0.005) and somatic symptoms (p = 0.028) at the 46-year follow-up compared with the 31-year follow-up. This was not observed among those diagnosed <3 or >8 years before or among controls. Females diagnosed with breast cancer reported more lack of strength or energy compared with controls at the 46-year follow-up (p = 0.047). Among females who did not report feeling that the future is hopeless at the 31-year follow-up, significantly more females diagnosed with breast cancer reported this feeling at the 46-year follow-up compared with controls (p = 0.006).

Conclusion: Depressive and somatic symptoms increased significantly among young females at 3-8 years after breast-cancer diagnosis compared with the time before the cancer diagnosis. Psychosocial measures of support for breast-cancer survivors should be provided over the long-term.

研究目的研究旨在通过考虑癌症发病前后的症状,探讨年轻乳腺癌幸存者的抑郁、焦虑和与心理健康相关的躯体症状:研究样本包括1966年北芬兰前瞻性出生队列中的女性。在 31 岁和 46 岁时,使用霍普金斯症状检查表-25 对症状进行评估。我们对抑郁、焦虑和躯体症状的子量表以及单一症状进行了二次分析:结果:共纳入 31 例病例和 3.077 例对照。与 31 年的随访相比,在 46 年的随访中,在 3-8 年前诊断出乳腺癌的女性抑郁症状(p = 0.005)和躯体症状(p = 0.028)有所增加。而在 8 年前确诊的患者或对照组中则未观察到这种情况。与对照组相比,确诊为乳腺癌的女性在 46 年的随访中更多地表示缺乏力量或精力(p = 0.047)。在 31 年随访时未报告感觉未来无望的女性中,与对照组相比,在 46 年随访时报告感觉未来无望的确诊乳腺癌女性显著增多(p = 0.006):结论:与癌症确诊前相比,年轻女性在乳腺癌确诊后 3-8 年的抑郁症状和躯体症状明显增加。应为乳腺癌幸存者提供长期的社会心理支持措施。
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引用次数: 0
Dietary Patterns and Breast Cancer Risk: A KCPS-II Cohort Study. 饮食模式与乳腺癌风险:KCPS-II 队列研究。
IF 1.3 Q4 ONCOLOGY Pub Date : 2024-09-26 DOI: 10.4274/ejbh.galenos.2024.2024-3-4
Ji-Young Lee, Hae In Cho, Heejin Kimm

Objective: There have been inconsistencies in the evidence for a role of dietary patterns in the development of breast cancer. In this study, we used a large-scale cohort [Korean Cancer Prevention Study-II (KCPS-II)] to examine the association between dietary patterns and breast cancer risk in Korean women.

Materials and methods: The dietary patterns of 14,807 women from the KCPS-II were derived by factor analysis and 135 cases of breast cancer were diagnosed during the follow-up period. Cox proportional models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of breast cancer.

Results: The following three major dietary patterns were identified: "Korean dietary pattern" (high intake of Kimchi, vegetables, and rice); "sweet dietary pattern" (high intake of soda and sugar); and "new (Western-like) dietary pattern" (high intake of dairy products, eggs, oil, fruits, and bread). After adjusting for potential confounders, neither the Korean (HR for the highest compared with the lowest tertile, 1.04; 95% CI 0.53-2.06) nor the sweet dietary patterns were associated with the risk of breast cancer. In contrast, the new (Western-like) dietary pattern was found to be significantly associated with an increased risk of breast cancer with an HR (95% CI) of 1.01 (0.65-1.60) for the second tertile and 1.61 (1.04-2.50) for the third tertile as compared with the lowest tertile. After stratifying by menopausal status, these effects were only statistically significant among premenopausal women for the third tertile, compared with those in the bottom tertile (HR 1.69; 95% CI 1.06-2.68; p = 0.028). No significant association was observed between the Korean or sweet dietary pattern and breast cancer among either pre- or postmenopausal women.

Conclusion: Our findings revealed that a greater consumption of a new (Western-like) diet was associated with an increased breast cancer risk and consequently offer a potential prevention strategy for Korean women.

目的:关于膳食模式在乳腺癌发病中的作用,证据并不一致。在这项研究中,我们利用大规模队列[韩国癌症预防研究-II(KCPS-II)]来研究韩国女性的饮食模式与乳腺癌风险之间的关系:通过因子分析得出了韩国癌症预防研究-II(KCPS-II)中 14 807 名女性的膳食模式,并在随访期间确诊了 135 例乳腺癌患者。采用 Cox 比例模型估算乳腺癌风险的危险比(HRs)和 95% 的置信区间(CIs):结果:确定了以下三种主要饮食模式:结果:确定了以下三种主要饮食模式:"韩国饮食模式"(泡菜、蔬菜和大米的高摄入量);"甜饮食模式"(苏打水和糖的高摄入量);以及 "新(类似西方)饮食模式"(乳制品、鸡蛋、油、水果和面包的高摄入量)。在对潜在的混杂因素进行调整后,韩国饮食模式(与最低三分位数相比,最高三分位数的 HR 为 1.04;95% CI 为 0.53-2.06)和甜食饮食模式都与乳腺癌风险无关。与此相反,新型(类西式)膳食模式被发现与乳腺癌风险的增加显著相关,与最低三分位数相比,第二三分位数的 HR(95% CI)为 1.01(0.65-1.60),第三三分位数的 HR 为 1.61(1.04-2.50)。根据绝经状况进行分层后,只有绝经前妇女的第三分层与最低分层相比才具有统计学意义(HR 1.69;95% CI 1.06-2.68;P = 0.028)。在绝经前或绝经后妇女中,均未观察到韩式或甜食饮食模式与乳腺癌之间存在明显关联:我们的研究结果表明,更多地摄入新式(类似西方的)饮食与乳腺癌风险的增加有关,因此为韩国妇女提供了一种潜在的预防策略。
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引用次数: 0
Construction of Low-Cost Simulators for Training in Minimally Invasive Breast Procedures. 建造用于乳腺微创手术培训的低成本模拟器。
Q4 ONCOLOGY Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.4274/ejbh.galenos.2023.2023-8-6
Mirian Khéde Careta, Maura Alambert, Rafael Da Silva Sá, Simone Elias

Objective: The aim of this work was to describe a technique for building low-cost simulators for training in minimally invasive breast procedures guided by ultrasound (US) and stereotactic mammography (MMG), focusing mainly on training medical professionals studying related areas.

Materials and methods: Low-cost phantoms were developed using organic structures that mimic breast tissue, such as chicken breast and eggplant, and materials that simulate breast lesions. A step-by-step description of the preparation and use of these simulators was made, enabling the reproducibility of the technique by the physicians in training themselves.

Results: The low-cost phantoms showed a high degree of echogenic and radiological similarity with human breast tissue, allowing adequate training in minimally invasive procedures.

Conclusion: It was possible to build low-cost phantoms that allow training in US- and stereotactic MMG-guided minimally invasive breast procedures.

目的:这项工作的目的是描述一种建造低成本模拟器的技术,用于培训在超声波(US)和立体定向乳腺 X 线照相术(MMG)引导下的微创乳腺手术,主要侧重于培训研究相关领域的医学专业人员:利用鸡胸肉和茄子等模拟乳腺组织的有机结构以及模拟乳腺病变的材料,开发了低成本模型。对这些模拟器的准备和使用方法进行了逐步说明,以便医生在培训中能够重复使用该技术:结果:低成本模型显示出与人体乳腺组织高度相似的回声和放射学特性,可以进行适当的微创手术培训:结论:制作低成本模型是可行的,可用于 US 和立体定向 MMG 引导的乳腺微创手术培训。
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引用次数: 0
Evaluation of the Influence of Geodimensional and Histological Parameters on the Need for Margin Widening in Breast Lesions Marked With Magnetic Seeds. 评估地理尺寸和组织学参数对磁性粒子标记乳腺病变边缘扩大需求的影响
IF 1.3 Q4 ONCOLOGY Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.4274/ejbh.galenos.2023.2023-11-5
João T Oliveira, Ana Munhoz, Jm Preza Fernandes, Cláudia Paiva, Tânia Teixeira, Susana Marta, José Polónia

Objective: Breast cancer is an important topic worldwide, posing morbidity and mortality to women. Considerable efforts have been put in the early recognition of malignancy through different screening methods, such as mammography and ultrasound. The precise localization of infraclinical malignant lesions is key in surgical management and magnetic seeds gather particular interest for this purpose. As with other systems, a need for reintervention may be needed to obtain adequate surgical margins. This work evaluated the relation between the need for surgical reintervention in order to obtain negative margins and geodimensional and histological parameters. The main objective was the identification of parameters significantly associated with reintervention for margin widening.

Materials and methods: A retrospective analysis of 198 patients from a single centre was performed. The association between pre-defined geodimensional and histological parameters and the need for margin widening in infraclinical lesions marked with magnetic seed was evaluated.

Results: Results showed that reintervention to widen margins was significantly higher in patients with ductal carcinoma in situ (DCIS) in the pre-operative biopsy when compared with invasive carcinoma (p = 0.03) in the bivariate analysis. No statistically significant differences were observed between the need for reintervention and lesion size (p = 0.197), breast quadrant location (p = 0.626) and distance of skin to lesion (p = 0.356).

Conclusion: This work suggests that a more invasive margin clearance in lesions with a pre-operative DCIS diagnosis might obviate the need for reintervention to obtain negative margins. On the other hand, it is not necessary to be surgically more invasive in larger lesions, deeply located or that are present in a certain quadrant, since there are no significant differences regarding the need for reintervention.

目的:乳腺癌是全世界的一个重要话题,它给妇女带来了发病率和死亡率。通过乳房 X 射线照相术和超声波等不同的筛查方法,人们在早期识别恶性肿瘤方面做出了巨大努力。临床下恶性病变的精确定位是手术治疗的关键,磁性种子在这方面尤其受到关注。与其他系统一样,为了获得足够的手术边缘,可能需要再次介入。这项研究评估了为获得阴性边缘而进行手术再介入的必要性与几何尺寸和组织学参数之间的关系。主要目的是确定与边缘增宽而再次介入手术显著相关的参数:对一个中心的 198 例患者进行了回顾性分析。评估了预先确定的几何尺寸和组织学参数与临床下病灶磁性种子标记边缘扩大需求之间的关联:结果:结果显示,在双变量分析中,术前活检结果为乳腺导管原位癌(DCIS)的患者与浸润癌患者相比,扩大边缘的再次干预率明显更高(P = 0.03)。再次干预的必要性与病灶大小(p = 0.197)、乳腺象限位置(p = 0.626)和皮肤到病灶的距离(p = 0.356)之间没有统计学差异:这项研究表明,对术前诊断为 DCIS 的病变进行更具创伤性的边缘清理,可避免为获得阴性边缘而再次进行手术。另一方面,对于病灶较大、位置较深或存在于某一象限的病灶,由于再次介入的必要性没有显著差异,因此没有必要采取更具创伤性的手术。
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引用次数: 0
New Approaches in Breast Cancer Radiotherapy. 乳腺癌放射治疗新方法。
Q4 ONCOLOGY Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.4274/ejbh.galenos.2023.2023-11-4
Niyazi Volkan Demircan, Nuran Bese

Breast cancer stands as the most prevalent malignancy, necessitating a well-established approach to its management due to its sustained prevalence over decades. The implementation of intensive treatments, combining various modalities, has yielded excellent survival outcomes. Consequently, the optimization of quality of life and the mitigation of long-term side effects emerge as critical considerations for clinicians. As a result, discussions regarding treatment de-intensification strategies have been initiated for all treatment modalities, including surgery, radiotherapy (RT), and chemotherapy. RT plays a crucial role in adjuvant therapy. The efficacy of RT in disease control and overall survival across all stages of breast cancer has been demonstrated in numerous clinical trials and meta-analyses utilizing extensive datasets. However, advancements in genetic tumor profiling and improved identification of disease subgroups have prompted a reevaluation of RT omission in low-risk groups as a strategy for treatment de-intensification. Conversely, technological improvements and shortened total treatment times with hypofractionation make RT a secure and feasible option for enhancing local control and survival with minimal impact on the quality of life.

乳腺癌是发病率最高的恶性肿瘤,由于几十年来的持续发病率,有必要对其采取行之有效的治疗方法。结合各种方式的强化治疗取得了良好的生存效果。因此,优化生活质量和减轻长期副作用成为临床医生的重要考虑因素。因此,所有治疗方式,包括手术、放射治疗(RT)和化疗,都开始了有关治疗减量化策略的讨论。RT 在辅助治疗中起着至关重要的作用。大量临床试验和荟萃分析(meta-analyses)利用广泛的数据集证明了 RT 在乳腺癌各期的疾病控制和总生存率方面的疗效。然而,肿瘤基因图谱分析的进步和对疾病亚组识别能力的提高,促使人们重新评估在低危人群中省略 RT 作为去强化治疗的策略。相反,技术的进步和低分次治疗总疗程的缩短使 RT 成为提高局部控制率和生存率的安全可行的选择,同时对生活质量的影响最小。
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引用次数: 0
The Clinical and Pathological Characteristics That Differentiate Cases With "Low Estrogen Receptor Expression" From Triple-Negative Breast Cancer. 区分 "低雌激素受体表达 "与三阴性乳腺癌病例的临床和病理特征。
Q4 ONCOLOGY Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.4274/ejbh.galenos.2023.2023-6-3
Cem Karaali, Mümin Emiroğlu, Mustafa Değirmenci, Murat Keser, Semra Salimoğlu, Canan Kelten Talu

Objective: Estrogen receptor (ER) expression is an immunohistochemical marker that is examined in all invasive breast cancers and has prognostic and predictive value. ER-positive breast cancers refer to those that show positivity for ER at 1% cellular expression or higher. The American Society of Clinical Oncology/College of American Pathologists guidelines suggest using the term "low ER-positive breast cancer" for tumors with ER expression between 1% and 10%. Low ER-positive breast cancers exhibit similarities, in terms of disease-free survival and overall survival rates, to triple-negative breast cancers (TNBCs) rather than ER-positive breast cancers. In this study, our aim was to compare the clinicopathological characteristics of low ER-positive breast cancer cases diagnosed and followed in our clinic with TNBCs.

Materials and methods: A total of 26 cases of low ER-positive breast cancer diagnosed at University of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital between 2010 and 2016 were retrieved from hospital records. The relevant histopathology slides and blocks were retrieved and re-evaluated retrospectively through microscopic examination. Thirteen cases that met the criteria were included in the study. Additionally, a consecutive series of 13 TNBC cases that did not receive neoadjuvant treatment within the same time period were identified.

Results: In the low ER-positive group, the presence of tumor necrosis, as well as histological grade, nuclear grade and Ki-67 proliferation index were significantly lower compared to the TNBC group. Ductal carcinoma in situ (DCIS) was significantly more common in the low ER-positive group compared to the TNBC group. There were no significant differences between the two groups in terms of tumor size, histological tumor type, axillary lymph node involvement, tumor margins, peritumoral and intratumoral inflammation, local recurrence, distant metastasis, survival, and other characteristics.

Conclusion: Although our study consisted of a small number of cases, some features showed significant differences between low ER-positive breast cancers and TNBCs. Histological and nuclear grades, as well as the presence of a DCIS component, were associated with low ER-positive breast cancer. In contrast, the presence of tumor necrosis, as well as Grade 3 features and a high Ki-67 proliferation index indicated TNBC.

目的:雌激素受体(ER)表达是所有浸润性乳腺癌的免疫组化标记,具有预后和预测价值。ER阳性乳腺癌是指细胞ER表达阳性率达到或超过1%的乳腺癌。美国临床肿瘤学会/美国病理学家学会指南建议使用 "低ER阳性乳腺癌 "来描述ER表达在1%到10%之间的肿瘤。就无病生存率和总生存率而言,低ER阳性乳腺癌与三阴性乳腺癌(TNBC)而非ER阳性乳腺癌有相似之处。在这项研究中,我们的目的是比较在本诊所诊断和随访的低ER阳性乳腺癌病例与TNBC的临床病理特征:从医院记录中检索了土耳其健康科学大学伊兹密尔泰佩契克培训与研究医院在2010年至2016年期间诊断的26例低ER阳性乳腺癌病例。检索了相关的组织病理学切片和切块,并通过显微镜检查重新进行了评估。符合标准的 13 例病例被纳入研究。此外,研究还发现了同一时期未接受新辅助治疗的13例TNBC病例:结果:与TNBC组相比,低ER阳性组的肿瘤坏死、组织学分级、核分级和Ki-67增殖指数均明显较低。与TNBC组相比,低ER阳性组中乳腺导管原位癌(DCIS)的发生率明显更高。两组患者在肿瘤大小、肿瘤组织学类型、腋窝淋巴结受累、肿瘤边缘、瘤周和瘤内炎症、局部复发、远处转移、生存期和其他特征方面无明显差异:尽管我们的研究只涉及少量病例,但一些特征显示低ER阳性乳腺癌与TNBC之间存在显著差异。组织学和核分级以及是否存在 DCIS 成分与低 ER 阳性乳腺癌有关。相反,出现肿瘤坏死、3级特征和高Ki-67增殖指数则表示TNBC。
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引用次数: 0
Mastalgia - The Burden Beneath. 乳腺增生--身下的负担
Q4 ONCOLOGY Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.4274/ejbh.galenos.2023.2023-3-10
Akanksha Arvind Sharma, Ashwani Kumar, Dinesh Kumar Pasi, Parth Dhamija, Gurleen Kaur Garry, Anshu Saini, Ruchi Jakhar

Objective: Mastalgia is the most common breast-related complaint. A multitude of hormonal changes and lifestyle associated factors have been implicated in its causation. A long list of treatment modalities have been tried with varying success rates. To identify the most common risk factors and the most effective management strategies for mastalgia in our clinic population.

Materials and methods: A total of 100 women between 18-65 years of age presenting to the breast clinic with mastalgia were followed throughout their course of diagnosis and management. Stepwise treatment was provided, starting with reassurance and breast support and progressing to include pharmacological measures, when necessary. The risk factors and outcomes of treatment were analysed.

Results: The majority (66%) were aged 25-47 years and the left breast was found to be most frequently involved. Involvement of the upper outer quadrant was significantly more common. Lump/nodularity was the most prevalent risk factor. Most patients showed a positive response to non-steroid anti-inflammatories (NSAIDs) in addition to reassurance, breast support and dietary changes.

Conclusion: A detailed history and clinical examination helps to identify the risk factors and the best approach for the management of mastalgia. Educating women regarding breast self-examination at regular intervals helps in early presentation and diagnosis of the underlying condition. Reassurance, breast support and lifestyle changes are the first line treatment and have good results in a significant number of patients. In our practice topical and oral NSAIDs, evening primrose oil and vitamin E were frequently used as additional treatments to non-pharmacological methods.

目的:乳房疼痛是最常见的乳房相关症状。引起乳痛症的原因与多种激素变化和生活方式有关。人们尝试了许多治疗方法,但成功率不一。材料和方法:对乳腺门诊就诊的 100 名年龄在 18-65 岁之间、患有乳腺增生症的女性进行全程跟踪诊断和治疗。从安抚和乳房支持开始,逐步进行治疗,必要时采取药物治疗。对风险因素和治疗结果进行了分析:大多数患者(66%)的年龄在25-47岁之间,左侧乳房最常受累。外上象限受累明显更常见。肿块/结节是最常见的风险因素。大多数患者对非类固醇抗炎药(NSAIDs)有积极的反应,此外,他们还得到了安慰、乳房支持和饮食改变:详细的病史和临床检查有助于确定乳腺增生的风险因素和最佳治疗方法。对妇女进行定期乳房自我检查的教育有助于早期发现和诊断潜在疾病。安抚、乳房支持和改变生活方式是一线治疗方法,对很多患者都有很好的效果。在我们的临床实践中,局部和口服非甾体抗炎药、月见草油和维生素 E 经常被用作非药物治疗方法的辅助治疗。
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引用次数: 0
Efficacy of the Radiofrequency Identification Technique in Breast Cancer Patients: A Single Institution Retrospective Study. 乳腺癌患者射频识别技术的疗效:单机构回顾性研究
Q4 ONCOLOGY Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.4274/ejbh.galenos.2023.2023-10-9
Mahmoud Kassem, Ahmed Kamr, Creighton B Wright, Anna P Sobolewski

Objective: Breast conserving surgery is an excellent option in the treatment of breast cancer. To achieve a good result with this modality, a surgeon needs to identify and excise the tumor with adequate margins. The radiofrequency identification (RFID) technique is a wireless localization technique used for intraoperative breast lesion identification. We assessed the efficacy and outcomes of the RFID technique in breast cancer patients at our institution.

Materials and methods: This is a single institution, retrospective study (BSMH 22-02X-MWH) of 73 patients. We analyzed the medical records of women with biopsy-proven breast cancer from June 2020 to August 2022; participants received surgical care at Mercy Health West Hospital. Data collected included demographics, clinicopathological characteristics, and surgical procedure. The primary objective was to determine the safety and efficacy of RFID. The secondary objective was to assess the impact of obesity and breast density on the RFID outcomes.

Results: A total of 73 female patients met the eligibility criteria with stage I (59%) and grade 1 (51%) breast cancer with mean age of at diagnosis of 66.8 years and mean body mass index of 31.4 kg/m2. Patients had invasive ductal carcinoma (61%), hormonal positive (56%), and human epidermal growth factor receptor 2 negative (68%) disease. All RFID tags were placed under image guidance with 100% accuracy of placement with no evidence of migration or procedure revision. Ninety percent of patients had free surgical margins and only seven patients needed margin re-excision with successful removal of the lesion and the tag.

Conclusion: RFID localization technique is a safe, effective and reliable procedure that results in favorable patient outcomes and quality of life.

目的:保乳手术是治疗乳腺癌的最佳选择。为取得良好的疗效,外科医生需要识别并切除肿瘤,同时保留足够的边缘。射频识别(RFID)技术是一种用于术中乳腺病灶识别的无线定位技术。我们评估了射频识别技术在本院乳腺癌患者中的疗效和结果:这是一项单一机构的回顾性研究(BSMH 22-02X-MWH),共有 73 名患者。我们分析了 2020 年 6 月至 2022 年 8 月期间经活检证实患有乳腺癌的妇女的医疗记录;参与者在 Mercy Health West 医院接受了手术治疗。收集的数据包括人口统计学、临床病理特征和手术过程。首要目标是确定 RFID 的安全性和有效性。次要目标是评估肥胖和乳房密度对 RFID 结果的影响:共有 73 名女性患者符合资格标准,她们均为 I 期(59%)和 1 级(51%)乳腺癌患者,确诊时的平均年龄为 66.8 岁,平均体重指数为 31.4 kg/m2。患者为浸润性导管癌(61%)、激素阳性(56%)和人类表皮生长因子受体 2 阴性(68%)。所有 RFID 标签都是在图像引导下放置的,准确率达 100%,无移位或手术修正迹象。90%的患者手术切缘游离,只有7名患者需要再次切除切缘,并成功切除病灶和标签:射频识别定位技术是一种安全、有效、可靠的手术,能为患者带来良好的治疗效果和生活质量。
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引用次数: 0
Omission of Radiotherapy in Women >60 Years Old After Breast Conserving Surgery for Breast Cancer is Non-Inferior in Terms of Local Recurrence: A Retrospective Cohort Study. 乳腺癌保乳手术后 60 岁以上女性放弃放疗在局部复发率方面并无劣势:一项回顾性队列研究。
Q4 ONCOLOGY Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.4274/ejbh.galenos.2023.2023-9-5
Anna Sachoulidou, Fani Apostolidou, Charalambos Fronis, Despoina Misailidou, Aichan Bozoglou, Themis Anastasia Tataridou, Aristomenis Ampatzoglou, Ioannis Galanis

Objective: Local recurrence rate may show no significant differences between women aged 60 and older who receive breast-conserving surgery followed by radiotherapy and those in the same age group who undergo breast-conserving surgery without subsequent radiotherapy.

Materials and methods: Retrospective cohort study from a single practice with median follow-up time 44 months (interquartile range: 16, 82), comparing women older than 60 years old at diagnosis of breast cancer, treated with breast conserving surgery and either receiving or not receiving radiation therapy postoperatively. The primary endpoint was local recurrence difference between the two groups.

Results: Local recurrence did not differ significantly between the two groups in terms of radiotherapy or not [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.89-1.02, Fisher's exact test p = 0.388], nor between two age groups with cut-off at 65 years of age (OR: 0.99, 95% CI 0.92-1.07, Fisher's Exact test p = 0.6). Local recurrence also did not differ when subgroups of age (60-65 years and >66 years) were considered. All patients received 5 years of hormonal therapy.

Conclusion: Omission of radiotherapy in selected patients is not inferior to radiotherapy after breast conserving surgery in terms of preventing local recurrence.

摘要接受保乳手术后再接受放疗的 60 岁及以上女性与接受保乳手术后不接受放疗的同龄女性的局部复发率可能没有明显差异:中位随访时间为 44 个月(四分位间距:16-82),比较了确诊乳腺癌时年龄超过 60 岁、接受保乳手术治疗且术后接受或不接受放疗的女性。主要终点是两组患者的局部复发率差异:结果:接受或不接受放疗的两组患者局部复发率无明显差异[几率比(OR)0.96,95% 置信区间(CI)0.89-1.02,费舍尔精确检验 p = 0.388],以 65 岁为分界线的两个年龄组之间也无明显差异(OR:0.99,95% CI 0.92-1.07,费舍尔精确检验 p = 0.6)。在考虑年龄分组(60-65 岁和大于 66 岁)时,局部复发率也没有差异。所有患者均接受了为期5年的激素治疗:结论:在预防局部复发方面,对选定患者不进行放疗并不比保乳手术后进行放疗差。
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引用次数: 0
Potential Usefulness a Coronal View using an Automated Breast Ultrasound System in Detecting Breast Lesions. 使用自动乳腺超声系统的冠状视图检测乳腺病变的潜在用途。
Q4 ONCOLOGY Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.4274/ejbh.galenos.2023.2023-11-6
Megumi Suzuki, Ryohei Nakayama, Kiyoshi Namba, Hiroyuki Kawami, Mayumi Nara, Seigo Nakamura

Objective: An automated breast ultrasound system (ABUS) combined with screening mammography has increased cancer detection rates; however, supplemental ABUS use has increased recall rates. In this study, we aimed to identify an accurate and efficient method of ABUS interpretation and evaluate the potential usefulness of its coronal view versus the conventional transverse view.

Materials and methods: This retrospective observer study included comprised 114 ABUS cases (40 normal, 35 benign, 39 malignant). Ten physicians from multiple institutions interpreted the anonymized coronal and transverse views independently. The observers scored their confidence in the lesion detection for each case using a continuous scale and recorded reading times for each coronal and transverse view interpretation. Free-response receiver operating characteristic analysis was employed to compare detection accuracies between views; a paired t-test was used to compare the average reading times.

Results: Detection accuracy did not differ significantly between the coronal and transverse views (figure of merit=0.740 and 0.745, respectively; p = 0.72). However, the average reading time for the coronal view was significantly shorter than that for the transverse view (149.7 vs. 200.3 seconds per case, p = 0.003).

Conclusion: The coronal view obtained with the ABUS was useful for interpretation and associated with significantly shorter reading times compared with the conventional transverse view while maintaining breast lesion detection accuracy.

目的:自动乳腺超声系统(ABUS)与乳腺放射摄影筛查的结合提高了癌症检出率;然而,辅助使用 ABUS 增加了召回率。在这项研究中,我们旨在确定一种准确、高效的 ABUS 解释方法,并评估其冠状视图与传统横向视图的潜在实用性:这项回顾性观察研究包括 114 例 ABUS 病例(40 例正常、35 例良性、39 例恶性)。来自多个机构的 10 名医生对匿名冠状切面和横切面进行了独立解读。观察员使用连续量表对每个病例的病变检测信心进行评分,并记录每个冠状切面和横切面解读的阅读时间。采用自由响应接收器操作特征分析比较不同切面的检测准确性;采用配对 t 检验比较平均阅读时间:结果:冠状切面和横切面的检测准确率没有明显差异(优劣值分别为 0.740 和 0.745;P = 0.72)。然而,冠状视图的平均阅读时间明显短于横向视图(每例 149.7 秒对 200.3 秒,p = 0.003):结论:在保持乳腺病变检测准确性的前提下,使用 ABUS 获得的冠状切面有助于解读,与传统的横向切面相比,冠状切面的阅读时间明显更短。
{"title":"Potential Usefulness a Coronal View using an Automated Breast Ultrasound System in Detecting Breast Lesions.","authors":"Megumi Suzuki, Ryohei Nakayama, Kiyoshi Namba, Hiroyuki Kawami, Mayumi Nara, Seigo Nakamura","doi":"10.4274/ejbh.galenos.2023.2023-11-6","DOIUrl":"10.4274/ejbh.galenos.2023.2023-11-6","url":null,"abstract":"<p><strong>Objective: </strong>An automated breast ultrasound system (ABUS) combined with screening mammography has increased cancer detection rates; however, supplemental ABUS use has increased recall rates. In this study, we aimed to identify an accurate and efficient method of ABUS interpretation and evaluate the potential usefulness of its coronal view versus the conventional transverse view.</p><p><strong>Materials and methods: </strong>This retrospective observer study included comprised 114 ABUS cases (40 normal, 35 benign, 39 malignant). Ten physicians from multiple institutions interpreted the anonymized coronal and transverse views independently. The observers scored their confidence in the lesion detection for each case using a continuous scale and recorded reading times for each coronal and transverse view interpretation. Free-response receiver operating characteristic analysis was employed to compare detection accuracies between views; a paired t-test was used to compare the average reading times.</p><p><strong>Results: </strong>Detection accuracy did not differ significantly between the coronal and transverse views (figure of merit=0.740 and 0.745, respectively; <i>p</i> = 0.72). However, the average reading time for the coronal view was significantly shorter than that for the transverse view (149.7 <i>vs.</i> 200.3 seconds per case, <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>The coronal view obtained with the ABUS was useful for interpretation and associated with significantly shorter reading times compared with the conventional transverse view while maintaining breast lesion detection accuracy.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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European journal of breast health
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