WorldWideScience

Sample records for mammographically occult cancer

  1. Breast-Specific γ-Imaging for the Detection of Mammographically Occult Breast Cancer in Women at Increased Risk.

    Science.gov (United States)

    Brem, Rachel F; Ruda, Rachel C; Yang, Jialu L; Coffey, Caitrín M; Rapelyea, Jocelyn A

    2016-05-01

    Breast-specific γ-imaging (BSGI) is a physiologic imaging modality that can detect subcentimeter and mammographically occult breast cancer, with a sensitivity and specificity comparable to MRI. The purpose of this study was to determine the incremental increase in breast cancer detection when BSGI is used as an adjunct to mammography in women at increased risk for breast cancer. All patients undergoing BSGI from April 2010 through January 2014 were retrospectively reviewed. Eligible patients were identified as women at increased risk for breast cancer and whose most recent mammogram was benign. Examinations exhibiting focally increased radiotracer uptake were considered positive. Incremental increase in cancer detection was calculated as the percentage of mammographically occult BSGI-detected breast cancer and the number of mammographically occult breast cancers detected per 1,000 women screened. Included in this study were 849 patients in whom 14 BSGI examinations detected mammographically occult breast cancer. Patients ranged in age from 26 to 83 y, with a mean age of 57 y. Eleven of 14 cancers were detected in women with dense breasts. The addition of BSGI to the annual breast screen of asymptomatic women at increased risk for breast cancer yields 16.5 cancers per 1,000 women screened. When high-risk lesions and cancers were combined, BSGI detected 33.0 high-risk lesions and cancers per 1,000 women screened. BSGI is a reliable adjunct modality to screening mammography that increases breast cancer detection by 1.7% (14/849) in women at increased risk for breast cancer, comparable to results reported for breast MRI. BSGI is beneficial in breast cancer detection in women at increased risk, particularly in those with dense breasts. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  2. Breast MRI in clinically and mammographically occult breast cancer presenting with an axillary metastasis: a systematic review

    OpenAIRE

    Bresser, J; De Vos, B.; van der Ent, F.; Hulsewé, K.

    2010-01-01

    Abstract Background Axillary metastatic lymphadenopathy with no primary tumour identified in the breast on physical examination, mammography or ultrasound is referred to as occult breast cancer. The goal of this systematic review is to give an overview of the value and additional considerations of using breast MRI in occult breast cancer. Methods The databases of Pubmed, Embase, CINAHL and the Cochrane library were searched for studies addressing th...

  3. In newly diagnosed breast cancer, screening MRI of the contralateral breast detects mammographically occult cancer, even in elderly women: the mayo clinic in Florida experience.

    Science.gov (United States)

    Bernard, Johnny Ray; Vallow, Laura A; DePeri, Elizabeth R; McNeil, Rebecca B; Feigel, Deborah G; Amar, Surabhi; Buskirk, Steven J; Perez, Edith A

    2010-01-01

    The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution. MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopausal status, breast density, and primary-tumor characteristics. Logistic regression was used to explore the association between contralateral carcinoma and potential patient risk factors. A total of 425 women were evaluated, of whom 129 (30%) were aged 70 years or older. A contralateral biopsy was recommended and performed solely on the basis of MRI in 72 of the 425 women (17%). Sixteen of these 72 women (22%) had pathologically confirmed carcinoma, including seven in the older subgroup. The prevalence of clinically and mammographically occult contralateral carcinoma detected by MRI was 3.8% (16/425) overall and 5.4% (7/129) in the group of older women. When potential risk factors for contralateral breast cancer were evaluated, postmenopausal status was the only significant predictor of contralateral cancer detected by MRI (p = 0.016). We concluded that contralateral breast screening with MRI should be considered in postmenopausal women with newly diagnosed breast cancer, even those aged 70 years or older at diagnosis.

  4. Prediction of occult invasive disease in ductal carcinoma in situ using computer-extracted mammographic features

    Science.gov (United States)

    Shi, Bibo; Grimm, Lars J.; Mazurowski, Maciej A.; Marks, Jeffrey R.; King, Lorraine M.; Maley, Carlo C.; Hwang, E. Shelley; Lo, Joseph Y.

    2017-03-01

    Predicting the risk of occult invasive disease in ductal carcinoma in situ (DCIS) is an important task to help address the overdiagnosis and overtreatment problems associated with breast cancer. In this work, we investigated the feasibility of using computer-extracted mammographic features to predict occult invasive disease in patients with biopsy proven DCIS. We proposed a computer-vision algorithm based approach to extract mammographic features from magnification views of full field digital mammography (FFDM) for patients with DCIS. After an expert breast radiologist provided a region of interest (ROI) mask for the DCIS lesion, the proposed approach is able to segment individual microcalcifications (MCs), detect the boundary of the MC cluster (MCC), and extract 113 mammographic features from MCs and MCC within the ROI. In this study, we extracted mammographic features from 99 patients with DCIS (74 pure DCIS; 25 DCIS plus invasive disease). The predictive power of the mammographic features was demonstrated through binary classifications between pure DCIS and DCIS with invasive disease using linear discriminant analysis (LDA). Before classification, the minimum redundancy Maximum Relevance (mRMR) feature selection method was first applied to choose subsets of useful features. The generalization performance was assessed using Leave-One-Out Cross-Validation and Receiver Operating Characteristic (ROC) curve analysis. Using the computer-extracted mammographic features, the proposed model was able to distinguish DCIS with invasive disease from pure DCIS, with an average classification performance of AUC = 0.61 +/- 0.05. Overall, the proposed computer-extracted mammographic features are promising for predicting occult invasive disease in DCIS.

  5. Occult inflammatory breast cancer: review of clinical, mammographic, US and pathologic signs; Carcinoma infiammatorio occulto della mammella: revisione di reperti mammografici, ecografici, clinici ed anatomo-patologici

    Energy Technology Data Exchange (ETDEWEB)

    Cumo, Francesca; Gaioni, Maria Berenice; Bonetti, Franco; Manfrin, Erminia; Remo, Andrea; Pattaro, Christian [Policlinico G.B. Rossi, Verona (Italy). Dipartimento di scienze morfologico biomediche; Policlinico G.B. Rossi, Verona (Italy). Sezione di radiologia, Sezione di anatomia patologica. Dipartimento di medicina e sanita' pubblica, Sezione di epidemiologia e statistica medica, igiene

    2005-04-01

    Purpose: To examine the clinical, radiologic and pathologic findings of occult inflammatory breast cancer (OIBC) in order to identify features useful for diagnosis. Materials and methods: We retrospectively reviewed the records of 19 women with OIBC observed at our Department between 1992 and 2001. We analysed the clinical history, mammographic, ultrasonographic, and pathologic findings and investigated overall survival (OS), prognostic variables and radio-pathologic correlations. Results: The most common mammographic findings were: diffusely density (52.63%), trabecular thickening (42.1%), mass (36.84%). The most common US findings were axillary lymphadenopathy (68,75%), skin thickening (43.75%) and mass (56.25%). At least one inflammatory sign was found in 14 women (74%) at mammography (subcutaneous thickening, trabecular thickening, diffuse increase of density) or at US (subcutaneous thickening, diffuse increase in echogenicity due to oedema, lymph vessel dilatation). Estrogen receptors (ER) were present in 63.2% and Progesterone receptors (PgR) in 36.8%. Significant prognostic variables were ER and Ki 67. Conclusions: The typical radiological pattern of clinical inflammatory breast carcinoma is less frequently present in OIBC; nevertheless the radiologist must pay attention because frequently OIBC presents just one radiological sign and this should be enough for a diagnostic suspicion. Moreover, the absence of clinical and radiological inflammatory signs does not exclude inflammatory breasts cancer because OIBC can manifest at imaging as a mass or isolated calcification. ER and PgR are positive in a high percentage of patients and confirm that OIBC has a better prognosis that clinical inflammatory breast cancer. [Italian] Scopo: Esaminare i reperti clinici, radiologici ed anatomo-patologici del carcinoma infiammatorio occulto della mammella (IBCO) al fine di identificare alcune caratteristiche utili alla diagnosi. Materiale e metodi: E' stato effettuato

  6. Detection of mammographically occult architectural distortion on digital breast tomosynthesis screening: initial clinical experience.

    Science.gov (United States)

    Partyka, Luke; Lourenco, Ana P; Mainiero, Martha B

    2014-07-01

    Digital breast tomosynthesis (DBT) has been shown to improve the sensitivity of screening mammography. DBT may have the most potential impact in cases of subtle mammographic findings such as architectural distortion (AD). The objective of our study was to determine whether DBT provides better visualization of AD than digital mammography (DM) and whether sensitivity for cancer detection is increased by the addition of DBT as it relates to cases of mammographically occult AD. Retrospective review of BI-RADS category 0 reports from 9982 screening DM examinations with adjunct DBT were searched for the term "architectural distortion" and were reviewed in consensus by three radiologists. ADs were classified by whether they were seen better on DM or DBT, were seen equally well on both, or were occult on either modality. The electronic medical record was reviewed to identify additional imaging studies, biopsy results, and surgical excision pathology results. Review identified 26 cases of AD, 19 (73%) of which were seen only on the DBT images. Of the remaining seven ADs, six were seen better on DBT than DM. On diagnostic workup, nine lesions were assigned to BI-RADS category 4 or 5. Surgical pathology revealed two invasive carcinomas, two ductal carcinoma in situ lesions, three radial scars, and two lesions showing atypia. The cancer detection rate of DBT in mammographically occult AD was 21% (4/19). The positive predictive value of biopsy was 44%. DBT provides better visualization of AD than DM and identifies a subset of ADs that are occult on DM. Identification of additional ADs on DBT increases the cancer detection rate.

  7. Computed tomographic mammography. Diagnosis of mammographically and clinically occult carcinoma of the breast.

    Science.gov (United States)

    Sibala, J L; Chang, C H; Lin, F; Jewell, W R

    1981-01-01

    If breast cancer can be detected early, while it is still localized and before it can be palpated, the prognosis for cure is excellent. Heretofore, conventional mammography has been the only means available to detect cancer at such an early stage. Two cases of minimal breast carcinoma measuring less than 5 mm in diameter have been detected and correctly diagnosed using computed tomographic mammography (CT/M). Both cases occurred in fatty breasts and were clinically and mammographically occult. These cases demonstrate the value of CT/M in the diagnosis of minimal breast carcinoma that would have been missed otherwise.

  8. Clinically and mammographically occult breast lesions: detection and classification with high-resolution sonography.

    Science.gov (United States)

    Buchberger, W; Niehoff, A; Obrist, P; DeKoekkoek-Doll, P; Dünser, M

    2000-08-01

    With recent significant advances in ultrasound technology, the potential of high-resolution sonography to improve the sensitivity of cancer diagnosis in women with dense breasts has become a matter of interest for breast imagers. To determine how often physician-performed high-resolution sonography can detect nonpalpable breast cancers that are not revealed by mammography, 8,970 women with breast density grades 2 through 4 underwent high-resolution sonography as an adjunct to mammography. All sonographically detected, clinically and mammographically occult breast lesions that were not simple cysts were prospectively classified into benign, indeterminate, or malignant categories. Diagnoses were confirmed by ultrasound-guided fine-needle aspiration, core-needle biopsy, or surgical biopsy. In 8,103 women with normal findings at mammography and physical examination, 32 cancers and 330 benign lesions were detected in 273 patients with sonography only. Eight additional cancers were found in 867 patients with a malignant (n = 5) or a benign (n = 3) palpable or mammographically detected index lesion. The overall prevalence of cancers detected with screening sonography was 0.41%, and the proportion of sonographically detected cancers to the total number of nonpalpable cancers was 22%. The mean size of invasive cancers detected only by sonography was 9.1 mm, and was not statistically different from the mean size of invasive cancers detected by mammography. The sensitivity of prospective sonographic classification for malignancy was 100%, and the specificity was 31%. In conclusion, the use of high-resolution sonography as an adjunct to mammography in women with dense breasts may lead to detection of a significant number of otherwise occult cancers that are no different in size from nonpalpable mammographically detected cancers. Prospective classification of these lesions based on sonographic characteristics resulted in an acceptable benign-to-malignant biopsy rate of 6.3:1.

  9. Use of magnetic resonance imaging for detecting clinically and mammographically occult ductal carcinoma in situ.

    Science.gov (United States)

    Lo, G; Cheung, Polly S Y

    2008-06-01

    We report on two cases where breast magnetic resonance imaging examination changed clinical management. Breast magnetic resonance imaging is now recognised as an indispensable adjunctive examination to mammography and ultrasound. In each of the two cases described, breast magnetic resonance imaging revealed unsuspected, extensive, and mammographically and ultrasonologically occult, ductal carcinoma in situ. In each of these cases, planned breast conserving surgery was changed to mastectomy. The success of breast conservation treatment depends on removal of all tumour with clear margins at the time of surgery. Magnetic resonance imaging is now considered the most sensitive method for evaluating the extent of breast cancer. Breast magnetic resonance imaging has a very high sensitivity for invasive carcinoma (near 100%), and recent studies show its specificity in high-risk patients is between 93 and 99%. Magnetic resonance imaging may well be proven an important adjunctive examination in patients who have dense breasts or extensive fibrocystic change.

  10. Nonpalpable breast cancer : mammographic and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jae Seung; Kim, Eun Kyung; Oh, Ki Keun; Cheon, Young Jik; Lee, Byung Chan [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-08-01

    To evaluate the mammographic and clinical findings of nonpalpable breast cancer. Materials and Methods : In 28 of 607 breast cancer patients examined between January 1994 and April 1997, lesions were nonpalpable. We retrospectively analyzed the mammographic, clinical and pathologic features of 25 patients (28 lesions) whose mammograms we obtained. Results : Among these 25 patients (28 lesions) screening was abnormal in 22; other symptoms were bloody nipple discharge(n=4), and nipple eczema(n=2). The patients were 34-62 (mean 52)years old. Invasive ductal carcinoma(n=13), DCIS(ductal carcinoma in situ, n-12), Paget's disease (n=2), and LCIS(lobular carcinoma in situ, n=1) were found during surgery. Six of 28 lesions(21%) showed evidence of axillary nodal metastasis;the majority arose from the upper outer quadrant of the breast (n=21). The mammographic findings were mass (50%), (and mass with microcalcification, 11%); microcalcification(29%); asymmetrical density(14%); and normal (7%). According to the mammographic density of breast parenchyma, the major finding in the low density group(N1+P1) was mass(9/9), and in the high density group(P2+DY) was microcalcification (12/19). Conclusion : The most common mammographic findings of nonpalpable breast cancer were mass (50%) and microcalcification(29%). Its features varied according to the mammographic density of breast parenchyma;mass was the main finding in the low density group and microcalcification in the high density group.

  11. THE MAMMOGRAPHIC CALCIFICATIONS IN BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    Tang Ruiying; Liu Jingxian; Gaowen

    1998-01-01

    Objective: This study was performed to exam the relativeship between mammographic calcifications and breast cancer. Methods: All of the 184 patients with breast diseases underwent mammography before either an open biopsy or a mastectomy. The presence,morphology, and distribution of calcifications visualized on mammograms for breast cancer were compared with the controls who remained cancer free. Statistical comparisons were made by using the x2 test. Results:Of the 184 patients with breast diaeases, 93 malignant and 91 benign lesions were histologically confirmed.Calcifications were visualized on mammograms in 60(64%) of 93 breast cancers and 26 (28%) of 91 non breast cancers. The estimated odds ratio (OR) of breast cancer was 4.5 in women with calcifications seen on mammograms, compared with those having none (P<0.01). Of the 60 breast carcinomas having mammographic calcifications, 28 (47%) were infiltrating ductal carcinomas.There were only 8 (24%) cases with infiltrating ductal cancers in the group of without calcifications seen on the mammograms (P<0.05). Conclusion: Our finding suggests that mammographic calcification appears to be a risk factor for breast cancer. The granular and linear cast type calcification provide clues to the presence of breast cancer, especially when the carcinomas without associated masses were seen on mammograms.

  12. The occult urothelial cancer.

    Science.gov (United States)

    Ragonese, Mauro; Racioppi, Marco; D'Agostino, Daniele; Di Gianfrancesco, Luca; Lenci, Niccolò; Bientinesi, Riccardo; Palermo, Giuseppe; Sacco, Emilio; Pinto, Francesco; Bassi, Pier Francesco

    2016-05-24

    Transitional cell carcinoma (TCC) is the tumor that most frequently affects the urinary tract. The most common location is in the bladder; the diagnosis, as the follow-up, is based on urine cytology, endoscopic, and radiological examinations. Urinary cytology is an important non invasive tool used in the diagnosis and follow-up of patients with TCC. A positive urine cytology result is highly predictive of the presence of TCC, even in the presence of normal cystoscopy, because malignant cells may appear in the urine long time before any cystoscopically visible lesion becomes apparent. The presence of a positive urinary cytology, in the absence of clinical or endoscopic evidence of a TCC, can identify an occult urothelial cancer, located in any site of the urinary tract (upper urinary tract, bladder, prostatic urethra). Most of the urothelial tumors of the renal pelvis and ureters are diagnosed by radiological examinations, but we can observe a high rate of false negatives. In order to improve the diagnostic role of urinary cytology and other conventional examinations, numerous molecular markers have been identified; however, the real clinical application remains unclear. Photodynamic diagnosis and narrow band imaging (NBI) cystoscopy increase the diagnostic accuracy of endoscopic examinations in the presence of lesions not easily detectable. The aim of this review is to analyze the current diagnostic standards in the presence of occult urothelial cancer.

  13. The mammographic correlations of a new immunohistochemical classification of invasive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Taneja, S. [Nottingham Breast Institute, City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom)], E-mail: sheeba_taneja@yahoo.co.uk; Evans, A.J. [Nottingham Breast Institute, City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom); Rakha, E.A.; Green, A.R. [Division of Pathology, School of Molecular Medical Sciences, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham (United Kingdom); Ball, G. [Nottingham Trent University, School of Biomedical and Natural Sciences, Nottingham (United Kingdom); Ellis, I.O. [Division of Pathology, School of Molecular Medical Sciences, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham (United Kingdom)

    2008-11-15

    Aim: Recent protein expression profiling of breast cancer has identified specific subtypes with clinical, biological, and therapeutic implications. The aim of this study was to identify the mammographic correlates of these novel molecular classes of invasive breast cancer. Materials and methods: The mammographic findings of 415 patients with operable breast cancer were correlated with the previously described protein expression classes identified by our group using immunohistochemical (IHC) assessment of a large series of breast cancer cases prepared as tissue microarrays (TMAs). Twenty-five proteins of known relevance in breast cancer were assessed, including hormone receptors, HER-2 status, basal and luminal markers, p53 expression, and E-cadherin. Results: The mammographic background pattern and proportion of lesions that were mammographically occult were similar in all groups. Groups characterized by luminal and hormone receptor positivity had significantly more spiculate lesions at mammography. Groups characterized by HER-2 overexpression, basal characteristics, and E-cadherin positivity had a significantly higher proportion of ill-defined masses. These findings were independent of histological grade. Conclusion: The mammographic features of breast cancer show significant correlation with molecular classes of invasive breast cancer identified by protein expression IHC analysis. The biological reasons for the findings and implications of these regarding imaging protocols require further study and may provide mechanisms for improvement of detection of these lesions.

  14. Posterior breast cancer: Mammographic and ultrasonographic features

    Directory of Open Access Journals (Sweden)

    Janković Ana

    2013-01-01

    Full Text Available Background/Aim. Posterior breast cancers are located in the prepectoral region of the breast. Owing to this distinctive anatomical localization, physical examination and mammographic or ultrasonographic evaluation can be difficult. The purpose of the study was to assess possibilities of diagnostic mammography and breast ultrasonography in detection and differentiation of posterior breast cancers. Methods. The study included 40 women with palpable, histopathological confirmed posterior breast cancer. Mammographic and ultrasonographic features were defined according to Breast Imaging Reporting and Data System (BI-RADS lexicon. Results. Based on standard two-view mammography 87.5%, of the cases were classified as BI-RADS 4 and 5 categories, while after additional mammographic views all the cases were defined as BIRADS 4 and 5 categories. Among 96 mammographic descriptors, the most frequent were: spiculated mass (24.0%, architectural distortion (16.7%, clustered microcalcifications (12.6% and focal asymmetric density (12.6%. The differentiation of the spiculated mass was significantly associated with the possibility to visualize the lesion at two-view mammography (p = 0.009, without the association with lesion diameter (p = 0.083 or histopathological type (p = 0.055. Mammographic signs of invasive lobular carcinoma were significantly different from other histopathological types (architectural distortion, p = 0.003; focal asymmetric density, p = 0.019; association of four or five subtle signs of malignancy, p = 0.006. All cancers were detectable by ultrasonography. Mass lesions were found in 82.0% of the cases. Among 153 ultrasonographic descriptors, the most frequent were: irregular mass (15.7%, lobulated mass (7.2%, abnormal color Doppler signals (20.3%, posterior acoustic attenuation (18.3%. Ultrasonographic BI-RADS 4 and 5 categories were defined in 72.5% of the cases, without a significant difference among various histopathological types (p = 0

  15. Changes in mammographic density and breast cancer risk

    NARCIS (Netherlands)

    Lokate, A.J.M.

    2012-01-01

    Breast cancer is the most frequently occurring cancer among women worldwide. One of the most important risk factors for breast cancer is high mammographic density. Mammographic density represents the amount of fibroglandular tissue relative to the fat tissue in the breast. Women with >75% of their b

  16. Impact of full field digital mammography on the classification and mammographic characteristics of interval breast cancers

    Energy Technology Data Exchange (ETDEWEB)

    Knox, Mark, E-mail: marktknox@gmail.com; O’Brien, Angela, E-mail: angelaobrien@doctors.org.uk; Szabó, Endre, E-mail: endrebacsi@freemail.hu; Smith, Clare S., E-mail: csmith@mater.ie; Fenlon, Helen M., E-mail: helen.fenlon@cancerscreening.ie; McNicholas, Michelle M., E-mail: michelle.mcnicholas@cancerscreening.ie; Flanagan, Fidelma L., E-mail: fidelma.flanagan@cancerscreening.ie

    2015-06-15

    Highlights: • Digital mammography has changed the presentation of interval breast cancer. • Less interval breast cancers are associated with microcalcifications following FFDM. • Interval breast cancer audit remains a key feature of any breast screening program. - Abstract: Objective: Full field digital mammography (FFDM) is increasingly replacing screen film mammography (SFM) in breast screening programs. Interval breast cancers are an issue in all screening programs and the purpose of our study is to assess the impact of FFDM on the classification of interval breast cancers at independent blind review and to compare the mammographic features of interval cancers at FFDM and SFM. Materials and methods: This study included 138 cases of interval breast cancer, 76 following an FFDM screening examination and 62 following screening with SFM. The prior screening mammogram was assessed by each of five consultant breast radiologists who were blinded to the site of subsequent cancer. Subsequent review of the diagnostic mammogram was performed and cases were classified as missed, minimal signs, occult or true interval. Mammographic features of the interval cancer at diagnosis and any abnormality identified on the prior screening mammogram were recorded. Results: The percentages of cancers classified as missed at FFDM and SFM did not differ significantly, 10.5% (8 of 76) at FFDM and 8.1% (5 of 62) at SFM (p = .77). There were significantly less interval cancers presenting as microcalcifications (alone or in association with another abnormality) following screening with FFDM, 16% (12 of 76) than following a SFM examination, 32% (20 of 62) (p = .02). Conclusion: Interval breast cancers continue to pose a problem at FFDM. The switch to FFDM has changed the mammographic presentation of interval breast cancer, with less interval cancers presenting in association with microcalcifications.

  17. [Occult multicentric breast cancer].

    Science.gov (United States)

    Vtorushin, S V; Zab'ialova, M V; Glushchenko, S A; Perel'muter, V M; Slonimskaia, E M

    2009-01-01

    The study included 92 patients with invasive ductal breast cancer (T2-4N0-2M0-1). In 38 cases, tumor growth was unicentric while histologically identifiable ones as multicentric in 44. Multicentricity mostly occurred in cases of macroscopically-identifiable nodes located in the central segments of the breast. Clinically-identifiable nodes of multicentric tumor growth measured more than 3 cm. Multicentric tumors were mostly grade III, featured lower expression of sex hormone receptors and positive Her2 status.

  18. Overdiagnosis in mammographic screening for breast cancer in Europe

    DEFF Research Database (Denmark)

    Puliti, Donella; Duffy, Stephen W; Miccinesi, Guido

    2012-01-01

    Overdiagnosis, the detection through screening of a breast cancer that would never have been identified in the lifetime of the woman, is an adverse outcome of screening. We aimed to determine an estimate range for overdiagnosis of breast cancer in European mammographic service screening programmes....

  19. The impact of mammographic screening on breast cancer mortality in Europe

    DEFF Research Database (Denmark)

    Broeders, Mireille; Moss, Sue; Nyström, Lennarth

    2012-01-01

    To assess the impact of population-based mammographic screening on breast cancer mortality in Europe, considering different methodologies and limitations of the data.......To assess the impact of population-based mammographic screening on breast cancer mortality in Europe, considering different methodologies and limitations of the data....

  20. Usefulness of MRI in detecting occult breast cancer associated with Paget's disease of the nipple-areolar complex.

    Science.gov (United States)

    Echevarria, J J; Lopez-Ruiz, J A; Martin, D; Imaz, I; Martin, M

    2004-12-01

    MRI allows for the detection of mammographically and clinically occult breast neoplasms. We analysed the ability of MRI to detect occult breast cancer in three patients with Paget's disease of the nipple-areolar complex, proven histologically. In all three cases we observed differences in the morphological and dynamic features of healthy and pathological nipples, and we also found enhancement foci in breast tissue, with suspicious kinetic and morphological characteristics, which in the case of two patients corresponded to ductal carcinoma in situ. The detection and location with MRI of underlying neoplastic foci may be of help in choosing the most reasonable and conservative treatment in these patients.

  1. Paraneoplastic retinopathy associated with occult bladder cancer

    DEFF Research Database (Denmark)

    Nivean, M; Muttuvelu, Danson V; Afzelius, Pia Maria Tullia

    2016-01-01

    The aim was to report the first case of cancer-associated retinopathy (CAR) presenting before bladder cancer diagnosis. A 71-year-old woman with a history of bilateral vision loss underwent subsequent complete ophthalmic examination include a fluorescein angiography, full-field electroretinogram ...... photoreceptor dysfunction, confirmed by ERG, should alert to a possible remote effect of known or occult malignancy. In the latter, PET-CT may be exploited as a powerful diagnostic tool....

  2. Mammographic density and breast cancer risk: a mediation analysis.

    Science.gov (United States)

    Rice, Megan S; Bertrand, Kimberly A; VanderWeele, Tyler J; Rosner, Bernard A; Liao, Xiaomei; Adami, Hans-Olov; Tamimi, Rulla M

    2016-09-21

    High mammographic density (MD) is a strong risk factor for breast cancer. However, it is unclear whether high MD is an intermediate phenotype or whether breast cancer risk factors influence breast cancer risk and MD independently. Our study population included 1290 invasive breast cancer cases and 3422 controls from the Nurses' Health Studies. We estimated the percent of the total association between the risk factor and breast cancer that was mediated by MD. In both pre- and postmenopausal women, the association between history of biopsy-confirmed benign breast disease and risk was partially mediated by percent MD (percent mediated (PM) = 17 %, p breast cancer risk were substantially mediated by percent MD (PM = 73 %, p = 0.05 and PM = 82 %, p = 0.04, respectively). In postmenopausal women, the proportion of the associations of childhood somatotype and adolescent somatotype that were mediated by percent MD were lower (PM = 26 %, p = 0.01 for both measures). Hormone therapy use at mammogram was significantly mediated by percent MD in postmenopausal women (PM = 22 %, p breast cancer, were not mediated by percent MD. Percent MD partially mediated some of the associations between risk factors and breast cancer, though the magnitude varied by risk factor and menopausal status. These findings suggest that high MD may be an intermediate in some biological pathways for breast cancer development.

  3. The impact of mammographic screening on breast cancer mortality in Europe

    DEFF Research Database (Denmark)

    Moss, S M; Nyström, L; Jonsson, H.

    2012-01-01

    Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value.......Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value....

  4. Venous thromboembolism and occult cancer: impact on clinical practice.

    Science.gov (United States)

    Gheshmy, Afshan; Carrier, Marc

    2016-04-01

    Unprovoked venous thromboembolism (VTE) can be the first manifestation of cancer. Given this relationship between unprovoked VTE and cancer, it is appealing for clinicians to screen their patients with a first episode of acute unprovoked VTE for a potential occult malignancy. Five different studies have compared a limited (thorough history and physical exam, basic bloodwork) to a more extensive occult cancer screening strategy (e.g. computed tomography, fludeoxyglucose positron emission tomography, etc.). Most of these studies have failed to show that an extensive occult cancer screening strategy diagnoses more occult cancer (including early cancers), misses fewer cancers during follow-up or improves overall and/or cancer-related mortality suggesting that extensive occult cancer screening should not be performed routinely. Therefore, patients with a first unprovoked VTE should undergo a limited cancer screening only and clinicians should ensure that their patients are up to date regarding age- and gender- specific cancer screening (colon, breast, cervix and prostate) as per their national recommendations. Current evidence does not support a net clinical benefit to perform an extensive occult cancer screening on all patients, and a decision to do additional testing should be made on a case by case basis.

  5. Overdiagnosis by mammographic screening for breast cancer studied in birth cohorts in The Netherlands

    NARCIS (Netherlands)

    Ripping, T.M.; Verbeek, A.L.; Fracheboud, J.; Koning, H.J. de; Ravesteyn, N.T. van; Broeders, M.J.

    2015-01-01

    A drawback of early detection of breast cancer through mammographic screening is the diagnosis of breast cancers that would never have become clinically detected. This phenomenon, called overdiagnosis, is ideally quantified from the breast cancer incidence of screened and unscreened cohorts of women

  6. A novel and automatic mammographic texture resemblance marker is an independent risk factor for breast cancer

    DEFF Research Database (Denmark)

    Nielsen, Mads; Karemore, Gopal; Loog, Marco

    2011-01-01

    Objective: We investigated whether breast cancer is predicted by a breast cancer risk mammographic texture resemblance (MTR) marker. Methods: A previously published case-control study included 495 women of which 245 were diagnosed with breast cancer. In baseline mammograms, 2-4 years prior...

  7. A novel and automatic mammographic texture resemblance marker is an independent risk factor for breast cancer

    NARCIS (Netherlands)

    Nielsen, M.; Karemore, G.; Loog, M.; Raundahl, J.; Karssemeijer, N.; Otten, J.D.M.; Karsdal, M.A.; Vachon, C.M.; Christiansen, C.

    2011-01-01

    OBJECTIVE: We investigated whether breast cancer is predicted by a breast cancer risk mammographic texture resemblance (MTR) marker. METHODS: A previously published case-control study included 495 women of which 245 were diagnosed with breast cancer. In baseline mammograms, 2-4 years prior to diagno

  8. Mammographic phenotypes of breast cancer risk driven by breast anatomy

    Science.gov (United States)

    Gastounioti, Aimilia; Oustimov, Andrew; Hsieh, Meng-Kang; Pantalone, Lauren; Conant, Emily F.; Kontos, Despina

    2017-03-01

    Image-derived features of breast parenchymal texture patterns have emerged as promising risk factors for breast cancer, paving the way towards personalized recommendations regarding women's cancer risk evaluation and screening. The main steps to extract texture features of the breast parenchyma are the selection of regions of interest (ROIs) where texture analysis is performed, the texture feature calculation and the texture feature summarization in case of multiple ROIs. In this study, we incorporate breast anatomy in these three key steps by (a) introducing breast anatomical sampling for the definition of ROIs, (b) texture feature calculation aligned with the structure of the breast and (c) weighted texture feature summarization considering the spatial position and the underlying tissue composition of each ROI. We systematically optimize this novel framework for parenchymal tissue characterization in a case-control study with digital mammograms from 424 women. We also compare the proposed approach with a conventional methodology, not considering breast anatomy, recently shown to enhance the case-control discriminatory capacity of parenchymal texture analysis. The case-control classification performance is assessed using elastic-net regression with 5-fold cross validation, where the evaluation measure is the area under the curve (AUC) of the receiver operating characteristic. Upon optimization, the proposed breast-anatomy-driven approach demonstrated a promising case-control classification performance (AUC=0.87). In the same dataset, the performance of conventional texture characterization was found to be significantly lower (AUC=0.80, DeLong's test p-valuebreast anatomy may further leverage the associations of parenchymal texture features with breast cancer, and may therefore be a valuable addition in pipelines aiming to elucidate quantitative mammographic phenotypes of breast cancer risk.

  9. Mammographic texture resemblance generalizes as an independent risk factor for breast cancer

    NARCIS (Netherlands)

    Nielsen, M.; Vachon, C.M.; Scott, C.G.; Chernoff, K.; Karemore, G.; Karssemeijer, N.; Lillholm, M.; Karsdal, M.A.

    2014-01-01

    Breast density has been established as a major risk factor for breast cancer. We have previously demonstrated that mammographic texture resemblance (MTR), recognizing the local texture patterns of the mammogram, is also a risk factor for breast cancer, independent of percent breast density. We exami

  10. Birth weight, childhood body mass index, and height in relation to mammographic density and breast cancer

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Baker, Jennifer Lyn; Bihrmann, Kristine

    2014-01-01

    High breast density, a strong predictor of breast cancer may be determined early in life. Childhood anthropometric factors have been related to breast cancer and breast density, but rarely simultaneously. We examined whether mammographic density (MD) mediates an association of birth weight...

  11. Breast Tissue Composition and Immunophenotype and Its Relationship with Mammographic Density in Women at High Risk of Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Jia-Min B Pang

    Full Text Available To investigate the cellular and immunophenotypic basis of mammographic density in women at high risk of breast cancer.Mammograms and targeted breast biopsies were accrued from 24 women at high risk of breast cancer. Mammographic density was classified into Wolfe categories and ranked by increasing density. The histological composition and immunophenotypic profile were quantified from digitized haematoxylin and eosin-stained and immunohistochemically-stained (ERα, ERβ, PgR, HER2, Ki-67, and CD31 slides and correlated to mammographic density.Increasing mammographic density was significantly correlated with increased fibrous stroma proportion (rs (22 = 0.5226, p = 0.0088 and significantly inversely associated with adipose tissue proportion (rs (22 = -0.5409, p = 0.0064. Contrary to previous reports, stromal expression of ERα was common (19/20 cases, 95%. There was significantly higher stromal PgR expression in mammographically-dense breasts (p=0.026.The proportion of stroma and fat underlies mammographic density in women at high risk of breast cancer. Increased expression of PgR in the stroma of mammographically dense breasts and frequent and unexpected presence of stromal ERα expression raises the possibility that hormone receptor expression in breast stroma may have a role in mediating the effects of exogenous hormonal therapy on mammographic density.

  12. Breast Tissue Composition and Immunophenotype and Its Relationship with Mammographic Density in Women at High Risk of Breast Cancer.

    Science.gov (United States)

    Pang, Jia-Min B; Byrne, David J; Takano, Elena A; Jene, Nicholas; Petelin, Lara; McKinley, Joanne; Poliness, Catherine; Saunders, Christobel; Taylor, Donna; Mitchell, Gillian; Fox, Stephen B

    2015-01-01

    To investigate the cellular and immunophenotypic basis of mammographic density in women at high risk of breast cancer. Mammograms and targeted breast biopsies were accrued from 24 women at high risk of breast cancer. Mammographic density was classified into Wolfe categories and ranked by increasing density. The histological composition and immunophenotypic profile were quantified from digitized haematoxylin and eosin-stained and immunohistochemically-stained (ERα, ERβ, PgR, HER2, Ki-67, and CD31) slides and correlated to mammographic density. Increasing mammographic density was significantly correlated with increased fibrous stroma proportion (rs (22) = 0.5226, p = 0.0088) and significantly inversely associated with adipose tissue proportion (rs (22) = -0.5409, p = 0.0064). Contrary to previous reports, stromal expression of ERα was common (19/20 cases, 95%). There was significantly higher stromal PgR expression in mammographically-dense breasts (p=0.026). The proportion of stroma and fat underlies mammographic density in women at high risk of breast cancer. Increased expression of PgR in the stroma of mammographically dense breasts and frequent and unexpected presence of stromal ERα expression raises the possibility that hormone receptor expression in breast stroma may have a role in mediating the effects of exogenous hormonal therapy on mammographic density.

  13. Bilateral mammographic density asymmetry and breast cancer risk: A preliminary assessment

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Bin, E-mail: zhengb@upmc.edu [Department of Radiology, University of Pittsburgh, 3362 Fifth Ave, Pittsburgh, PA 15213 (United States); Sumkin, Jules H., E-mail: jsumkin@mail.magee.edu [Department of Radiology, Magee Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213 (United States); Zuley, Margarita L., E-mail: zuleyml@upmc.edu [Department of Radiology, Magee Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213 (United States); Wang, Xingwei, E-mail: wangx6@upmc.edu [Department of Radiology, University of Pittsburgh, 3362 Fifth Ave, Pittsburgh, PA 15213 (United States); Klym, Amy H., E-mail: klymah@upmc.edu [Department of Radiology, University of Pittsburgh, 3362 Fifth Ave, Pittsburgh, PA 15213 (United States); Gur, David, E-mail: gurd@upmc.edu [Department of Radiology, University of Pittsburgh, 3362 Fifth Ave, Pittsburgh, PA 15213 (United States)

    2012-11-15

    To improve efficacy of breast cancer screening and prevention programs, it requires a risk assessment model with high discriminatory power. This study aimed to assess classification performance of using computed bilateral mammographic density asymmetry to predict risk of individual women developing breast cancer in near-term. The database includes 451 cases with multiple screening mammography examinations. The first (baseline) examinations of all case were interpreted negative. In the next sequential examinations, 187 cases developed cancer or surgically excised high-risk lesions, 155 remained negative (not-recalled), and 109 were recalled benign cases. From each of two bilateral cranio-caudal view images acquired from the baseline examination, we computed two features of average pixel value and local pixel value fluctuation. We then computed mean and difference of each feature computed from two images. When applying the computed features and other two risk factors (woman's age and subjectively rated mammographic density) to predict risk of cancer development, areas under receiver operating characteristic curves (AUC) were computed to evaluate the discriminatory/classification performance. The AUCs are 0.633 {+-} 0.030, 0.535 {+-} 0.036, 0.567 {+-} 0.031, and 0.719 {+-} 0.027 when using woman's age, subjectively rated, computed mean and asymmetry of mammographic density, to classify between two groups of cancer-verified and negative cases, respectively. When using an equal-weighted fusion method to combine woman's age and computed density asymmetry, AUC increased to 0.761 {+-} 0.025 (p < 0.05). The study demonstrated that bilateral mammographic density asymmetry could be a significantly stronger risk factor associated to the risk of women developing breast cancer in near-term than woman's age and assessed mean mammographic density.

  14. Computerized prediction of breast cancer risk: comparison between the global and local bilateral mammographic tissue asymmetry

    Science.gov (United States)

    Wang, Xingwei; Lederman, Dror; Tan, Jun; Wang, Xiao Hui; Zheng, Bin

    2011-03-01

    We have developed and preliminarily tested a new breast cancer risk prediction model based on computerized bilateral mammographic tissue asymmetry. In this study, we investigated and compared the performance difference of our risk prediction model when the bilateral mammographic tissue asymmetrical features were extracted in two different methods namely (1) the entire breast area and (2) the mirror-matched local strips between the left and right breast. A testing dataset including bilateral craniocaudal (CC) view images of 100 negative and 100 positive cases for developing breast abnormalities or cancer was selected from a large and diverse full-field digital mammography (FFDM) image database. To detect bilateral mammographic tissue asymmetry, a set of 20 initial "global" features were extracted from the entire breast areas of two bilateral mammograms in CC view and their differences were computed. Meanwhile, a pool of 16 local histogram-based statistic features was computed from eight mirror-matched strips between the left and right breast. Using a genetic algorithm (GA) to select optimal features, two artificial neural networks (ANN) were built to predict the risk of a test case developing cancer. Using the leave-one-case-out training and testing method, two GAoptimized ANNs yielded the areas under receiver operating characteristic (ROC) curves of 0.754+/-0.024 (using feature differences extracted from the entire breast area) and 0.726+/-0.026 (using the feature differences extracted from 8 pairs of local strips), respectively. The risk prediction model using either ANN is able to detect 58.3% (35/60) of cancer cases 6 to 18 months earlier at 80% specificity level. This study compared two methods to compute bilateral mammographic tissue asymmetry and demonstrated that bilateral mammographic tissue asymmetry was a useful breast cancer risk indicator with high discriminatory power.

  15. Benefits and harms of detecting clinically occult breast cancer.

    Science.gov (United States)

    Amir, Eitan; Bedard, Philippe L; Ocaña, Alberto; Seruga, Bostjan

    2012-10-17

    Over the last few decades there has been an increase in the use of strategies to detect clinically occult breast cancer with the aim of achieving diagnosis at an earlier stage when prognosis may be improved. Such strategies include screening mammography in healthy women, diagnostic imaging and axillary staging in those diagnosed with breast cancer, and the use of follow-up imaging for the early detection of recurrent or metastatic disease. Some of these strategies are established, whereas for others there are inconsistent supportive data. Although the potential benefit of early detection of clinically occult breast cancer seems intuitive, use of such strategies can also be associated with harm. In this commentary, we provide an extended discussion on the potential benefits and harms of the routine and frequent use of screening interventions to detect clinically occult breast cancer and question whether we may be causing more harm than good.

  16. Mammographic findings predicting an extensive intraductal component in early stage invasive breast cancer : analysis on microcalcification

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ah; Kim, Mi Hye; Lee, Mi Kyung; Oh, Ki Keun [College of Medicine, Yonsei University, Seoul (Korea, Republic of); Kim, Eun Kyung [Pundang CHA General Hospital, College of Medicine, Pochon CHA University, Seoul (Korea, Republic of)

    2000-05-01

    To analyze the mammographic findings of extensive intraductal component (EIC)-positive early invasive breast carcinoma and to determine the mammographic features which predict an EIC positivity in an invasive carcinoma. The mammographic and pathologic findings in 71 patients aged 34-79 (mean 50) years in whom stage I or II invasive breast carcinoma had been diagnosed were retrospectively analysed. The mammographic findings were assigned to one of three groups: mass, mass with microcalcification, or microcalcification only. The shape and distribution of a calcification were classified according to the BI-RADS lexicon, and its extent was classified as either more or less than 3 cm. To detect the presence or absence of EIC and the type of ductal carcinoma in situ (DCIS), the findings were re-examined by means of slide mappings. Twenty-eight of 71 patients (39%) showed ECI positivity. The mammographic findings of EIC-positive invasive cancer (n=3D28) were mass with microcalcification (n=3D14), microcalcification only (n=3D7) and mass only (n=3D7). The mammographic finding which predicted EIC positivity was mass with microcalcification (PPV:0.67, NPV:0.33, p=3D0.02). A mammographic of mass only (n=3D39) showed a significantly high negative predictive value for EIC positivity. (PPV 0.18, NPV 0.82, P less than 0.01). A comparison of cases with or without calcification showed that those with microcalcifications (n=3D32) showed a significantly high PPV of 0.66 (NPV:0.34, p less than 0.01) while those without calcification (n=3D39) showed a significantly high NPV of 0.82 (PPV:0.18, p less than 0.01). There were no significant differences in positive predictive values for EIC between the shape, distribution and extent of calcifications. Whenever microcalcification with or without mass is seen on mammographs obtained during early breast cancer, we can predict EIC-positivity, regardless of shape or distribution according to the BI-RADS lexicon. (author)

  17. Mammographic Breast Density and Common Genetic Variants in Breast Cancer Risk Prediction.

    Directory of Open Access Journals (Sweden)

    Charmaine Pei Ling Lee

    Full Text Available Known prediction models for breast cancer can potentially by improved by the addition of mammographic density and common genetic variants identified in genome-wide associations studies known to be associated with risk of the disease. We evaluated the benefit of including mammographic density and the cumulative effect of genetic variants in breast cancer risk prediction among women in a Singapore population.We estimated the risk of breast cancer using a prospective cohort of 24,161 women aged 50 to 64 from Singapore with available mammograms and known risk factors for breast cancer who were recruited between 1994 and 1997. We measured mammographic density using the medio-lateral oblique views of both breasts. Each woman's genotype for 75 SNPs was simulated based on the genotype frequency obtained from the Breast Cancer Association Consortium data and the cumulative effect was summarized by a genetic risk score (GRS. Any improvement in the performance of our proposed prediction model versus one containing only variables from the Gail model was assessed by changes in receiver-operating characteristic and predictive values.During 17 years of follow-up, 680 breast cancer cases were diagnosed. The multivariate-adjusted hazard ratios (95% confidence intervals were 1.60 (1.22-2.10, 2.20 (1.65-2.92, 2.33 (1.71-3.20, 2.12 (1.43-3.14, and 3.27 (2.24-4.76 for the corresponding mammographic density categories: 11-20cm2, 21-30cm2, 31-40cm2, 41-50cm2, 51-60cm2, and 1.10 (1.03-1.16 for GRS. At the predicted absolute 10-year risk thresholds of 2.5% and 3.0%, a model with mammographic density and GRS could correctly identify 0.9% and 0.5% more women who would develop the disease compared to a model using only the Gail variables, respectively.Mammographic density and common genetic variants can improve the discriminatory power of an established breast cancer risk prediction model among females in Singapore.

  18. Detection of occult metastasis in patients with breast cancer.

    Science.gov (United States)

    Hawes, D; Neville, A M; Cote, R J

    2001-06-01

    The most important factor affecting the outcome of patients with invasive cancer is whether the tumor has spread, either regionally (to regional lymph nodes) or systemically. However, a proportion of patients with no evidence of systemic dissemination will develop recurrent disease after primary "curative" therapy. Clearly, these patients had occult systemic spread of disease that was undetectable by routinely employed methods (careful pathological, clinical, biochemical, and radiological evaluation). In addition, the success of adjuvant therapy is assumed to stem from its ability to eradicate occult metastases before they become clinically evident. Therefore, methods for the detection of occult metastases in patients with the earliest stage of cancer, i.e., prior to detection of metastases by any other clinical or pathological analysis, have received a great deal of attention.

  19. Study of Mammographic Findings of Breast Cancer in Women under 35 Years Old

    Directory of Open Access Journals (Sweden)

    D. Farrokh

    2008-01-01

    Full Text Available Background/Objective: Brest cancer is the second reason of mortality due to cancer in women and according to its high prevalence and psychosociophysical complications, immediate diagnosis is always under consideration. In most cases diagnosis of breast cancer in young women in reproductive ages is difficult. The objective of this study was report mammographic findings of breast cancer in women under 35 years old."nPatients and Methods: In this study the present files in storage room of radiology ward of Imam Reza, Qaem, and Omid Hospitals (1995-2004. In Mashad university of Medical sciences related to women under 35 years with breast cancer were assessed. Specific goals in this study were specification the clinical signs, mammographic findings, the pathology of breast cancer and also family history."nResults: A total of 2570 patients with breast cancer during 10 years period refered to these centers that 231 patients (9% were ≤35 years. Sixty two patients (51.3% had positive family history. The most common cancer according to the history was breast cancer in 30 cases (48.4%. The most common chief complain in these patients was a mass in 74 cases (80.4%.The most common mammographic pattern was mass with microcalcification in 37 cases (33.9%. Identifying a mass alone in mammography was seen in 17 cases (15.6%. The tumors were in the left breast in 114 cases (49%, and the most common site was supralateral quadrant (50.8%. The most common pathology was ductal carcinoma invasive in 200 cases (86.6%."nConclusion: Breast cancer in young women have poor prognosis. It may be difficult to detect breast cancer in mammography and the other modalities are usually helpful. Masses which discovered by patients themselves must be considered strictly and diagnostic procedures must be performed due to that, immediate treatment would be effective.

  20. Assessment of two mammographic density related features in predicting near-term breast cancer risk

    Science.gov (United States)

    Zheng, Bin; Sumkin, Jules H.; Zuley, Margarita L.; Wang, Xingwei; Klym, Amy H.; Gur, David

    2012-02-01

    In order to establish a personalized breast cancer screening program, it is important to develop risk models that have high discriminatory power in predicting the likelihood of a woman developing an imaging detectable breast cancer in near-term (e.g., BIRADS), and computed mammographic density related features we compared classification performance in estimating the likelihood of detecting cancer during the subsequent examination using areas under the ROC curves (AUC). The AUCs were 0.63+/-0.03, 0.54+/-0.04, 0.57+/-0.03, 0.68+/-0.03 when using woman's age, BIRADS rating, computed mean density and difference in computed bilateral mammographic density, respectively. Performance increased to 0.62+/-0.03 and 0.72+/-0.03 when we fused mean and difference in density with woman's age. The results suggest that, in this study, bilateral mammographic tissue density is a significantly stronger (p<0.01) risk indicator than both woman's age and mean breast density.

  1. Long-term exposure to air pollution and mammographic density in the Danish Diet, Cancer and Health cohort

    DEFF Research Database (Denmark)

    Huynh, Stephanie; von Euler-Chelpin, My; Raaschou-Nielsen, Ole

    2015-01-01

    BACKGROUND: Growing evidence suggests that air pollution may be a risk factor for breast cancer, but the biological mechanism remains unknown. High mammographic density (MD) is one of the strongest predictors and biomarkers of breast cancer risk, but it has yet to be linked to air pollution. We...... pollution increases breast cancer risk, it is not via MD....... investigated the association between long-term exposure to traffic-related air pollution and MD in a prospective cohort of women 50 years and older. METHODS: For the 4,769 women (3,930 postmenopausal) participants in the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening...

  2. Neural Network Analysis of Breast Cancer from Mammographic Evaluation

    Directory of Open Access Journals (Sweden)

    P. Abdolmaleki

    2006-06-01

    Full Text Available Background/Objective: Mammographic differentiation of benign lesions from malignancies is a difficult task. We developed an artificial neural network (ANN as a diagnostic aid in mammography using radiographic features as input. Materials & Methods: A three-layered ANN was used to differentiate malignant from benign findings in a group of patients with proven breast lesions on the basis of morphological data extracted from conventional mammograms. Our database included 122 patient records on 14qualitative variables. The database was randomly divided into training and validation samples including 82 and 40 patient records, respectively, to construct the ANN and validate its performance. Sensitivity, specificity, accuracy and receiver operating characteristic curve (ROC analysis for this method and the radiologist were compared. Results: Our results showed that the neural network model was able to correctly classify 30 out of 40 cases presented in the validation sample. Comparing the output with that of the radiologist, showed a reasonable diagnostic accuracy (75%, a moderate specificity (64% and a relatively high sensitivity (89%. Conclusion: A diagnostic aid was developed that accurately differentiates malignant from benign pattern using radiological features extracted from mammograms.

  3. Risk of Breast Cancer in Women with False-Positive Results according to Mammographic Features.

    Science.gov (United States)

    Castells, Xavier; Torá-Rocamora, Isabel; Posso, Margarita; Román, Marta; Vernet-Tomas, Maria; Rodríguez-Arana, Ana; Domingo, Laia; Vidal, Carmen; Baré, Marisa; Ferrer, Joana; Quintana, María Jesús; Sánchez, Mar; Natal, Carmen; Espinàs, Josep A; Saladié, Francina; Sala, María

    2016-08-01

    Purpose To assess the risk of breast cancer in women with false-positive screening results according to radiologic classification of mammographic features. Materials and Methods Review board approval was obtained, with waiver of informed consent. This retrospective cohort study included 521 200 women aged 50-69 years who underwent screening as part of the Spanish Breast Cancer Screening Program between 1994 and 2010 and who were observed until December 2012. Cox proportional hazards regression analysis was used to estimate the age-adjusted hazard ratio (HR) of breast cancer and the 95% confidence interval (CI) in women with false-positive mammograms as compared with women with negative mammograms. Separate models were adjusted for screen-detected and interval cancers and for screen-film and digital mammography. Time without a breast cancer diagnosis was plotted by using Kaplan-Meier curves. Results When compared with women with negative mammograms, the age-adjusted HR of cancer in women with false-positive results was 1.84 (95% CI: 1.73, 1.95; P < .001). The risk was higher in women who had calcifications, whether they were (HR, 2.73; 95% CI: 2.28, 3.28; P < .001) or were not (HR, 2.24; 95% CI: 2.02, 2.48; P < .001) associated with masses. Women in whom mammographic features showed changes in subsequent false-positive results were those who had the highest risk (HR, 9.13; 95% CI: 8.28, 10.07; P < .001). Conclusion Women with false-positive results had an increased risk of breast cancer, particularly women who had calcifications at mammography. Women who had more than one examination with false-positive findings and in whom the mammographic features changed over time had a highly increased risk of breast cancer. Previous mammographic features might yield useful information for further risk-prediction models and personalized follow-up screening protocols. (©) RSNA, 2016 Online supplemental material is available for this article.

  4. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Alex C [ORNL; Hitt, Austin N [ORNL; Voisin, Sophie [ORNL; Tourassi, Georgia [ORNL

    2013-01-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  5. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    Science.gov (United States)

    Williams, Alex C.; Hitt, Austin; Voisin, Sophie; Tourassi, Georgia

    2013-03-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists' manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  6. Occult Breast Cancer: Scintimammography with High-Resolution Breast-specific Gamma Camera in Women at High Risk for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rachel F. Brem; Jocelyn A. Rapelyea; , Gilat Zisman; Kevin Mohtashemi; Joyce Raub; Christine B. Teal; Stan Majewski; Benjamin L. Welch

    2005-08-01

    To prospectively evaluate a high-resolution breast-specific gamma camera for depicting occult breast cancer in women at high risk for breast cancer but with normal mammographic and physical examination findings. MATERIALS AND METHODS: Institutional Review Board approval and informed consent were obtained. The study was HIPAA compliant. Ninety-four high-risk women (age range, 36-78 years; mean, 55 years) with normal mammographic (Breast Imaging Reporting and Data System [BI-RADS] 1 or 2) and physical examination findings were evaluated with scintimammography. After injection with 25-30 mCi (925-1110 MBq) of technetium 99m sestamibi, patients were imaged with a high-resolution small-field-of-view breast-specific gamma camera in craniocaudal and mediolateral oblique projections. Scintimammograms were prospectively classified according to focal radiotracer uptake as normal (score of 1), with no focal or diffuse uptake; benign (score of 2), with minimal patchy uptake; probably benign (score of 3), with scattered patchy uptake; probably abnormal (score of 4), with mild focal radiotracer uptake; and abnormal (score of 5), with marked focal radiotracer uptake. Mammographic breast density was categorized according to BI-RADS criteria. Patients with normal scintimammograms (scores of 1, 2, or 3) were followed up for 1 year with an annual mammogram, physical examination, and repeat scintimammography. Patients with abnormal scintimammograms (scores of 4 or 5) underwent ultrasonography (US), and those with focal hypoechoic lesions underwent biopsy. If no lesion was found during US, patients were followed up with scintimammography. Specific pathologic findings were compared with scintimammographic findings. RESULTS: Of 94 women, 78 (83%) had normal scintimammograms (score of 1, 2, or 3) at initial examination and 16 (17%) had abnormal scintimammograms (score of 4 or 5). Fourteen (88%) of the 16 patients had either benign findings at biopsy or no focal abnormality at US; in two

  7. Changes in mammographic density over time in breast cancer cases and women at high risk for breast cancer.

    Science.gov (United States)

    Work, Meghan E; Reimers, Laura L; Quante, Anne S; Crew, Katherine D; Whiffen, Amy; Terry, Mary Beth

    2014-10-01

    High mammographic breast density is one of the strongest intermediate markers of breast cancer risk, and decreases in density over time have been associated with decreases in breast cancer risk. Using repeated measures of mammographic density in a cohort of high-risk women, the Women at Risk (WAR) cohort at Columbia University Medical Center (N = 2670), we examined whether changes in prediagnostic mammographic density differed among 85 prospectively-ascertained breast cancer cases and 85 age-matched controls, using a nested case-control design. Median age at first mammogram was 51 years (range, 29-77 years), with a median of 4 years between first and second prediagnostic mammogram (range, 1-15 years). Using linear regression with change in percent density as the outcome, we found that in women who did not go on to be diagnosed with breast cancer, change in percent density decreased as time between first and second mammogram increased (β = -1.62% per year, p = 0.004). However, in women who did go on to be diagnosed with breast cancer, there was no overall change in percent density associated with time between first and second mammogram (β = 0.29% per year, p = 0.61); the change over time was statistically significantly different between cases versus controls (p breast cancer risk.

  8. Breast cancer mortality in mammographic screening in Europe

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Nyström, Lennarth; Moss, Sue

    2012-01-01

    To estimate the impact of service mammography screening on breast cancer mortality using European incidence-based mortality (IBM) studies (or refined mortality studies). IBM studies include only breast cancer deaths occurring in women with breast cancer diagnosed after their first invitation...

  9. BREAST CANCER RISK EVALUATION - A CORRELATION BETWEEN MAMMOGRAPHIC DENSITY AND THE GAIL MODEL

    Directory of Open Access Journals (Sweden)

    George Baytchev

    2015-05-01

    Full Text Available The Gail model is a statistical tool, which assesses breast cancer probability, based on nonmodifiable risk factors. In contrast, the evaluation of mammographic breast density is an independent and dynamic risk factor influenced by interventions modifying breast cancer risk incidence. The aim of the present study is to compare the possibilities for risk factor integration and analysis and to search for a correlation between mammographic density and the Gail model for breast cancer risk evaluation. The subject of this prospective study is a cohort of 107 women at ages from 37 to 71 years, who have had benign breast diseases, digital mammograms, and Gail model risk evaluation. Mammographic density is evaluated in craniocaudal projection subjectively visually and objectively using the computer imaging software. (Image J software The Gail risk evaluation is completed using the standardized NCI questionnaire (Breast Cancer Risk Assessment Tool. In concordance with the Breast Imaging Reporting and Data System (BI-RAD by ACR, mammographic density is evaluated using a four-grade scale. Low density D1 (less than 25% was determined in 24 cases, D2 (25-50% in 36 cases, D3 (51-75% in 31 cases and high density D4 (greater than 75% in 16 cases. According to the Gail model, 80 (74,8% of the examined patients did not have an increased risk (less than 1,67% for a five-year period, whereas the remaining 27 (25,2% had a statistically significant increase in risk (greater than 1,67% for a five-year period. Women with increased risk more often present with denser breast (34% with D3, D4 versus 18,3% for D1, D2. The Gail model does not adequately explain the correlation between breast density and statistically calculated risk. The development of more detailed tools, which take into consideration breast density, as well as other risk factors, may be helpful for a more accurate evaluation of the individual risk for breast cancer.

  10. Tubulolobular carcinoma of the breast: Clinical, mammographic and sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil [Ege University Hospital, Department of Radiology, Bornova, Izmir (Turkey)]. E-mail: isilbilgen@hotmail.com; Oktay, Aysenur [Ege University Hospital, Department of Radiology, Bornova, Izmir (Turkey)

    2006-12-15

    Purpose: To determine and quantitate radiologic characteristics of tubulolobular carcinoma of the breast and to report clinical and pathologic findings. Materials and methods: A retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 26 histopathologically proven tubulolobular carcinoma of the breast. Analysis included history; findings at physical examination, mammography, and sonography (US) at the time of diagnosis and in postoperative follow-up, and histopathological results. Results: At physical examination, palpable mass was present in 85% (n = 22) of the patients. The mammographic findings were mass in 17 (65%), asymmetric focal density in 2 (8%), architectural distortion in 2 (8%) and negative mammograms in 5 (19%) of the 26 patients. US depicted 25 masses in 24 patients, all of which were hypoechoic, with spiculated (n = 13) or microlobulated (n = 12) margins. The cancer was clinically occult in 12% (n = 3), mammographically occult in 19% (n = 5), and radiologically occult in 4% (n = 1) of the patients. Histologically, the mean size of the tumor was 1.7 cm and 18 (69%) patients were node negative. Conclusion: Tubulolobular carcinoma of the breast usually manifests clinically as a firm, immobile mass and mammographically as a spiculated or ill-defined, irregular, isodense mass without microcalcifications. Common findings on sonography include a homogeneously hypoechoic, spiculated or microlobulated mass with posterior acoustic shadowing or normal acoustic transmission. Tubulolobular carcinoma should be included in the differential diagnosis for breast masses with these imaging features.

  11. Cigarette smoking and mammographic density in the Danish Diet, Cancer and Health cohort

    DEFF Research Database (Denmark)

    Jacobsen, Katja Kemp; Lynge, Elsebeth; Vejborg, Ilse

    2016-01-01

    between smoking and MD was strongest in women who initiated smoking before age of 16 years (0.79, 0.64-0.96), smoked ≥15 cigarettes/day (0.83, 0.71-0.98), smoked ≥5 pack-years (0.62, 0.43-0.89), smoked >30 years (0.86, 0.75-0.99), and smoked ≥11 years before first childbirth (0.70, 0.51-0.96). Association......PURPOSE: Smoking before first childbirth increases breast cancer risk, but the biological mechanism remains unknown and may involve mammographic density (MD), one of the strongest biomarkers of breast cancer risk. We aimed to examine whether active smoking and passive smoking were associated...... with MD. METHODS: For the 5,356 women (4,489 postmenopausal) from the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening in Copenhagen (1993-2001), we used MD (mixed/dense or fatty) assessed at the first screening after cohort entry. Active smoking (status, duration...

  12. Mammographic density and estimation of breast cancer risk in intermediate risk population.

    Science.gov (United States)

    Tesic, Vanja; Kolaric, Branko; Znaor, Ariana; Kuna, Sanja Kusacic; Brkljacic, Boris

    2013-01-01

    It is not clear to what extent mammographic density represents a risk factor for breast cancer among women with moderate risk for disease. We conducted a population-based study to estimate the independent effect of breast density on breast cancer risk and to evaluate the potential of breast density as a marker of risk in an intermediate risk population. From November 2006 to April 2009, data that included American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) breast density categories and risk information were collected on 52,752 women aged 50-69 years without previously diagnosed breast cancer who underwent screening mammography examination. A total of 257 screen-detected breast cancers were identified. Logistic regression was used to assess the effect of breast density on breast carcinoma risk and to control for other risk factors. The risk increased with density and the odds ratio for breast cancer among women with dense breast (heterogeneously and extremely dense breast), was 1.9 (95% confidence interval, 1.3-2.8) compared with women with almost entirely fat breasts, after adjustment for age, body mass index, age at menarche, age at menopause, age at first childbirth, number of live births, use of oral contraceptive, family history of breast cancer, prior breast procedures, and hormone replacement therapy use that were all significantly related to breast density (p density and decreased with number of live births. Our finding that mammographic density is an independent risk factor for breast cancer indicates the importance of breast density measurements for breast cancer risk assessment also in moderate risk populations. © 2012 Wiley Periodicals, Inc.

  13. Impact of contra-lateral breast reshaping on mammographic surveillance in women undergoing breast reconstruction following mastectomy for breast cancer.

    Science.gov (United States)

    Nava, Maurizio B; Rocco, Nicola; Catanuto, Giuseppe; Falco, Giuseppe; Capalbo, Emanuela; Marano, Luigi; Bordoni, Daniele; Spano, Andrea; Scaperrotta, Gianfranco

    2015-08-01

    The ultimate goal of breast reconstruction is to achieve symmetry with the contra-lateral breast. Contra-lateral procedures with wide parenchymal rearrangements are suspected to impair mammographic surveillance. This study aims to evaluate the impact on mammographic detection of mastopexies and breast reductions for contralateral adjustment in breast reconstruction. We retrospectively evaluated 105 women affected by uni-lateral breast cancer who underwent mastectomy and immediate two-stage reconstruction between 2002 and 2007. We considered three groups according to the contra-lateral reshaping technique: mastopexy or breast reduction with inferior dermoglandular flap (group 1); mastopexy or breast reduction without inferior dermoglandular flap (group 2); no contra-lateral reshaping (group 3). We assessed qualitative mammographic variations and breast density in the three groups. Statistically significant differences have been found when comparing reshaped groups with non reshaped groups regarding parenchymal distortions, skin thickening and stromal edema, but these differences did not affect cancer surveillance. The surveillance mammography diagnostic accuracy in contra-lateral cancer detection was not significantly different between the three groups (p = 0.56), such as the need for MRI for equivocal findings at mammographic contra-lateral breast (p = 0.77) and the need for core-biopsies to confirm mammographic suspect of contra-lateral breast cancer (p = 0.90). This study confirms previous reports regarding the safety of mastopexies and breast reductions when performed in the setting of contra-lateral breast reshaping after breast reconstruction. Mammographic accuracy, sensitivity and specificity are not affected by the glandular re-arrangement. These results provide a further validation of the safety of current reconstructive paradigms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Mammographic Texture Resemblance generalizes as an independent risk factor of breast cancer

    DEFF Research Database (Denmark)

    Chernoff, Konstantin; Christopher, S G; Karemore, Gopal

    as an independent risk factor in an unrelated cohort. METHOD AND MATERIALS The statistics of texture were recorded in digitalized film-mammograms of one 4-year prospective study (S1, Dutch screening program) of 245 breast cancers and 250 matched controls. From an independent cohort study (S2, Mayo Mammography...... Health Study cohort) 226 incident breast cancer cases diagnosed through 2008 and 442 matched controls (on age) were used for scoring screening digitized mammograms that were ascertained years prior to diagnosis 1993-2006. Mammographic percent density (PD), using Cumulus, and other major risk factors were...... ascertained in S2. Finally S2 was MTR scored based on textures from S1 and S2 in a leave-two-out fashion. Scores on S2 were related to future breast cancer incidence by AUC and analyses of quartiles adjusted for BMI, menopause status, and postmenopausal hormone (PMH) use. A combined density and MTR model...

  15. Mammographic density and structural features can individually and jointly contribute to breast cancer risk assessment in mammography screening

    DEFF Research Database (Denmark)

    Winkel, Rikke Rass; von Euler-Chelpin, My; Nielsen, Mads;

    2016-01-01

    BACKGROUND: Mammographic density is a well-established risk factor for breast cancer. We investigated the association between three different methods of measuring density or parenchymal pattern/texture on digitized film-based mammograms, and examined to what extent textural features independently......-RADS alone). CONCLUSION: Our findings suggest that the (relative) amount of fibroglandular tissue (density) and mammographic structural features (texture/parenchymal pattern) jointly can improve risk segregation of screening women, using information already available from normal screening routine, in respect...... to future personalized screening strategies....

  16. Association of mammographic image feature change and an increasing risk trend of developing breast cancer: an assessment

    Science.gov (United States)

    Tan, Maxine; Leader, Joseph K.; Liu, Hong; Zheng, Bin

    2015-03-01

    We recently investigated a new mammographic image feature based risk factor to predict near-term breast cancer risk after a woman has a negative mammographic screening. We hypothesized that unlike the conventional epidemiology-based long-term (or lifetime) risk factors, the mammographic image feature based risk factor value will increase as the time lag between the negative and positive mammography screening decreases. The purpose of this study is to test this hypothesis. From a large and diverse full-field digital mammography (FFDM) image database with 1278 cases, we collected all available sequential FFDM examinations for each case including the "current" and 1 to 3 most recently "prior" examinations. All "prior" examinations were interpreted negative, and "current" ones were either malignant or recalled negative/benign. We computed 92 global mammographic texture and density based features, and included three clinical risk factors (woman's age, family history and subjective breast density BIRADS ratings). On this initial feature set, we applied a fast and accurate Sequential Forward Floating Selection (SFFS) feature selection algorithm to reduce feature dimensionality. The features computed on both mammographic views were individually/ separately trained using two artificial neural network (ANN) classifiers. The classification scores of the two ANNs were then merged with a sequential ANN. The results show that the maximum adjusted odds ratios were 5.59, 7.98, and 15.77 for using the 3rd, 2nd, and 1st "prior" FFDM examinations, respectively, which demonstrates a higher association of mammographic image feature change and an increasing risk trend of developing breast cancer in the near-term after a negative screening.

  17. Occult male breast cancer with axillary metastasis: A rare case report

    Directory of Open Access Journals (Sweden)

    Komal Sawaimul

    2015-01-01

    Full Text Available Breast cancer is very rare in men. It accounts for 0.2% of all cancers and 1% of all breast cancers. The occurrence of occult breast cancer that present as axillary metastasis as the first manifestation is even rarer in men. We are hereby presenting an extremely rare case of a septuagenarian male patient who presented with occult breast cancer and axillary lymph node metastasis.

  18. Mammographic texture resemblance generalizes as an independent risk factor for breast cancer

    DEFF Research Database (Denmark)

    Nielsen, Mads; Vachon, Celine M.; Scott, Christopher G.

    2014-01-01

    density. We examine if these findings generalize to another population.METHODS:Texture patterns were recorded in digitalized pre-diagnosis (3.7years) film mammograms of a nested case-control study within the Dutch screening program (S1) comprising of 245 breast cancers and 250 matched controls....... The patterns were recognized in the same study using cross-validation to form resemblance scores associated with breast cancer. Texture patterns from S1 were examined in an independent nested case-control study within the Mayo Mammography Health Study cohort (S2) of 226 cases and 442 matched controls......: mammograms on average 8.5years prior to diagnosis, risk factor information and percent mammographic density (PD) estimated using Cumulus were available. MTR scores estimated from S1, S2 and S1+S2 (the latter two as cross-validations) were evaluated in S2. MTR scores were analyzed as both quartiles...

  19. Contrast-enhanced dedicated breast CT detection of invasive breast cancer preceding mammographic diagnosis

    Directory of Open Access Journals (Sweden)

    Nicolas D. Prionas, MD, PhD

    2015-01-01

    Full Text Available Dedicated breast computed tomography (bCT generates high-resolution, three-dimensional images of the pendent uncompressed breast. Intravenous iodinated contrast during bCT provides additional physiologic information. In this case, a 10.0-mm invasive ductal carcinoma was visualized using contrast-enhanced breast CT one year before mammographic detection. Mammography four months before bCT was negative. The bCT contrast enhancement pattern closely matched the dynamic contrast-enhanced MRI obtained after diagnosis. Lesion enhancement at contrast-enhanced breast CT matched previously published enhancement values of breast cancer. Contrast-enhanced dedicated bCT provided high-resolution tomographic images and physiologic contrast enhancement data that facilitated the detection of an early breast cancer.

  20. Regional trends in breast cancer incidence and mortality in Denmark prior to mammographic screening

    DEFF Research Database (Denmark)

    Andreasen, A H; Andersen, K W; Madsen, Mette

    1994-01-01

    To provide a basis for the evaluation of mammographic screening programmes in Denmark, a study was undertaken of the regional differences in breast cancer incidence and mortality. All 16 regions were followed for the 20 year period, 1970-89, before the start of the first population...... among women below age 60. The mortality was more stable, changing only from 24 to 28 (per 100,000 standardised WSP), but a significant increase occurred in the late 1980s. The study showed regional differences in both incidence and mortality of breast cancer in Denmark. Both the incidence...... and the mortality varied between the regions, with maximum differences of 22%. The analysis showed no variation in the time trends in the different regions, and thus indicates that the use of a regional comparison group would be a valid basis for evaluation of the Copenhagen programme. Our study, however, underlies...

  1. Diabetes, diabetes treatment, and mammographic density in Danish Diet, Cancer, and Health cohort

    DEFF Research Database (Denmark)

    Buschard, Karsten; Thomassen, Katrin; Lynge, Elsebeth;

    2017-01-01

    /dense breasts (2.08; 0.68-6.35). There was no effect modification of these associations by menopausal status or BMI. CONCLUSIONS: Having diabetes controlled by diet or oral antidiabetic agents is associated with a decrease in MD, whereas taking insulin is associated with an increase in MD.......PURPOSE: We examined whether diabetes and diabetes treatment are associated with MD in a cohort study of Danish women above age of 50 years. METHODS: Study cohort consisted of 5,644 women (4,500 postmenopausal) who participated in the Danish Diet, Cancer, and Health cohort (1993......-1997) and subsequently attended mammographic screening in Copenhagen (1993-2001). We used MD assessed at the first screening after the cohort entry, defined as mixed/dense or fatty. Diabetes diagnoses and diabetes treatments (diet, insulin, or oral antidiabetic agents) were self-reported at the time of recruitment (1993...

  2. Clinical and mammographic profile of patients with breast cancer surgically treated

    Directory of Open Access Journals (Sweden)

    Raquel Rodrigues Muradas

    2015-06-01

    Full Text Available Summary Objective: to analyze the epidemiological, clinical and mammographic profile of women with breast cancer who were treated at the mastology clinic of the University Hospital of Santa Maria and who underwent breast surgery between January 2007 and December 2012. Methods: this was a cross-sectional study, approved by the Ethics in Research Committee. A review of the patients' medical records was performed. The data were then exported to a software program for statistical analysis, namely Minitab 14.1. Results: the patients' profile indicated that they were mostly born and raised in Santa Maria (respectively 11.1%, n=16, and 26.3%, n=68. They were about 55.6 years old (SD±12.3, white (90.2%, n=213, had already given birth and breastfed their children, were nonsmokers, but also overweight (average BMI of 27kg/m2. On physical examination of the first medical consultation, these patients, as described in the records: had a palpable mass (81.1%, n=184 measuring over three centimeters, located in the left breast, precisely in the upper outer quadrant (41.4%, n=81. Mammography (39%, n=109 showed that this lump was classified as BIRADS ® 5 (40%, n=81. On histopathological examination, the lump was diagnosed as an invasive ductal cancer (71.1%, n=191. Surgery was generally a radical mastectomy (84.7%, n=236 with axillary dissection (92.5%, n=222. Conclusion: some of the epidemiological, clinical and mammographic features mentioned above resembled those found in the literature reviewed. However, these patients had advanced disease and underwent non conservative surgical procedures.

  3. Mammographic screening: keeping women alive

    NARCIS (Netherlands)

    Verbeek, A.L.M.

    2011-01-01

    Evaluation of: Tabar L, Vitak B, Chen TH et al. Swedish Two-County Trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology 260(3), 658-663 (2011). In the 1980s, the periodic invitation of women aged 40-69 years for mammographic screening in the Swedish Two-Coun

  4. Clues to occult cancer in patients with ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Suk Jae Kim

    Full Text Available BACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke group and without active cancer (CR-stroke group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control. Clinical factors, lesion patterns on diffusion-weighted MRI (DWI, and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4% patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001. Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001. D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06-1.15; P<0.001 and DWI lesion patterns (OR 7.13; 95% CI 3.42-14.87; P<0.001 were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. CONCLUSION: Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke.

  5. Results of a pilot programme of mammographic breast cancer screening in the Western Cape.

    Science.gov (United States)

    Apffelstaedt, J P; Hattingh, R; Baatjes, K; Wessels, N

    2014-04-01

    Mammographic screening programmes are now established in developing countries. We present an analysis of the first screening programme in sub-Saharan Africa. Women aged > or = 40 years were identified at three primary healthcare centres in the Western Cape Province, South Africa, and after giving informed consent underwent mammography at a mobile unit. After a single reading, patients with American College of Radiology Breast Imaging Reporting and Data System (BIRADS) 3 - 5 lesions were referred to a tertiary centre for further management. Between 1 February 2011 and 31 August 2012, 2 712 screening mammograms were performed. A total of 261 screening mammograms were reported as BIRADS 3 - 5 (recall rate 9.6%). Upon review of the 250 available screening mammograms, 58 (23%) were rated benign or no abnormalities (BIRADS 1 and 2) and no further action was taken. In 32 women, tissue was acquired (biopsy rate for the series 1.2%); 10 cancers were diagnosed (biopsy malignancy rate 31%). For the entire series of 2 712 screening mammograms, the cancer diagnosis rate was 3.7/1 000 examinations. Of 10 cancers diagnosed at screening, 5 were TNM clinical stage 0, 2 stage I and 3 stage II. The low cancer detection rate achieved, and the technical and multiple administrative problems experienced do not justify installation of a screening programme using the model utilised in this series.

  6. Genome-wide association study identifies multiple loci associated with both mammographic density and breast cancer risk.

    Science.gov (United States)

    Lindström, Sara; Thompson, Deborah J; Paterson, Andrew D; Li, Jingmei; Gierach, Gretchen L; Scott, Christopher; Stone, Jennifer; Douglas, Julie A; dos-Santos-Silva, Isabel; Fernandez-Navarro, Pablo; Verghase, Jajini; Smith, Paula; Brown, Judith; Luben, Robert; Wareham, Nicholas J; Loos, Ruth J F; Heit, John A; Pankratz, V Shane; Norman, Aaron; Goode, Ellen L; Cunningham, Julie M; deAndrade, Mariza; Vierkant, Robert A; Czene, Kamila; Fasching, Peter A; Baglietto, Laura; Southey, Melissa C; Giles, Graham G; Shah, Kaanan P; Chan, Heang-Ping; Helvie, Mark A; Beck, Andrew H; Knoblauch, Nicholas W; Hazra, Aditi; Hunter, David J; Kraft, Peter; Pollan, Marina; Figueroa, Jonine D; Couch, Fergus J; Hopper, John L; Hall, Per; Easton, Douglas F; Boyd, Norman F; Vachon, Celine M; Tamimi, Rulla M

    2014-10-24

    Mammographic density reflects the amount of stromal and epithelial tissues in relation to adipose tissue in the breast and is a strong risk factor for breast cancer. Here we report the results from meta-analysis of genome-wide association studies (GWAS) of three mammographic density phenotypes: dense area, non-dense area and percent density in up to 7,916 women in stage 1 and an additional 10,379 women in stage 2. We identify genome-wide significant (P<5 × 10(-8)) loci for dense area (AREG, ESR1, ZNF365, LSP1/TNNT3, IGF1, TMEM184B and SGSM3/MKL1), non-dense area (8p11.23) and percent density (PRDM6, 8p11.23 and TMEM184B). Four of these regions are known breast cancer susceptibility loci, and four additional regions were found to be associated with breast cancer (P<0.05) in a large meta-analysis. These results provide further evidence of a shared genetic basis between mammographic density and breast cancer and illustrate the power of studying intermediate quantitative phenotypes to identify putative disease-susceptibility loci.

  7. The psychological impact of mammographic screening on women with a family history of breast cancer--a systematic review.

    Science.gov (United States)

    Watson, Eila K; Henderson, Bethan J; Brett, Joanne; Bankhead, Clare; Austoker, Joan

    2005-11-01

    This systematic review aims to assess the psychological impact of mammographic screening on women with a family history of breast cancer. Women with a family history, and hence increased risk, of breast cancer are known to experience higher levels of anxiety about cancer. They are also often offered screening from an earlier age. The psychological consequences of screening are therefore of particular importance for this group of women. A comprehensive search of 4 electronic databases was conducted from 1982 to 2003, combining sets of terms relating to (1) breast screening or mammography (breast screen*; mammogra*), (2) psychological impact (adverse effects; anxi*; distress; nervous; psych*, psychological consequences; stress; worry) and (3) family history. Reference lists from relevant papers were examined for additional papers. The review identified seven papers from four countries. Overall, the findings indicate that, similar to women in the general population, most women with a family history do not appear to experience high levels of anxiety associated with mammographic screening. Although women who are recalled for further tests do experience increased anxiety the levels appear to be no greater than for women without a family history. We conclude that further research on this topic is required--this should include studies designed specifically to consider both the negative and positive impact of mammographic screening on women with a family history, using validated measures of anxiety and worry in combination with qualitative research.

  8. Mammographic screening for breast cancer in a resource-restricted environment.

    Science.gov (United States)

    Apffelstaedt, S P; Dalmayer, L; Baatjes, K

    2014-04-01

    Mammographic screening is carried out at public sector hospitals as part of clinical practice. We report the experience of such screening at Tygerberg Academic Hospital (TBAH), a tertiary referral hospital in the Western Cape Province, South Africa. All mammograms performed between 2003 and 2012 at TBAH were analysed regarding patient demographics, clinical data, indication and outcome according to the American College of Radiology Breast Imaging Reporting and Data System (BIRADS). Screening mammography was offered to patients > 40 years of age and mammograms were read by experienced breast surgeons. Patients with BIRADS 3 and 4 lesions were recalled for short-term follow-up, further imaging or tissue acquisition. Patients with BIRADS 5 lesions were recalled for tissue acquisition. Further imaging, method of tissue acquisition, histology results and use of neo-adjuvant therapy were also recorded. Of 16 105 mammograms, 3 774 (23.4%) were carried out for screening purposes. The median age of patients undergoing screening was 54 years. Of 407 women with mammograms that were reported as BIRADS 3 - 5 (10.8% of screening mammograms), 187 (46% of recalled women) went on to have further imaging only. Tissue was acquired in 175 patients (43% of recalled women), comprising a biopsy rate of 4.6% of the total series. The malignancy rate in cases in which tissue acquisition was done was 25%. Forty-three breast cancers were diagnosed (11.4/1 000 examinations). Of the cancers, nine (31%) were ductal carcinomas in situ. Of 20 invasive cancers, nine (45%) were < 10 mm in size. Of the invasive cancers, 40% were node-positive. The cancer diagnosis rate indicates a high breast cancer load in an urbanised population.

  9. Association between mammographic density and pregnancies relative to age and BMI: a breast cancer case-only analysis.

    Science.gov (United States)

    Hack, Carolin C; Emons, Julius; Jud, Sebastian M; Heusinger, Katharina; Adler, Werner; Gass, Paul; Haeberle, Lothar; Heindl, Felix; Hein, Alexander; Schulz-Wendtland, Rüdiger; Uder, Michael; Hartmann, Arndt; Beckmann, Matthias W; Fasching, Peter A; Pöhls, Uwe G

    2017-08-21

    Percentage mammographic density (PMD) is a major risk factor for breast cancer (BC). It is strongly associated with body mass index (BMI) and age, which are themselves risk factors for breast cancer. This analysis investigated the association between the number of full-term pregnancies and PMD in different subgroups relative to age and BMI. Patients were identified in the breast cancer database of the University Breast Center for Franconia. A total of 2410 patients were identified, for whom information on parity, age, and BMI, and a mammogram from the time of first diagnosis were available for assessing PMD. Linear regression analyses were conducted to investigate the influence on PMD of the number of full-term pregnancies (FTPs), age, BMI, and interaction terms between them. As in previous studies, age, number of FTPs, and BMI were found to be associated with PMD in the expected direction. However, including the respective interaction terms improved the prediction of PMD even further. Specifically, the association between PMD and the number of FTPs differed in young patients under the age of 45 (mean decrease of 0.37 PMD units per pregnancy) from the association in older age groups (mean decrease between 2.29 and 2.39 PMD units). BMI did not alter the association between PMD and the number of FTPs. The effect of pregnancies on mammographic density does not appear to become apparent before the age of menopause. The mechanism that drives the effect of pregnancies on mammographic density appears to be counter-regulated by other influences on mammographic density in younger patients.

  10. Interval breast cancers: Absolute and proportional incidence and blinded review in a community mammographic screening program

    Energy Technology Data Exchange (ETDEWEB)

    Carbonaro, Luca A., E-mail: luca.carbonaro@gmail.com [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Azzarone, Antonio [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Paskeh, Bijan Babaei [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Brambilla, Giorgio [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Brunelli, Silvia [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Calori, Anna [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Caumo, Francesca [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Malerba, Paolo [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Menicagli, Laura [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Sconfienza, Luca M. [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano (Italy); Vadalà, Giuseppe [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Brambilla, Gelma; Fantini, Luigi [Servizio di Medicina Preventiva delle Comunità, ASL Milano 2, Via Friuli 2, Lacchiarella (Mi) 20084 (Italy); Ciatto, Stefano [Screening Program, ULSS 16, Padova (Italy); and others

    2014-02-15

    Purpose: To evaluate the performance of the first years since the beginning of a mammographic population-based screening program. Materials and methods: Women aged 49–69 were invited biennially for two-view film-screen mammography and double reading without arbitration was performed. Interval cancers (ICs) from 2001 to 2006 were identified using screening archives, local pathology archives, and hospital discharge records. The proportional incidence of IC was determined considering breast cancers expected without screening. Three offsite radiologists experienced in breast cancer screening blindly evaluated mammograms prior to diagnosis, randomly mixed with negative mammograms (1:2 ratio). Cases unrecalled at review were considered as true ICs, those recalled by only one reviewer as minimal signs, and those recalled by two or three reviewers as missed cancers. T and N stage of the reviewed ICs were evaluated and compared. Results: A total of 86,276 first level mammograms were performed. Mean recall rate was 6.8% at first and 4.6% at repeat screening. We had 476 screen-detected cancers and 145 ICs (10 of them ductal carcinomas in situ). Absolute incidence was 17 per 10,000 screening examinations. Invasive proportional incidence was 19% (44/234) in the first year, 39% (91/234) in the second year, and 29% (135/468) in the two-year interval. Of 145 ICs, 130 (90%) were reviewed mixed with 287 negative controls: 55% (71/130) resulted to be true ICs, 24% (31/130) minimal signs, and 22% (28/130) missed cancers. The rate of ICs diagnosed in the first year interval was 21% (15/71) for true ICs, 46% (13/28) for missed cancers, and 39% (12/31) for minimal signs, with a significant difference of true ICs rate compared to missed cancers rate (p = 0.012). A higher rate of T3 and T4 stages was found for missed cancers (18%, 5/28) compared to minimal signs (6%, 2/31) or true ICs (8%, 6/71), while the rate of N2 and N3 stage for both minimal signs (19%, 6/31) or missed cancers (25

  11. Seroprevalence of occult hepatitis B among Egyptian paediatric hepatitis C cancer patients.

    Science.gov (United States)

    Raouf, H E; Yassin, A S; Megahed, S A; Ashour, M S; Mansour, T M

    2015-02-01

    Occult hepatitis B infection is characterized by the presence of hepatitis B virus (HBV) DNA in the serum in the absence of hepatitis B surface antigen (HBsAg). Prevalence of hepatitis C virus (HCV) infections in Egypt is among the highest in the world. In this study, we aim at analysing the rates of occult HBV infections among HCV paediatric cancer patients in Egypt. The prevalence of occult HBV was assessed in two groups of paediatric cancer patients (HCV positive and HCV negative), in addition to a third group of paediatric noncancer patients, which was used as a general control. All groups were negative for HBsAg and positive for HCV antibody. HBV DNA was detected by nested PCR and real-time PCR. HCV was detected by real-time PCR. Sequencing was carried out in order to determine HBV genotypes to all HBV patients as well as to detect any mutation that might be responsible for the occult phenotype. Occult hepatitis B infection was observed in neither the non-HCV paediatric cancer patients nor the paediatric noncancer patients but was found in 31% of the HCV-positive paediatric cancer patients. All the detected HBV patients belonged to HBV genotype D, and mutations were found in the surface genome of HBV leading to occult HBV. Occult HBV infection seems to be relatively frequent in HCV-positive paediatric cancer patients, indicating that HBsAg negativity is not sufficient to completely exclude HBV infection. These findings emphasize the importance of considering occult HBV infection in HCV-positive paediatric cancer patients especially in endemic areas as Egypt.

  12. Correlation of mammographic density and serum calcium levels in patients with primary breast cancer.

    Science.gov (United States)

    Hack, Carolin C; Stoll, Martin J; Jud, Sebastian M; Heusinger, Katharina; Adler, Werner; Haeberle, Lothar; Ganslandt, Thomas; Heindl, Felix; Schulz-Wendtland, Rüdiger; Cavallaro, Alexander; Uder, Michael; Beckmann, Matthias W; Fasching, Peter A; Bayer, Christian M

    2017-06-01

    Percentage mammographic breast density (PMD) is one of the most important risk factors for breast cancer (BC). Calcium, vitamin D, bisphosphonates, and denosumab have been considered and partly confirmed as factors potentially influencing the risk of BC. This retrospective observational study investigated the association between serum calcium level and PMD. A total of 982 BC patients identified in the research database at the University Breast Center for Franconia with unilateral BC, calcium and albumin values, and mammogram at the time of first diagnosis were included. PMD was assessed, using a semiautomated method by two readers. Linear regression analyses were conducted to investigate the impact on PMD of the parameters of serum calcium level adjusted for albumin level, and well-known clinical predictors such as age, body mass index (BMI), menopausal status and confounder for serum calcium like season in which the BC was diagnosed. Increased calcium levels were associated with reduced PMD (P = 0.024). Furthermore, PMD was inversely associated with BMI (P < 0.001) and age (P < 0.001). There was also an association between PMD and menopausal status (P < 0.001). The goodness-of-fit of the regression model was moderate. This is the first study assessing the association between serum calcium level and PMD. An inverse association with adjusted serum calcium levels was observed. These findings add to previously published data relating to vitamin D, bisphosphonates, denosumab, and the RANK/RANKL signaling pathway in breast cancer risk and prevention. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  13. [A retrospective analysis on occult neck lymphatic metastasis in early tongue cancer].

    Science.gov (United States)

    Gong, Q L; Bian, C; Liu, H

    2016-10-07

    Objective: To investigate the number and level of occult neck lymphatic metastasis for squamous cell carcinoma of tongue in clinical stage Ⅰ/Ⅱ, and the relationship between cell differentiation and occult neck lymphatic metastasis. Methods: A total of 101 cases diagnosed preoperatively as having squamous cell carcinoma of tongue in clinical stage Ⅰ/Ⅱ (cT1/T2N0M0) between January 2005 and April 2015 were analysed retrospectively. Whether presence of occult neck lymphatic metastasis in these cases was studied. Results: Occult neck lymphatic metastases were found in 22 (21.78%) of 101 cases, 10 men and 12 women, with an age range of 22 to 83 years. There was not statistically significant association between tumor size or cell differentiation and occult neck lymphatic metastasis (P>0.05). The metastasis occurred most commonly in level Ⅱ, followed by levelsⅠ, Ⅲ and Ⅳ. There was no lymph node metastasis in Level Ⅴ. There were total 20 cases with occult neck lymphatic metastasis in at least one of levelⅠ, Ⅱ, Ⅲ(90.9%), One of these case was skipping metastasis in level Ⅲ(4.6%). Conclusion: The early tongue cancer has a high rate of occult lymph metastasis, which occurs commonly in levels Ⅱ, Ⅰ and Ⅲ, but there is not significant association between the metastasis and tumor size or cell differentiation.

  14. Evaluation of the association between quantitative mammographic density and breast cancer occurred in different quadrants.

    Science.gov (United States)

    Chan, Siwa; Chen, Jeon-Hor; Li, Shunshan; Chang, Rita; Yeh, Darh-Cherng; Chang, Ruey-Feng; Yeh, Lee-Ren; Kwong, Jessica; Su, Min-Ying

    2017-04-17

    To investigate the relationship between mammographic density measured in four quadrants of a breast with the location of the occurred cancer. One hundred and ten women diagnosed with unilateral breast cancer that could be determined in one specific breast quadrant were retrospectively studied. Women with previous cancer/breast surgery were excluded. The craniocaudal (CC) and mediolateral oblique (MLO) mammography of the contralateral normal breast were used to separate a breast into 4 quadrants: Upper-Outer (UO), Upper-Inner (UI), Lower-Outer (LO), and Lower-Inner (LI). The breast area (BA), dense area (DA), and percent density (PD) in each quadrant were measured by using the fuzzy-C-means segmentation. The BA, DA, and PD were compared between patients who had cancer occurring in different quadrants. The upper-outer quadrant had the highest BA (37 ± 15 cm(2)) and DA (7.1 ± 2.9 cm(2)), with PD = 20.0 ± 5.8%. The order of BA and DA in the 4 separated quadrants were: UO > UI > LO > LI, and almost all pair-wise comparisons showed significant differences. For tumor location, 67 women (60.9%) had tumor in UO, 16 (14.5%) in UI, 7 (6.4%) in LO, and 20 (18.2%) in LI quadrant, respectively. The estimated odds and the 95% confidence limits of tumor development in the UO, UI, LO and LI quadrants were 1.56 (1.06, 2.29), 0.17 (0.10, 0.29), 0.07 (0.03, 0.15), and 0.22 (0.14, 0.36), respectively. In these 4 groups of women, the order of quadrant BA and DA were all the same (UO > UI > LO > LI), and there was no significant difference in BA, DA or PD among them (all p > 0.05). Breast cancer was most likely to occur in the UO quadrant, which was also the quadrant with highest BA and DA; but for women with tumors in other quadrants, the density in that quadrant was not the highest. Therefore, there was no direct association between quadrant density and tumor occurrence.

  15. Implications of occult metastatic cells for systemic cancer treatment in patients with breast or gastrointestinal cancer.

    Science.gov (United States)

    Braun, S; Rosenberg, R; Thorban, S; Harbeck, N

    2001-06-01

    The early and clinically occult spread of viable tumour cells to the organism is becoming acknowledged as a hallmark in cancer progression, since abundant clinical and experimental data suggest that these cells are precursors of subsequent distant relapse. Using monoclonal antibodies against epithelial cytokeratins or tumour-associated cell membrane glycoproteins, individual carcinoma cells can be detected in cytological bone marrow preparations at frequencies of 10(-5) to 10(-6). Prospective clinical studies have shown that the presence of such immunostained cells in bone marrow is prognostically relevant with regard to relapse-free and overall survival, even in malignancies that do not preferentially metastasise to bone. As current treatment strategies have resulted in a substantial improvement of cancer mortality rates, it is noteworthy to consider the intriguing options of immunocytochemical screening of bone marrow aspirates for occult metastatic cells. Besides improved tumour staging, such screening offers opportunities for guiding patient stratification for adjuvant therapy trials, monitoring response to adjuvant therapies (which, at present, can only be assessed retrospectively after an extended period of clinical follow-up), and specifically targeting tumour-biological therapies against disseminated tumour cells. The present review summarises the current data on the clinical significance of occult metastatic cancer cells in bone marrow.

  16. Correlation between mammographic and sonographic findings and prognostic factors in patients with node-negative invasive breast cancer.

    Science.gov (United States)

    Shin, H J; Kim, H H; Huh, M O; Kim, M J; Yi, A; Kim, H; Son, B H; Ahn, S H

    2011-01-01

    The purpose of this study was to correlate sonographic and mammographic findings with prognostic factors in patients with node-negative invasive breast cancer. Sonographic and mammographic findings in 710 consecutive patients (age range 21-81 years; mean age 49 years) with 715 node-negative invasive breast cancers were retrospectively evaluated. Pathology reports relating to tumour size, histological grade, lymphovascular invasion (LVI), extensive intraductal component (EIC), oestrogen receptor (ER) status and HER-2/neu status were reviewed and correlated with the imaging findings. Statistical analysis was performed using logistic regression analysis and intraclass correlation coefficient (ICC). On mammography, non-spiculated masses with calcifications were associated with all poor prognostic factors: high histological grade, positive LVI, EIC, HER-2/neu status and negative ER. Other lesions were associated with none of these poor prognostic factors. Hyperdense masses on mammography, the presence of mixed echogenicity, posterior enhancement, calcifications in-or-out of masses and diffusely increased vascularity on sonography were associated with high histological grade and negative ER. Associated calcifications on both mammograms and sonograms were correlated with EIC and HER-2/neu overexpression. The ICC value for the disease extent was 0.60 on mammography and 0.70 on sonography. Several sonographic and mammographic features can have a prognostic value in the subsequent treatment of patients with node-negative invasive breast cancer. Radiologists should pay more attention to masses that are associated with calcifications because on both mammography and sonography associated calcifications were predictors of positive EIC and HER-2/neu overexpression.

  17. Association between the Adherence to the International Guidelines for Cancer Prevention and Mammographic Density.

    Directory of Open Access Journals (Sweden)

    Adela Castelló

    Full Text Available Mammographic density (MD is considered a strong predictor of Breast Cancer (BC. The objective of the present study is to explore the association between MD and the compliance with the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR recommendations for cancer prevention.Data of 3584 women attending screening from a population-based multicenter cross-sectional study (DDM-Spain collected from October 7, 2007 through July 14, 2008, was used to calculate a score that measures the level of compliance with the WCRF/AICR recommendations: R1Maintain adequate body weight; R2Be physically active; 3RLimit the intake of high density foods; R4Eat mostly plant foods; R5Limit the intake of animal foods; R6Limit alcohol intake; R7Limit salt and salt preserved food intake; R8Meet nutritional needs through diet. The association between the score and MD (assessed by a single radiologist using a semi-quantitative scale was evaluated using ordinal logistic models with random center-specific intercepts adjusted for the main determinants of MD. Stratified analyses by menopausal status and smoking status were also carried out.A higher compliance with the WCRF/AICR recommendations was associated with lower MD (OR1-unit increase = 0.93 95%CI:0.86;0.99. The association was stronger in postmenopausal women (OR = 0.91 95%CI:0.84;0.99 and nonsmokers (OR = 0.87;95%CI:0.80;0.96 for nonsmokers, OR = 1.01 95%CI:0.91;1.12 for smokers, P-interaction = 0.042. Among nonsmokers, maintaining adequate body weight (OR = 0.81 95%CI:0.65;1.01, practicing physical activity (OR = 0.68 95%CI:0.48;0.96 and moderating the intake of high-density foods (OR = 0.58 95%CI:0.40;0.86 and alcoholic beverages (OR = 0.76 95%CI:0.55;1.05 were the recommendations showing the strongest associations with MD.postmenopausal women and non-smokers with greater compliance with the WCRF/AICR guidelines have lower MD. These results may provide guidance to design specific

  18. MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer

    OpenAIRE

    Sangeeta Taneja; Amarnath Jena; Syed. Mohd. Shuaib Zaidi; Anuj Khurana

    2012-01-01

    Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI) is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral bre...

  19. Does the prediction of breast cancer improve using a combination of mammographic density measures compared to individual measures alone?

    Science.gov (United States)

    Wong Sik Hee, Joseph Ryan; Harkness, Elaine F.; Gadde, Soujanya; Lim, Yit Y.; Maxwell, Anthony J.; Evans, D. Gareth; Howell, Anthony; Astley, Susan M.

    2017-03-01

    High mammographic density is associated with an increased risk of breast cancer, however whether the association is stronger when there is agreement across measures is unclear. This study investigates whether a combination of density measures is a better predictor of breast cancer risk than individual methods alone. Women recruited to the Predicting Risk of Cancer At Screening (PROCAS) study and with mammographic density assessed using three different methods were included (n=33,304). Density was assessed visually using Visual Analogue Scales (VAS) and by two fully automated methods, Quantra and Volpara. Percentage breast density was divided into (high, medium and low) and combinations of measures were used to further categorise individuals (e.g. `all high'). A total of 667 breast cancers were identified and logistic regression was used to determine the relationship between breast density and breast cancer risk. In total, 44% of individuals were in the same tertile for all three measures, 8.6% were in non-adjacent (high and low) or mixed categories (high, medium and low). For individual methods the strongest association with breast cancer risk was for medium and high tertiles of VAS with odds ratios (OR) adjusted for age and BMI of 1.63 (95% CI 1.31-2.03) and 2.33 (1.87-2.90) respectively. For the combination of density methods the strongest association was for `all high' (OR 2.42, 1.77-3.31) followed by "two high" (OR 1.90, 1.35-3.31) and "two medium" (OR 1.88, 1.40-2.52). Combining density measures did not affect the magnitude of risk compared to using individual methods.

  20. Miscellaneous syndromes and their management: occult breast cancer, breast cancer in pregnancy, male breast cancer, surgery in stage IV disease.

    Science.gov (United States)

    Colfry, Alfred John

    2013-04-01

    Surgical therapy for occult breast cancer has traditionally centered on mastectomy; however, breast conservation with whole breast radiotherapy followed by axillary lymph node dissection has shown equivalent results. Patients with breast cancer in pregnancy can be safely and effectively treated; given a patient's pregnancy trimester and stage of breast cancer, a clinician must be able to guide therapy accordingly. Male breast cancer risk factors show strong association with BRCA2 mutations, as well as Klinefelter syndrome. Several retrospective trials of surgical therapy in stage IV breast cancer have associated a survival advantage with primary site tumor extirpation.

  1. False negative fecal occult blood tests due to delayed sample return in colorectal cancer screening.

    NARCIS (Netherlands)

    Rossum, L.G.M. van; Rijn, A.F. van; Oijen, M.G.H. van; Fockens, P.; Laheij, R.J.F.; Verbeek, A.L.M.; Jansen, J.B.M.J.; Dekker, E.

    2009-01-01

    Delayed return of immunochemical fecal occult blood test (iFOBT) samples to a laboratory might cause false negatives because of hemoglobin degradation. Quantitative iFOBT's became increasingly more accepted in colorectal cancer screening. Therefore, we studied the effects of delay between sampling a

  2. Incidence and Risk Factors for Occult Level 3 Lymph Node Metastases in Papillary Thyroid Cancer

    NARCIS (Netherlands)

    Fraser, Sheila; Zaidi, Nisar; Norlen, Olov; Glover, Anthony; Kruijff, Schelto; Sywak, Mark; Delbridge, Leigh; Sidhu, Stan B.

    2016-01-01

    Papillary thyroid cancer (PTC) frequently disseminates into cervical lymph nodes. Lateral node involvement is described in up to 50 % patients undergoing prophylactic lateral neck dissection. This study aimed to assess this finding and identify which factors predict for occult lateral node disease.

  3. Neurofibromatosis and breast cancer: Do we need to revise the mammographic screening schedule in patients of neurofibromatosis?

    Directory of Open Access Journals (Sweden)

    Dinesh Pradhan

    2017-01-01

    Full Text Available Neurofibromatosis type 1 (NF-1 is a neurocutaneous syndrome with autosomal dominant mode of inheritance and has a high propensity to develop benign and malignant nervous system tumors. Although uncommon, case reports describing the association of NF-1 and breast cancer are available in the literature. We illustrate one such case of NF-1, with no family history of the disorder and presenting with multifocal invasive carcinoma of the right breast, in an attempt to describe the association between these two entities. We also attempt to extensively review the current literature on the subject. Since patients with NF-1 are at an increased risk of developing breast cancer, we recommend strict adherence to careful clinical breast examination and annual screening mammographic examination starting at 40 years of age in all patients of NF-1.

  4. Mammographic parenchymal patterns and breast cancer risk in New South Wales North Coast Aboriginal and Torres Strait Islander women.

    Science.gov (United States)

    Pape, Ruth; Spuur, Kelly Maree; Currie, Geoffrey; Greene, Lacey

    2016-06-01

    The objective of the study was to document the distribution of mammographic parenchymal patterns (MPP) of Indigenous Australian women attending BreastScreen New South Wales (NSW) North Coast, to profile breast cancer risk as it relates to breast density and to explore the correlation between MPP, breast size as described by the posterior nipple line (PNL) and age. Ethics was granted from CQUniversity Human Research Ethics Committee, NSW Population Health Services Research Ethics Committee and the Aboriginal Health and Medical Research Council Ethics Committee. A quantitative retrospective analysis reviewed 502 screening mammograms against the Tabár I-V MPP classification system. The PNL was measured in millimetres (mm) and the age of the patient documented. A statistically significant variation in the distribution of MPP (P distribution of MPP was noted in this snapshot of Indigenous women. A larger study of Indigenous Australian women is required for validation.

  5. Test Sensitivity in the Computer-Aided Detection of Breast Cancer from Clinical Mammographic Screening: a Meta-analysis

    CERN Document Server

    Levman, Jacob

    2013-01-01

    Objectives: To assess evaluative methodologies for comparative measurements of test sensitivity in clinical mammographic screening trials of computer-aided detection (CAD) technologies. Materials and Methods: This meta-analysis was performed by analytically reviewing the relevant literature on the clinical application of computer-aided detection (CAD) technologies as part of a breast cancer screening program based on x-ray mammography. Each clinical study's method for measuring the CAD system's improvement in test sensitivity is examined in this meta-analysis. The impact of the chosen sensitivity measurement on the study's conclusions are analyzed. Results: This meta-analysis demonstrates that some studies have inappropriately compared sensitivity measurements between control groups and CAD enabled groups. The inappropriate comparison of control groups and CAD enabled groups can lead to an underestimation of the benefits of the clinical application of computer-aided detection technologies. Conclusions: The po...

  6. Occult Pelvic Lymph Node Involvement in Bladder Cancer: Implications for Definitive Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Goldsmith, Benjamin; Baumann, Brian C.; He, Jiwei; Tucker, Kai; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vaughn, David; Keefe, Stephen M. [Department of Medical Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Guzzo, Thomas; Malkowicz, S. Bruce [Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-03-01

    Purpose: To inform radiation treatment planning for clinically staged, node-negative bladder cancer patients by identifying clinical factors associated with the presence and location of occult pathologic pelvic lymph nodes. Methods and Materials: The records of patients with clinically staged T1-T4N0 urothelial carcinoma of the bladder undergoing radical cystectomy and pelvic lymphadenectomy at a single institution were reviewed. Logistic regression was used to evaluate associations between preoperative clinical variables and occult pathologic pelvic or common iliac lymph nodes. Percentages of patient with involved lymph node regions entirely encompassed within whole bladder (perivesicular nodal region), small pelvic (perivesicular, obturator, internal iliac, and external iliac nodal regions), and extended pelvic clinical target volume (CTV) (small pelvic CTV plus common iliac regions) were calculated. Results: Among 315 eligible patients, 81 (26%) were found to have involved pelvic lymph nodes at the time of surgery, with 38 (12%) having involved common iliac lymph nodes. Risk of occult pathologically involved lymph nodes did not vary with clinical T stage. On multivariate analysis, the presence of lymphovascular invasion (LVI) on preoperative biopsy was significantly associated with occult pelvic nodal involvement (odds ratio 3.740, 95% confidence interval 1.865-7.499, P<.001) and marginally associated with occult common iliac nodal involvement (odds ratio 2.307, 95% confidence interval 0.978-5.441, P=.056). The percentages of patients with involved lymph node regions entirely encompassed by whole bladder, small pelvic, and extended pelvic CTVs varied with clinical risk factors, ranging from 85.4%, 95.1%, and 100% in non-muscle-invasive patients to 44.7%, 71.1%, and 94.8% in patients with muscle-invasive disease and biopsy LVI. Conclusions: Occult pelvic lymph node rates are substantial for all clinical subgroups, especially patients with LVI on biopsy. Extended

  7. Physical activity and mammographic breast density: a systematic review

    OpenAIRE

    Yaghjyan, Lusine; Colditz, Graham A.; Wolin, Kathleen

    2012-01-01

    Studies show a protective relationship between physical activity and breast cancer risk across the life course from menarche to postmenopausal years. Mammographic breast density is a known and strong breast cancer risk factor. Whether the association of physical activity with breast cancer risk is mediated through mammographic breast density is poorly understood. This systematic review summarizes published studies that investigated the association between physical activity and mammographic br...

  8. Relationship between Full-Field Digital Mammographic Features and Clinicopathologic Characteristics in 176 Cases with Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Zhe Sun; Hongwei Liang; Huimian Xu

    2005-01-01

    OBJECTIVE Different mammographic features are probably predictive of different prognosis. However, ambiguity still exists in understanding the relationship between them. In resent years, digital mammography has been available for clinical use which has led to a revolution in the resolving of images and an increase in early-stage breast cancer detection.Based on the above knowledge, this study was performed to evaluate the relationship between full-field digital mammographic features and clinicopathologic characteristics in breast cancer.METHODS Digital mammograms of 176 patients with pathologically proven breast cancer were reviewed. Also, clinical and pathologic records (histological types and axillary lymph nodes status) were retrospectively examined.RESULTS Most of the patients with a solitary microcalcification were young women under the age of 50(84.4%), but the majority of the patients with microcalcifications complicated by a mass were elderly women. Microcalcifications detected by mammography occurred frequently in ductal carcinoma in situ (28.1%) and in early invasive carcinoma (15.6%). Breast cancers with expression of microcalcifications combined with a spiculate mass had a high metastatic rate of axillary lymph nodes (69.4%). A high metastatic rate of axillary lymph nodes was also found in the patients with solitary worm-like microcalcifications (57.1%), solitary spiculate mass (53.7%) and solitary non-worm-like microcalcifications (44.4%). Simple worm-like microcalcifications accompanied with metastasis of 4 to 9 axillary lymph nodes occurred in 42.9% of the(6/14) cases. The patients with microcalcifications combined by a spiculate mass and with metastasis of 4 to 9 axillary lymph nodes accounted for 27.8% (10/36) of the cases,and those with metastases of 10 and over accounted for 16.7% (6/36).CONCLUSION Solitary microcalcifications occur frequently in young women and are usually associated with early breast cancer. There is a close relationship

  9. Association of a mammographic parenchymal pattern (MPP) descriptor with breast cancer risk: a case-control study

    Science.gov (United States)

    Wei, Jun; Chan, Heang-Ping; Zhou, Chuan; Helvie, Mark A.; Hadjiiski, Lubomir M.; Sahiner, Berkman

    2010-03-01

    We are investigating the feasibility of improving breast cancer risk prediction by computerized mammographic parenchymal pattern (MPP) analysis. A case-control study was conducted to investigate the association of the MPP measures with breast cancer risk. The case group included 168 contralateral CC-view mammograms of breast cancer patients dated at least one year prior to cancer diagnosis, and the control group included 522 CC-view mammograms from one breast of normal subjects. We extracted and compared four types of statistical texture feature spaces that included run length statistics and region size statistics (RLS/RSS) features, spatial gray level dependence (SGLD) features, gray level difference statistics (GLDS) features, and the feature space combining these three types of texture features. A linear discriminant analysis (LDA) classifier with stepwise feature selection was trained and tested with leave-one-case-out resampling to evaluate whether the breast parenchyma of future cancer patients could be distinguished from those of normal subjects in each feature space. The areas under ROC curves (Az) were 0.71, 0.72, 0.71 and 0.76 for the four feature spaces, respectively. The Az obtained from the combined feature space was significantly (pbreast cancer risk and four categories of MPP measures: 0.2 (C4) while patient age was treated as a confounding factor. The adjusted ORs of breast cancer for C2, C3 and C4 were 3.23, 7.77 and 25.43, respectively. The preliminary result indicated that our proposed computerized MPP measures were strongly associated with breast cancer risk.

  10. Occult breast cancer with EDTA-dependent pseudothrombocytopenia -a case report-.

    Science.gov (United States)

    Abe, Hajime; Shimizu, Tomoharu; Cho, Hirotomi; Kubota, Yoshihiro; Umeda, Tomoko; Kurumi, Yoshimasa; Tani, Tohru

    2010-05-01

    A case of occult breast cancer with pseudothrombocytopenia (PTCP) is reported. A 50-year-old woman was consulted with a left axillary tumor. Ductal carcinoma was found by the core needle biopsy, and no primary lesion was detected. Her preoperative platelet count, obtained from an ethylene diamine tetraacetic acid (EDTA) sampling bottle, was 3.1 x 10(4) per mL, but she had no history of bleeding problems. A heparinized blood sample showed a normal platelet count of 390 x 10(4) per mL. These findings suggested a diagnosis of occult breast cancer with EDTA-dependent PTCP, and level II axillary lymph node dissection was performed. She received adjuvant chemotherapy and radiotherapy, but she died 2 years and 5 months after the surgery because of lung and brain metastases. Awareness of the phenomenon and knowledge of the underlying physiological principles will enable surgeons to manage patients with EDTA-dependent PTCP appropriately.

  11. Radiographically occult intrasinusoidal liver metastases leading to hepatic failure in a case of breast cancer.

    Science.gov (United States)

    Gulia, Seema; Khurana, Sachin; Shet, Tanuja; Gupta, Sudeep

    2016-02-15

    The liver is one of the commonest sites of metastatic involvement in breast cancer, usually evident as focal lesions on imaging tests. Rarely, the pattern of metastatic spread is so diffuse that it remains radiologically occult. Such patients usually present with signs of hepatic insufficiency without any focal lesions on liver imaging. In such cases, liver biopsy is required to make a definitive diagnosis. We report a case of a 56-year-old postmenopausal woman with metastatic breast cancer who presented with subacute progressive liver failure. Repeated imaging of the liver was normal or non-descript. Liver biopsy finally established the diagnosis of intrasinusoidal metastases from breast cancer.

  12. Tubular carcinoma of the breast: Mammographic, sonographic, clinical and pathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil [Ege University Hospital, Department of Radiology, Bornova, Izmir 35100 (Turkey)]. E-mail: isilbilgen@hotmail.com; Oktay, Aysenur [Ege University Hospital, Department of Radiology, Bornova, Izmir 35100 (Turkey)

    2007-01-15

    Purpose: To determine and quantitate the radiological characteristics of tubular carcinoma of the breast, to report clinical and pathologic findings and to define findings at follow-up. Materials and methods: A retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 32 histopathologically proven pure tubular carcinoma of the breast. Analysis included history; findings at physical examination, mammography, and sonography (US) at the time of diagnosis and in postoperative follow-up and histopathological results. Results: Fifty-nine percent of the patients (n = 19) presented with a palpable mass. The mammographic findings were a mass in 23 (72%), a mass with microcalcifications in 2 (6%), asymmetric focal density in 1 (3%), architectural distortion in 1 (3%) and negative in 5 (16%) of the 32 patients. Most (96%) masses had spiculated margins. US depicted 30 masses in 29 patients, all of which were hypoechoic, mostly (n = 27, 90%) with posterior acoustic shadowing. The cancer was clinically occult in 41% (n = 13), mammographically occult in 16% (n = 5), and sonographically occult in 6% (n = 2) of the patients. Histologically, the tumor was multifocal in 3% (n = 1) of the patients. Four (13%) patients developed contralateral breast carcinoma at follow-up. Conclusion: Tubular carcinoma has a variety of presentations, but it is mostly seen on mammography as a small spiculated mass, and on sonography as an irregular mass with posterior acoustic shadowing. Although tubular carcinoma is known as a well-differentiated tumor with excellent prognosis, the mammographic follow-up of the contralateral breast is important.

  13. The role of mammographic calcification in the neoadjuvant therapy of breast cancer imaging evaluation.

    Science.gov (United States)

    Li, Jun-jie; Chen, Canming; Gu, Yajia; Di, Genhong; Wu, Jiong; Liu, Guangyu; Shao, ZhiMin

    2014-01-01

    Investigate the patterns of mammographically detected calcifications before and after neoadjuvant chemotherapy (NACT) to determine their value for efficacy evaluation and surgical decision making. 187 patients with malignant mammographic calcifications were followed to record the appearances and changes in the calcifications and to analyze their responses to NACT. Patients with calcifications had higher rates of hormonal receptor (HR) positive tumors (74.3% versus 64.6%) and HER2 positive tumors (51.3% versus 33.4%, p = 0.004) and a similar pathologic complete response (pCR) rate compared to patients without calcifications (35.4% versus 29.8%). After NACT, the range of calcification decreased in 40% of patients, increased in 7.5% and remained stable in 52.5%; the calcification density decreased in 15% of patients, increased in 7.5% and remained stable in 77.5%; none of these change patterns were related to tumor response rate. No significant correlation was observed between the calcification appearance (morphology, distribution, range, diameter or density) and tumor subtypes or pCR rates. Among patients with malignant calcifications, 54 showed calcifications alone, 40 occurred with an architectural distortion (AD) and 93 with a mass. Calcifications were observed inside the tumor in 44% of patients and outside in 56%, with similar pCR rates and patterns of change. Calcification appearance did not clearly change after NACT, and calcification patterns were not related to pCR rate, suggesting that mammogram may not accurate to evaluate tumor response changes. Microcalcifications visible after NACT is essential for determining the extent of excision, patients with calcifications that occurred outside of the mass still had the opportunity for breast conservation.

  14. The role of mammographic calcification in the neoadjuvant therapy of breast cancer imaging evaluation.

    Directory of Open Access Journals (Sweden)

    Jun-jie Li

    Full Text Available INTRODUCTION: Investigate the patterns of mammographically detected calcifications before and after neoadjuvant chemotherapy (NACT to determine their value for efficacy evaluation and surgical decision making. METHODS: 187 patients with malignant mammographic calcifications were followed to record the appearances and changes in the calcifications and to analyze their responses to NACT. RESULTS: Patients with calcifications had higher rates of hormonal receptor (HR positive tumors (74.3% versus 64.6% and HER2 positive tumors (51.3% versus 33.4%, p = 0.004 and a similar pathologic complete response (pCR rate compared to patients without calcifications (35.4% versus 29.8%. After NACT, the range of calcification decreased in 40% of patients, increased in 7.5% and remained stable in 52.5%; the calcification density decreased in 15% of patients, increased in 7.5% and remained stable in 77.5%; none of these change patterns were related to tumor response rate. No significant correlation was observed between the calcification appearance (morphology, distribution, range, diameter or density and tumor subtypes or pCR rates. Among patients with malignant calcifications, 54 showed calcifications alone, 40 occurred with an architectural distortion (AD and 93 with a mass. Calcifications were observed inside the tumor in 44% of patients and outside in 56%, with similar pCR rates and patterns of change. CONCLUSIONS: Calcification appearance did not clearly change after NACT, and calcification patterns were not related to pCR rate, suggesting that mammogram may not accurate to evaluate tumor response changes. Microcalcifications visible after NACT is essential for determining the extent of excision, patients with calcifications that occurred outside of the mass still had the opportunity for breast conservation.

  15. Occult HBV Infection: A Faceless Enemy in Liver Cancer Development

    Directory of Open Access Journals (Sweden)

    Jaime Morales-Romero

    2014-04-01

    Full Text Available The hepatitis B virus (HBV represents a worldwide public health problem; the virus is present in one third of the global population. However, this rate may in fact be higher due to occult hepatitis B virus infection (OBI. This condition is characterized by the presence of the viral genome in the liver of individuals sero-negative for the virus surface antigen (HBsAg. The causes of the absence of HBsAg in serum are unknown, however, mutations have been identified that produce variants not recognized by current immunoassays. Epigenetic and immunological host mechanisms also appear to be involved in HBsAg suppression. Current evidence suggests that OBI maintains its carcinogenic potential, favoring the progression of fibrosis and cirrhosis of the liver. In common with open HBV infection, OBI can contribute to the establishment of hepatocellular carcinoma. Epidemiological data regarding the global prevalence of OBI vary due to the use of detection methods of different sensitivity and specificity. In Latin America, which is considered an area of low prevalence for HBV, diagnostic screening methods using gene amplification tests for confirmation of OBI are not conducted. This prevents determination of the actual prevalence of OBI, highlighting the need for the implementation of cutting edge technology in epidemiological surveillance systems.

  16. Detection of occult disease in breast cancer using fluorodeoxyglucose camera-based positron emission tomography.

    Science.gov (United States)

    Pecking, A P; Mechelany-Corone, C; Bertrand-Kermorgant, F; Alberini, J L; Floiras, J L; Goupil, A; Pichon, M F

    2001-10-01

    An isolated increase of blood tumor marker CA 15.3 in breast cancer is considered a sensitive indicator for occult metastatic disease but by itself is not sufficient for initiating therapeutic intervention. We investigated the potential of camera-based positron emission tomography (PET) imaging using [18F]-fluorodeoxyglucose (FDG) to detect clinically occult recurrences in 132 female patients (age, 35-69 years) treated for breast cancer, all presenting with an isolated increase in blood tumor marker CA 15.3 without any other evidence of metastatic disease. FDG results were correlated to pathology results or to a sequentially guided conventional imaging method. One hundred nineteen patients were eligible for correlations. Positive FDG scans were obtained for 106 patients, including 89 with a single lesion and 17 with 2 or more lesion. There were 92 true-positive and 14 false-positive cases, 10 of which became true positive within 1 year. Among the 13 negative cases, 7 were false negative and 6 were true negative. Camera-based PET using FDG has successfully identified clinically occult disease with an overall sensitivity of 93.6% and a positive predictive value of 96.2%. The smallest detected size was 6 mm for a lymph node metastasis (tumor to nontumor ratio, 4:2). FDG camera-based PET localized tumors in 85.7% of cases suspected for clinically occult metastatic disease on the basis of a significant increase in blood tumor marker. A positive FDG scan associated with an elevated CA 15.3 level is most consistent with metastatic relapse of breast cancer.

  17. A New Immunologic Method for Detection of Occult Breast Cancer

    Science.gov (United States)

    1999-09-01

    215, 1988. 29 P.I., Rishab K. Gupta, Ph.D. 38. Repetto L, Onetto M, Gardin G, Costanzi B, Guidici S, Vitiello E, Merlini L, Naso C, Zannini C...Serum CA15-3 assay in the diagnosis and follow-up of breast cancer. BrJ Cancer 58: 213-215, 1988. 40. Repetto L, Onetto M, Gardin G, Costanzi B... REPETTO L, ONETTO M, GARDIN G, et al: Serum CEA, CA15-3, and MCA in breast cancer patients: A clinical evaluation. Cancer Detection & Prevention 17:411

  18. Occult and subsequent cancer incidence following risk-reducing surgery in BRCA mutation carriers.

    Science.gov (United States)

    Zakhour, Mae; Danovitch, Yael; Lester, Jenny; Rimel, B J; Walsh, Christine S; Li, Andrew J; Karlan, Beth Y; Cass, Ilana

    2016-11-01

    To report the frequency and features of occult carcinomas and the incidence of subsequent cancers following risk-reducing salpingo-oophorectomy (RRSO) in BRCA mutation carriers. 257 consecutive women with germline BRCA mutations who underwent RRSO between January 1, 2000 and December 31, 2014 were identified in an Institutional Review Board approved study. All patients were asymptomatic with normal physical exams, CA 125 values, and imaging studies preoperatively, and had at least 12months of follow-up post-RRSO. All patients had comprehensive adnexal sectioning performed. Patient demographics and clinico-pathologic characteristics were extracted from medical and pathology records. The cohort included 148 BRCA1, 98 BRCA2, 6 BRCA not otherwise specified (NOS), and 5 BRCA1 and 2 mutation carriers. Occult carcinoma was seen in 14/257 (5.4%) of patients: 9 serous tubal intraepithelial carcinomas (STIC), 3 tubal cancers, 1 ovarian cancer, and 1 endometrial cancer. Three patients (1.2%) with negative pathology at RRSO subsequently developed primary peritoneal serous carcinoma (PPSC), and 2 of 9 patients (22%) with STIC subsequently developed pelvic serous carcinoma. 110 women (43%) were diagnosed with breast cancer prior to RRSO, and 14 of the remaining 147 (9.5%) developed breast cancer following RRSO. Median follow-up of the cohort was 63months. In this cohort, 5.4% of asymptomatic BRCA mutation carriers had occult carcinomas at RRSO, 86% of which were tubal in origin. The risk of subsequent PPSC for women with benign adnexa at RRSO is low; however, the risk of pelvic serous carcinoma among women with STIC is significantly higher. Copyright © 2016. Published by Elsevier Inc.

  19. Axillary metastasis as first symptom of occult breast cancer: a case report.

    Science.gov (United States)

    Frattaroli, Fabrizio Maria; Carrara, Alessandro; Conte, Anna Maria; Pappalardo, Giuseppe

    2002-01-01

    Axillary lymph node metastasis from an occult breast carcinoma is a rare occurrence. We report this condition in a 59-year-old woman who presented with a swelling in the right axilla. No breast mass was clinically evident. Mammography, ultrasonography and multiple random fine-needle breast biopsies yielded no pathological findings. No extramammary primary lesions were present. Axillary sampling was performed and histological examination revealed the presence of metastatic adenocarcinoma in three of the 12 dissected lymph nodes. Estrogen receptors were positive and immunohistochemistry pointed to a breast origin. All these data were suggestive of occult breast cancer. The patient refused any further treatment but accepted clinical and radiological follow-up. Eight years later mammography revealed in the same breast a 10-mm nodule containing microcalcifications, which was not evident at physical examination. The patient underwent a lumpectomy. Intraoperative histology was positive for breast carcinoma and complete axillary clearance was performed. Histological examination revealed a lobular invasive breast carcinoma and the presence of micrometastasis in one of the 23 removed lymph nodes. The patient was given radiotherapy to the breast and axilla and tamoxifen. At present, one year after the appearance of the primary tumor, she is free of disease. Based on this case report we suggest an eclectic approach in the management of patients with axillary metastasis from occult breast cancer, depending on the clinical, pathological and biological findings.

  20. Heterogeneity of triple-negative breast cancer: mammographic, US, and MR imaging features according to androgen receptor expression

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Min Sun; Song, Sung Eun; Kim, Won Hwa; Lee, Su Hyun; Moon, Woo Kyung [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, So Yeon; Park, In-Ae [Seoul National University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Han, Wonshik; Noh, Dong-Young [Seoul National University College of Medicine, Department of Surgery, Seoul (Korea, Republic of)

    2014-09-16

    Our aim was to determine whether triple-negative breast cancers (TNBCs) with and without androgen receptor (AR) expression have distinguishing imaging features on mammography, breast ultrasound (US), and magnetic resonance (MR) imaging. AR expression was assessed immunohistochemically in 125 patients with TNBC from a consecutive series of 1,086 operable invasive breast cancers. Two experienced radiologists blinded to clinicopathological findings reviewed all imaging studies in consensus using the BI-RADS lexicon. The imaging and pathological features of 33 AR-positive TNBCs were compared with those of 92 AR-negative TNBCs. The presence of mammographic calcifications with or without a mass (p < 0.001), non-mass enhancement on MR imaging (p < 0.001), and masses with irregular shape or spiculated margins on US (p < 0.001 and p = 0.002) and MR imaging (p = 0.001 and p < 0.001) were significantly associated with AR-positive TNBC. Compared with AR-negative TNBC, AR-positive TNBC was more likely to have a ductal carcinoma in situ component (59.8 % vs. 90.9 %, p = 0.001) and low Ki-67 expression (30.4 % vs. 51.5 %, p = 0.030). AR-positive and AR-negative TNBCs have different imaging features, and certain imaging findings can be useful to predict AR status in TNBC. (orig.)

  1. Male Occult Breast Cancer First Manifesting as a Supraclavicular Lymph Node Metastasis: A Case Report

    Directory of Open Access Journals (Sweden)

    Maoyuan Zhao

    2017-06-01

    Full Text Available Male occult breast cancer has a lower incidence, later clinical stage at detection, poorer differentiation, worse prognosis, and metastasizes earlier than breast cancer in females due to its rarity and a lack of public awareness. We report a 64 year old male patient presenting with palpable masses in his left cervical region, in whom imaging was unremarkable, except for slightly enlarged axillary lymph nodes without increased metabolic activity and an area of high metabolic activity in the left supraclavicular fossa. The purpose of this case report is to present the imaging, pathological features, and our treatment for male OBC.

  2. VEGF与肿瘤血管生成拟态关系的研究%Mammographic features of breast cancer: Analysis of 118 cases

    Institute of Scientific and Technical Information of China (English)

    Zhijian Cao

    2009-01-01

    Objective: The aim of this retrospective study was to evaluate the mammographic imaging features (markers) on different types of breast cancer and improve early radiological diagnosis of breast cancer. Methods: Analyzed the roam-mographic images of 118 patients with breast cancer confirmed by surgery and pathology. Among 118 cases, 70 cases were infiltrating ductal carcinoma (59.3%), 17 cases were ductal carcinoma in situ (DCIS, 14.4%), 7 cases were mucinous carcinoma (5.9%), 5 cases were medullary carcinoma (4.2%), 1 case was tiny micro carcinoma (0.9%) and 18 cases were other types cancer (15.3%). Results: The mammographic appearance of 118 patients with different breast cancer included: tumor mass (n=80, 68.8%), microcalcification (n=57, 48.3%), which were subdivided into two groups (a) microcalcification only, 13 cases (131118, 11%); (b) combined with other mammographic features: 31 cases with tumor mass (31/118, 26.3%); 7 cases with architecture distortion (7/118, 5.9%), 6 cases with focal asymmetric density (6/118, 5.1%). Six cases appeared as architecture distortion only, 41 cases with abnormal vessel signs (34.7%). Conclusion: The microcalcifications are the most frequently basal X-ray signs in DCIS. Architecture distortion and focal asymmetric density are special X-ray signs that were easily missed. The abnormal vessels are also important accompaniment signs of breast cancer. The use of coned compres-sion technique is particularly important to improve the radiological diagnosis of breast cancer.

  3. Paraneoplastic polymyositis presenting as a clinically occult breast cancer.

    Science.gov (United States)

    Merali, N; Yousuff, M; Pronisceva, V; Poddar, A

    2017-02-01

    Paraneoplastic syndrome affects less than 1% of cancer patients. Diagnosis of paraneoplastic syndrome with neurological presentation requires screening for an underlying malignancy, including a complete history, physical examination and imaging studies. Treatment often results in symptom stability, rather than improvement. Paraneoplastic polymyositis can precede or instantaneously occur at diagnosis or treatment of a primary tumour, while neurological symptoms can persist even following cancer treatment. We report a rare case of metaplastic breast carcinoma with an unusual presentation of paraneoplastic polymyositis.

  4. A modified sentinel node and occult lesion localization (SNOLL) technique in non-palpable breast cancer: a pilot study

    OpenAIRE

    Follacchio, Giulia Anna; Monteleone, Francesco; Anibaldi, Paolo; De Vincentis, Giuseppe; Iacobelli, Silvia; Merola, Raffaele; D’Orazi, Valerio; Monti, Massimo; Pasta, Vittorio

    2015-01-01

    Background The spread of mammographic screening programs has allowed an increasing amount of early breast cancer diagnosis. A modern approach to non-palpable breast lesions requires an accurate intraoperative localization, in order to achieve a complete surgical resection. In addiction, the assessment of lymph node status is mandatory as it represents a major prognostic factor in these patients. The aim of this study is to evaluate the reliability of a modified technical approach using a sing...

  5. Early mammographic and sonographic findings after intraoperative radiotherapy (IORT) as a boost in patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wasser, K.; Schoeber, C.; Neff, W. [University Hospital Mannheim, University of Heidelberg, Department of Radiology, Heidelberg (Germany); Kraus-Tiefenbacher, U.; Wenz, F. [University of Heidelberg, Department of Radiation Oncology, Mannheim Medical Center, Heidelberg (Germany); Bauer, L. [University Hospital Mannheim, University of Heidelberg, Department of Gynecology and Obstetrics, Heidelberg (Germany); Brade, J. [University Hospital Mannheim, University of Heidelberg, Department of Statistics, Heidelberg (Germany); Teubner, J. [University Hospital Mannheim, University of Heidelberg, Department of Radiology, Heidelberg (Germany); Diagnostic Breastcenter St. Elisabethklinik Heidelberg, Heidelberg (Germany)

    2007-07-15

    The aim of this study was to evaluate mammographic and sonographic changes at the surgical site within the first 2 years after IORT as a boost followed by whole-breast radiotherapy (WBRT), compared with a control group treated with WBRT alone. All patients had breast-conserving surgery for early-stage breast cancer. Group A: n = 27, IORT (20 Gy) followed by WBRT (46 Gy). Group B (control group): n = 27, WBRT alone (56-66 Gy). Mammography: fat necrosis in 14 group A versus four group B patients (P < 0.001); parenchymal scarring classified as unorganized at the last follow-up in 16 vs seven cases, respectively (P = 0.03). Ultrasound: overall number of patients with circumscribed findings 27 vs 18 (P < 0.001); particular hematomas/seromas in 26 vs 13 patients (P < 0.001). Synopsis of mammography and ultrasound: overall postoperative changes were significantly higher classified in group A (P = 0.01), but not judged to have a significantly higher impact on interpretation. Additional diagnostic procedures, due to unclear findings at the surgical site, were performed on four patients of both groups. Within the first 2 years after IORT as a boost, therapy-induced changes at the original tumor site are significantly more pronounced compared with a control group. There is no evidence that the interpretation of findings is complicated after IORT. (orig.)

  6. Detection of occult cancer in patients with idiopathic venous thrombosis

    DEFF Research Database (Denmark)

    Holt, Marianne Ingerslev; Knudsen, Søren Tang; Andersen, Birthe Søgaard;

    2015-01-01

    Idiopathic venous thrombosis (VTE) is frequently associated with underlying malignancy. Thus, it is tempting to search for underlying cancer in these patients. However, extensive screening is cost-intensive and no survival benefit has been demonstrated. Based on a review of the literature, we...

  7. Detection of occult cancer in patients with idiopathic venous thrombosis

    DEFF Research Database (Denmark)

    Holt, Marianne Ingerslev; Knudsen, Søren Tang; Andersen, Birthe Søgaard

    2015-01-01

    Idiopathic venous thrombosis (VTE) is frequently associated with underlying malignancy. Thus, it is tempting to search for underlying cancer in these patients. However, extensive screening is cost-intensive and no survival benefit has been demonstrated. Based on a review of the literature, we rec...

  8. Herpes zoster as a marker of occult cancer

    DEFF Research Database (Denmark)

    Schmidt, S A J; Mor, A; Schønheyder, H C;

    2016-01-01

    : Through February 18, 2016, we searched PubMed, EMBASE and references of relevant papers for studies on zoster and risk of any cancer. One author screened retrieved papers by title and abstract; included papers were reviewed by two authors for eligibility, data extraction, and potential biases. Despite...

  9. Mammographic features of screening detected pT1 (a–b) invasive breast cancer using BI-RADS lexicon

    Energy Technology Data Exchange (ETDEWEB)

    Bargalló, Xavier, E-mail: xbarga@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Santamaría, Gorane, E-mail: gsanta@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Velasco, Martín, E-mail: mvelasco@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Amo, Montse del, E-mail: mdelamo@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Arguis, Pedro, E-mail: parguis@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Burrel, Marta, E-mail: mburrel@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Capurro, Sebastian, E-mail: scapurro@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain)

    2012-10-15

    Aim: To describe mammographic features in screening detected invasive breast cancer less than or equal to 10 mm using Breast Imaging Reporting and Data System lexicon in full-field digital mammography. Patients and methods: A retrospective analysis of 123 pT1 (a–b) invasive breast cancers in women aged 50–69 years from our screening program. Radiologic patterns were: masses, calcifications, distortions, asymmetries and mixed. Masses: shape, margins and density, and calcifications: morphology, number of flecks and size of the cluster were taken into account, following Breast Imaging Reporting and Data System terminology. Results: We found 61 masses (49.6%), 8 masses with calcifications (6.5%), 30 groups of calcifications (24.4%), 19 architectural distortions (15.4%), 1 architectural distortion with calcifications (0.8%), 4 asymmetries (3.2%). Sixty out of 69 masses were irregular in shape, 6 lobular, 2 ovals and 1 round. Thirty-four showed ill-defined margins, 29 spiculated and 6 microlobulated. Most of them showed a density similar to surrounding fibroglandular tissue. Calcifications were pleomorphic or fine linear in 24 of 30 (80%). Most of cases showed more than 10 flecks and a size greater than 1 cm. Conclusion: The predominant radiologic finding is an irregular, isodense mass those margins tend to share different descriptors, being ill-defined margins the most constant finding. Calcifications representing invasive cancer are predominantly pleomorphic with more than 10 flecks per cm. Architectural distortion and invasive tubular carcinoma are more common than reported in general series.

  10. Can upstaging of ductal carcinoma in situ be predicted at biopsy by histologic and mammographic features?

    Science.gov (United States)

    Shi, Bibo; Grimm, Lars J.; Mazurowski, Maciej A.; Marks, Jeffrey R.; King, Lorraine M.; Maley, Carlo C.; Hwang, E. Shelley; Lo, Joseph Y.

    2017-03-01

    Reducing the overdiagnosis and overtreatment associated with ductal carcinoma in situ (DCIS) requires accurate prediction of the invasive potential at cancer screening. In this work, we investigated the utility of pre-operative histologic and mammographic features to predict upstaging of DCIS. The goal was to provide intentionally conservative baseline performance using readily available data from radiologists and pathologists and only linear models. We conducted a retrospective analysis on 99 patients with DCIS. Of those 25 were upstaged to invasive cancer at the time of definitive surgery. Pre-operative factors including both the histologic features extracted from stereotactic core needle biopsy (SCNB) reports and the mammographic features annotated by an expert breast radiologist were investigated with statistical analysis. Furthermore, we built classification models based on those features in an attempt to predict the presence of an occult invasive component in DCIS, with generalization performance assessed by receiver operating characteristic (ROC) curve analysis. Histologic features including nuclear grade and DCIS subtype did not show statistically significant differences between cases with pure DCIS and with DCIS plus invasive disease. However, three mammographic features, i.e., the major axis length of DCIS lesion, the BI-RADS level of suspicion, and radiologist's assessment did achieve the statistical significance. Using those three statistically significant features as input, a linear discriminant model was able to distinguish patients with DCIS plus invasive disease from those with pure DCIS, with AUC-ROC equal to 0.62. Overall, mammograms used for breast screening contain useful information that can be perceived by radiologists and help predict occult invasive components in DCIS.

  11. Mammographic, sonographic and MR imaging features of invasive micropapillary breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Alsharif, Shaza; Daghistani, Razan; Kamberoğlu, Elif Aşik; Omeroglu, Atilla; Meterissian, Sarkis; Mesurolle, Benoît, E-mail: benoit.mesurolle@muhc.mcgill.ca

    2014-08-15

    Purpose: Describe mammographic, sonographic and MRI findings of invasive micropapillary carcinoma (IMPC) of the breast. Materials and methods: Review of the pathology database identified 43 patients (mean age, 59.3 years) with the diagnosis of breast IMPC. Three patients had no available imaging studies. Mammograms (40), breast ultrasounds (33) and MRIs (8) were retrospectively evaluated by two radiologists in consensus following the BI-RADS Lexicon. Clinical, histopathologic features, as well as hormone status were recorded. Results: Twenty patients presented with palpable abnormality (20/40, 50%). Thirty-five patients had an abnormal mammogram (87.5%, 35/40) showing 39 lesions, 29 corresponding to masses (29/39, 74.4%), 11 associated with microcalcifications and two associated with architectural distortion. Sonography identified 41 masses (in 33 patients) displaying an irregular shape (30/41, 73.2%), appearing hypoechoic (39/41, 95%), with spiculated or angular margins (26/41, 63.4%), non-parallel orientation (26/41, 63.4%) and combined acoustic posterior pattern (18/41, 44%). MRI identified 13 lesions (in eight patients), 12 as masses (12/13, 92.3%) with irregular or spiculated margins (12/12, 100%), eight displaying an irregular or lobulated shape (8/12, 66.7%), six with homogeneous internal enhancement (6/12, 50%) and eight with type 3 enhancement curve (8/12, 61.5%). Associated non-mass like enhancement was noted in two patients. Twenty-nine patients had associated lymphovascular invasion (29/40, 72.5%) and axillary lymph node metastases were present in 22 of the 39 patients (22/39, 56%). Conclusion: Invasive ductal carcinoma with IMPC features display imaging findings highly suspicious of malignant lesions. They are associated with high lymphovascular invasion and lymph node metastases rates.

  12. The effect of chemotherapy on the mammographic appearance of breast cancer and correlation with histopathology.

    Science.gov (United States)

    Mistry, Kunal A; Thakur, Meenakshi H; Kembhavi, Seema A

    2016-01-01

    To document the mammographic changes after neoadjuvant chemotherapy with histopathological correlation, to calculate the accuracy of mammography (MG) in predicting residual tumour size and to measure the interobserver agreement in reading mammograms. In 446 consecutive cases, the pre- and post-chemotherapy mammograms were retrospectively evaluated by two blinded observers, and consensus findings were compared with reference standard of surgical specimen. The accuracy of MG in predicting residual tumour size was calculated. Kappa statistics were calculated for measuring the interobserver agreement for reading mammograms. The sensitivity, specificity, positive-predictive value and negative-predictive value for the prediction of residual disease were calculated. The most common primary abnormalities were mass lesions without and with microcalcifications. After chemotherapy, there was decrease in size of most (95.1%) of the measurable masses, with decrease in the mean tumour size from 4.1 to 2.5 cm. The density of the tumour decreased in 66.6% (241/362) cases with residual disease. There was almost perfect interobserver agreement for describing the primary abnormality in the pre- as well as post-chemotherapy mammograms (k = 0.87 and 0.81, respectively) with substantial agreement for measurement of the mass lesions before and after chemotherapy (k = 0.69 and 0.68, respectively). MG showed accuracy of 60.0%, sensitivity of 94.4%, specificity of 50.0%, positive-predictive value of 91.3% and negative-predictive value of 61.8%. MG remains a highly sensitive and reproducible investigation for the assessment of residual disease after chemotherapy. There is substantial interobserver agreement in characterizing and measuring breast tumours on mammograms.

  13. Innovation in early breast cancer surgery: radio-guided occult lesion localization and sentinel node biopsy.

    Science.gov (United States)

    Paganelli, G; Veronesi, U

    2002-07-01

    The surgical management of non-palpable breast lesions remains controversial. At the European Institute of Oncology we have introduced a new technique, radio-guided occult lesion localization (ROLL) to replace standard methods and overcome their disadvantages. Regarding axillary dissection, probe-guided biopsy of the sentinel node (SN) is easy to apply, and the whole procedure is associated to a low risk of false negatives. We suggest that the SN technique should be widely adopted to stage the axilla in patients with breast cancer with clinically negative lymph nodes. Large-scale implementation of the sentinel node technique will reduce the cost of treatment as a result of shorter hospitalization times.

  14. Mammographic breast density and breast cancer risk: interactions of percent density, absolute dense, and non-dense areas with breast cancer risk factors.

    Science.gov (United States)

    Yaghjyan, Lusine; Colditz, Graham A; Rosner, Bernard; Tamimi, Rulla M

    2015-02-01

    We investigated if associations of breast density and breast cancer differ according to the level of other known breast cancer risk factors, including body mass index (BMI), age at menarche, parity, age at first child's birth, age at menopause, alcohol consumption, a family history of breast cancer, a history of benign breast disease, and physical activity. This study included 1,044 postmenopausal incident breast cancer cases diagnosed within the Nurses' Health Study cohort and 1,794 matched controls. Percent breast density, absolute dense, and non-dense areas were measured from digitized film images with computerized techniques. Information on breast cancer risk factors was obtained prospectively from biennial questionnaires. Percent breast density was more strongly associated with breast cancer risk in current postmenopausal hormone users (≥50 vs. 10 %: OR 5.34, 95 % CI 3.36-8.49) as compared to women with past (OR 2.69, 95 % CI 1.32-5.49) or no hormone history (OR 2.57, 95 % CI 1.18-5.60, p-interaction = 0.03). Non-dense area was inversely associated with breast cancer risk in parous women, but not in women without children (p-interaction = 0.03). Associations of density with breast cancer risk did not differ by the levels of BMI, age at menarche, parity, age at first child's birth, age at menopause, alcohol consumption, a family history of breast cancer, a history of benign breast disease, and physical activity. Women with dense breasts, who currently use menopausal hormone therapy are at a particularly high risk of breast cancer. Most breast cancer risk factors do not modify the association between mammographic breast density and breast cancer risk.

  15. [Occult breast cancer. Detection and radioguided surgery with 99mTc-MIBI].

    Science.gov (United States)

    Barberá, L; Illanes, L; Terrier, F; Dopta, G

    2003-01-01

    We include those patients who present with an isolated metastasis of axillary adenopathy in the occult primary breast cancer group. Presumably, the primary tumor is a primitive breast carcinoma, unsuspected until this moment and not clinically demonstrable by mammography or ultrasonography. When no method succeeds in confirming the primary breast lesion, the patients are usually treated assuming the existing of breast cancer. Several diagnostic methods have been used to find the primary breast lesion. Magnetic Resonance imaging (MRI), Positron Emission (PET) and Doppler sonography have been used in this way and several papers present the results reached with them. Our group incorporates detection and radioguided surgery with 99mTechnetium (99mTc) methoxyisobutil isonitrile into the study of these patients. We perform a planar scintimammography and SPECT (Single Photon Emission Computed Tomography) with 99mTc-MIBI. If the radioisotopic method shows a functional image compatible with a carcinoma, a gamma detecting probe is then used to locate the lesion and guide its surgical removal. In this paper, we present the application of the technique in 5 cases and describe the technique and its possibilities. Its advantages are explained in comparison with other methods. The dosimetric values found in the performance of the technique are reported. We consider that detection and radioguided surgery with 99mTc-MIBI in the diagnosis and treatment of occult breast cancer adds an effective tool and means progress in the approach to this disease.

  16. Detection of colorectal cancer in symptomatic outpatients without visible rectal bleeding: Validity of the fecal occult blood test

    DEFF Research Database (Denmark)

    Bjerregaard, Niels Christian; Tøttrup, Anders; Sørensen, Henrik Toft

    2009-01-01

    In 2002, a new diagnostic strategy in symptomatic outpatients without known established colorectal cancer risk factors aged 40 years or older was implemented in Denmark. Fecal occult blood test (Hemoccult Sensa®) was a part of that strategy in patients without visible rectal bleeding.......In 2002, a new diagnostic strategy in symptomatic outpatients without known established colorectal cancer risk factors aged 40 years or older was implemented in Denmark. Fecal occult blood test (Hemoccult Sensa®) was a part of that strategy in patients without visible rectal bleeding....

  17. Determinants of participation in colorectal cancer screening with faecal occult blood testing

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My; Brasso, Klaus; Lynge, Elsebeth

    2009-01-01

    BACKGROUND: Colorectal cancer is one of the most common cancers in men and women. Participation rates in faecal occult blood testing (FOBT) screening activities are, however, relatively low. In terms of lowering the colorectal cancer mortality, high participation rates are essential, and therefore...... it is important to understand the barriers to FOBT screening. METHODS: We undertook a systematic search through PUBMED, Medline, EMBASE and PsycINFO in order to identify studies that provide information on socio-demographic determinants of participation in FOBT screening. RESULTS: FOBT participation varied...... considerably across countries, but they have rarely been above 60%. The use of other health-care services was in most studies a strong determinant for participation in screening with FOBT. There was a tendency to higher participation among women than among men and among married as opposed to not married...

  18. The impact of the number of occult metastatic lymph nodes on postoperative relapse of resectable esophageal cancer.

    Science.gov (United States)

    Morimoto, J; Tanaka, H; Ohira, M; Kubo, N; Muguruma, K; Sakurai, K; Yamashita, Y; Maeda, K; Sawada, T; Hirakawa, K

    2014-01-01

    Clinical stage II/III esophageal cancer (EC), as defined by the Japanese Classification, relapses at a moderately high rate even after curative resection. The number of lymph node metastases is known to be associated with tumor relapse. Recently, the prognostic significance of occult metastatic lymph nodes (MLNs), as well as that of overt MLNs, has been reported. The aim of this study was to investigate the impact of the total number of MLNs including occult MLNs on postoperative relapse in clinical stage II/III EC. One hundred and five patients with clinical stage II/III EC who underwent esophagectomy accompanied by radical lymphadenectomy at the Department of Surgical Oncology in Osaka City University Hospital between January 2000 and October 2008 were included in this study. Occult MLNs, metastases not detected by hematoxylin-eosin staining, were identified by immunohistochemistry (IHC) using antipancytokeratin antibody AE1/AE3. The clinicopathological features of occult MLNs were compared between the relapse and no relapse groups. A total of 6558 lymph nodes (1357 from two-field dissection and 5201 from three-field dissection) were examined by IHC staining; 362 overt MLNs and 143 occult MLNs were detected. The number of occult MLNs increased in proportion to the International Union Against Cancer pathological (p)N-status and pStage. When the number of occult MLNs was added to the number of pNs, the number of total MLNs was associated with postoperative relapse. With respect to tumor, node, metastasis stage, 6 of 22 patients (27%) who were pathological node-negative converted to node-positive by considering total MLNs. The number of N3 patients with relapse increased markedly with restaging by total MLNs. The number of total MLNs, but not overt MLNs, was an independent prognostic factor on multivariate analysis. These results suggest that occult MLNs were often found, and they were associated with postoperative relapse of resectable esophageal cancer. The total

  19. Clinical significance of occult metastatic cells in bone marrow of breast cancer patients.

    Science.gov (United States)

    Braun, S; Pantel, K

    2001-01-01

    The early and clinically occult spread of viable tumor cells to the organism is increasingly considered a hallmark in cancer progression, as emerging data suggest that these cells are precursors of subsequent distant relapse. Using monoclonal antibodies to epithelial cytokeratins or tumor-associated cell membrane glycoproteins, individual carcinoma cells can be detected on cytologic bone marrow preparations at frequencies of 10(-5) to 10(-6). Prospective clinical studies have shown that the presence of these immunostained cells in bone marrow, as a frequent site of overt metastases, is prognostically relevant with regard to relapse-free and overall survival. This screening approach may be, therefore, used to improve tumor staging and guide the stratification of patients for adjuvant therapy in clinical trials. Another promising application is monitoring the response of micrometastatic cells to adjuvant therapies, which, at present, can only be assessed retrospectively after an extended period of clinical follow-up. The present review summarizes the current data on the clinical significance of occult metastatic breast cancer cells in bone marrow.

  20. Paget's disease of the breast: Clinical, mammographic, sonographic and pathologic findings in 52 cases

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil [Ege University Hospital, Department of Radiology, Bornova 35100, Izmir (Turkey)]. E-mail: isilbilgen@hotmail.com; Oktay, Aysenur [Ege University Hospital, Department of Radiology, Bornova 35100, Izmir (Turkey)

    2006-11-15

    Purpose: To determine and quantitate radiologic characteristics of Paget's disease of the breast and to report clinical and pathologic findings. Materials and methods: A retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 52 histologicallly proved Paget's disease of the breast. Analysis included history, findings at physical examination, mammography and sonography (US) and histologic type of Paget's disease. Results: At physical examination, palpable mass (n = 33, 63%), nipple erythema-eczema-ulceration (n = 17, 33%) and blood-stained nipple discharge (n = 5, 10%) were noted. Among 17 patients who had clinically evident Paget's disease, the mammographic findings were isolated microcalcifications in 3 (18%), mass associated with microcalcifications in 5 (29%), mass in 2 (12%) and negative in 7 (41%) patients. In the 35 patients with clinically inevident Paget's disease, these mammographic findings were 43% (n = 15), 34% (n = 12), 20% (n = 7) and 3% (n = 1), respectively. US depicted 43 masses in 35 patients, all of which were lobulated or irregularly contoured, mostly (n = 41, 95%) without posterior acoustic shadowing. The cancer was clinically occult in 10% (n = 5), mammographically occult in 15% (n = 8) and radiologically occult in 13% (n = 7) of the 52 patients. Histologically, the tumor was multifocal and/or multicentric in 11 (21%) patients. Conclusion: The clinical features of Paget's disease are characteristic and should alert the clinician to the likelihood of an underlying carcinoma, which should be evaluated radiologically. However, as Paget's disease is primarily a clinical diagnosis and mammograms may be negative, screening programs without clinical examination may result with delay in diagnosis. As a result, both clinical and imaging findings are complementary and should be correlated to confirm or exclude a diagnosis of Paget

  1. Risk of breast cancer after false-positive results in mammographic screening

    DEFF Research Database (Denmark)

    Roman, Marta; Castells, Xavier; Hofvind, Solveig

    2016-01-01

    Women with false-positive results are commonly referred back to routine screening. Questions remain regarding their long-term outcome of breast cancer. We assessed the risk of screen-detected breast cancer in women with false-positive results. We conducted a joint analysis using individual level ...

  2. Correlativity study on mammographic features and c-erbB-2 of breast cancer%乳腺癌钼靶X线表现与c-erbB-2癌基因相关性

    Institute of Scientific and Technical Information of China (English)

    马捷; 左敏; 孙国平

    2006-01-01

    Objective: To investigate the correlativity between mammographic features and c-erbB-2 of breast cancer.Methods: The mammographic features of 165 patients,including calcification,distinct,esion concentration,breast cysitic hyperplasia accompanied,were studied comparatively with c-erbB-2 gene stained with immunohistochemical technique.Results: Of 165cases,calcification impression was 84 cases (50.91%),indistinct 80 cases (48.40%),lesions were concentrated of 87 case(52.73%),accompanied breast cysitic hyperplasia 85 cases (51.52%).Conclusion: Mammographic features of breast cancer could show the status of c-erbB-2,the positive chance is higher with calcification,indistinct,lesion concentration and accompanied breast cysitic hyperplasia.

  3. Utilization of mammographic complexity for improving risk assessment and cancer detection

    Science.gov (United States)

    Wang, Xiao Hui; King, Jill; Golla, Saraswathi; Durick, Janet E.; Britton, Cynthia; Sumkin, Jules H.; Leader, Joseph K.; Good, Walter F.

    2008-03-01

    Currently, breast cancer screening protocols are based on a woman's age, but not on other risk factors or on the physical characteristics of her breasts. One commonly cited risk factor is dense breast tissue. This study is part of an effort to provide basic information needed to develop automatically, individualized screening protocols, by clarifying the relationships between age, risk, breast composition, lesion conspicuity, and other factors. In this project, a database was established that includes 227 cancer negative cases and 116 cancer positive cases across a wide range of age groups. In the cancer positive cases, we included a subgroup in which the cancer had been missed in the previous exam. Using our physics based model of breast density, we quantified percentage of breast parenchyma as an index of density. Density distributions and changes over time were analyzed. The most significant finding within this data was a significantly slower density decrease over the time in the cancer positive group than in the cancer negative group, with no overall difference in the density distribution in those two groups. False negative cases were found to be significantly more dense than true positive cases. In addition, our results showed a trend of density decrease with increasing age, which is in agreement with others' widely reported results.

  4. The Psychological Impact of a Colorectal Cancer Diagnosis Following a Negative Fecal Occult Blood Test Result.

    Science.gov (United States)

    Miles, Anne; McClements, Paula L; Steele, Robert J C; Redeker, Claudia; Sevdalis, Nick; Wardle, Jane

    2015-07-01

    Screening using fecal occult blood testing (FOBt) reduces colorectal cancer mortality, but the test has low sensitivity. A "missed" cancer may cause psychologic harms in the screened population that partially counteract the benefits of early detection. Three hundred and eleven people diagnosed with colorectal cancer (i) after a negative FOBt result (interval cancer), (ii) a positive result (screen-detected cancer), or (iii) in regions where screening was not offered, completed questions on quality of life (FACT-C), depression (CES-D), perceived diagnostic delay, and trust in the results of FOBt screening. Fifteen withheld consent to data matching with medical records, leaving a sample size of 296. Controlling for demographic and clinical variables, patients with an interval cancer reported poorer quality of life (difference in means = 6.16, P = 0.03) and more diagnostic delay (OR, 0.37; P = 0.02) than patients with screen-detected disease, with no differences in depression. No differences were observed between the interval cancer group and the group not offered screening on these measures. Patients with an interval cancer reported the lowest levels of trust in FOBt. An interval cancer has adverse effects on trust in FOBt, but does not result in worse psychologic outcomes compared with people diagnosed in areas with no screening program. People with an interval cancer report poorer quality of life than people with screen-detected disease. Improvements in test sensitivity could improve quality of life among people who complete an FOB test over and above any benefits already conferred by earlier detection. ©2015 American Association for Cancer Research.

  5. Epidemiologic Studies of Isoflavones & Mammographic Density

    Directory of Open Access Journals (Sweden)

    Jeffrey A. Tice

    2010-01-01

    Full Text Available Isoflavones, phytoestrogens in soy beans with estrogen-like properties, have been examined for their cancer protective effects. Mammographic density is a strong predictor of breast cancer. This review summarizes studies that have examined the association between isoflavones and breast density. Observational investigations in Hawaii and Singapore suggest slightly lower breast density among women of Asian descent with regular soy intake, but two larger studies from Japan and Singapore did not observe a protective effect. The findings from seven randomized trials with primarily Caucasian women indicate that soy or isoflavones do not modify mammographic density. Soy foods and isoflavone supplements within a nutritional range do not appear to modify breast cancer risk as assessed by mammographic density.

  6. Epidemiologic studies of isoflavones & mammographic density.

    Science.gov (United States)

    Maskarinec, Gertraud; Verheus, Martijn; Tice, Jeffrey A

    2010-01-01

    Isoflavones, phytoestrogens in soy beans with estrogen-like properties, have been examined for their cancer protective effects. Mammographic density is a strong predictor of breast cancer. This review summarizes studies that have examined the association between isoflavones and breast density. Observational investigations in Hawaii and Singapore suggest slightly lower breast density among women of Asian descent with regular soy intake, but two larger studies from Japan and Singapore did not observe a protective effect. The findings from seven randomized trials with primarily Caucasian women indicate that soy or isoflavones do not modify mammographic density. Soy foods and isoflavone supplements within a nutritional range do not appear to modify breast cancer risk as assessed by mammographic density.

  7. Amplification and protein overexpression of cyclin D1 : Predictor of occult nodal metastasis in early oral cancer

    NARCIS (Netherlands)

    Noorlag, Rob; Boeve, Koos; Witjes, Max J. H.; Koole, Ronald; Peeters, Ton L. M.; Schuuring, Ed; Willems, Stefan M.; van Es, Robert J. J.

    2017-01-01

    Background. Accurate nodal staging is pivotal for treatment planning in early (stage I-II) oral cancer. Unfortunately, current imaging modalities lack sensitivity to detect occult nodal metastases. Chromosomal region 11q13, including genes CCND1, Fas-associated death domain (FADD), and CTTN, is ofte

  8. Clinical Analysis of Occult Breast Cancer%隐匿性乳腺癌诊治分析

    Institute of Scientific and Technical Information of China (English)

    马于平; 熊明涛

    2014-01-01

    目的探讨隐匿性乳腺癌的诊断和治疗方法。方法回顾分析5例隐匿性乳腺癌的临床资料。结果5例均以腋下肿块为首发症状,均行手术治疗及放化疗,3例行内分泌治疗。结论腋窝肿块活检为隐匿性乳腺癌的重要检查方法,综合治疗是治疗隐匿性乳腺癌的最佳方案。%Objective Discussion of the diagnosis of occult breast cancer and its treatment principles.Methods Retrospective analysis of 5 cases of occult breast cancer and clinical data.Results Five cases were initial y presented with axil ary mass.Al the cases received surgical treatment and chemoradiotherapy, 3 cases of endocrinetherapy.Conclusion The axillary mass biopsies is a very importantchecking method of occult breast cancer. Comprehensive care is the best plan for the treatment of occult breast cancer.

  9. Early life factors and adult mammographic density

    NARCIS (Netherlands)

    Lokate, M.; Duijnhoven, van F.J.B.; Berg, van den S.W.; Peeters, P.H.; Gils, van C.H.

    2013-01-01

    Purpose Early life factors have shown to be related to breast cancer risk. The pathophysiological link could be mammographic density, a strong risk factor for breast cancer. Mammary gland development already starts in utero and early life factors might affect the number of mammary cells at risk. In

  10. Fractal dimension and lacunarity analysis of mammographic patterns in assessing breast cancer risk related to HRT treated population: a longitudinal and cross-sectional study

    Science.gov (United States)

    Karemore, Gopal; Nielsen, Mads

    2009-02-01

    Structural texture measures are used to address the aspect of breast cancer risk assessment in screening mammograms. The current study investigates whether texture properties characterized by local Fractal Dimension (FD) and Lacunarity contribute to asses breast cancer risk. FD represents the complexity while the Lacunarity characterize the gappiness of a fractal. Our cross-sectional case-control study includes mammograms of 50 patients diagnosed with breast cancer in the subsequent 2-4 years and 50 matched controls. The longitudinal double blind placebo controlled HRT study includes 39 placebo and 36 HRT treated volunteers for two years. ROIs with same dimension (250*150 pixels) were created behind the nipple region on these radiographs. Box counting method was used to calculate the fractal dimension (FD) and the Lacunarity. Paired t-test and Pearson correlation coefficient were calculated. It was found that there were no differences between cancer and control group for FD (P=0.8) and Lacunarity (P=0.8) in crosssectional study whereas earlier published heterogeneity examination of radiographs (BC-HER) breast cancer risk score separated groups (p=0.002). In the longitudinal study, FD decreased significantly (PBIRADS (-0.34, P<0.001) and Percentage Density (-0.41, P<0.001). FD is invariant to the mammographic texture change from control to cancer population but marginally varying in HRT treated population. This study yields no evidence that lacunarity or FD are suitable surrogate markers of mammographic heterogeneity as they neither pick up breast cancer risk, nor show good sensitivity to HRT.

  11. Early detection of breast cancer through population-based mammographic screening in Asian women: a comparison study between screen-detected and symptomatic breast cancers.

    Science.gov (United States)

    Chuwa, Esther W L; Yeo, Allen W Y; Koong, Heng Nung; Wong, Chow Yin; Yong, Wei Sean; Tan, Puay Hoon; Ho, Juliana T S; Wong, Jill S L; Ho, Gay Hui

    2009-01-01

    The first nation-wide mammographic screening program in Asia, BreastScreen Singapore (BSS), was launched in Singapore in January 2002. This study compared the presentation and results of screen-detected breast cancers with symptomatic breast cancers in two affiliated high-volume institutions, one of which was an assessment centre for BSS. The medical records of patients diagnosed with primary breast cancer at the Department of General Surgery, Singapore General Hospital and the Department of Surgical Oncology, National Cancer Centre, Singapore, during the period January 2002 to December 2003 were reviewed. Clinical and pathological comparisons were made between screen-detected lesions and symptomatic lesions. Of a total of 767 cases, 640 (83.4%) were invasive carcinomas and 127 (16.6%) were ductal carcinoma in-situ (DCIS) lesions. Only 13.4% of them were screen-detected. Compared to symptomatic cancers, screen-detected lesions were of smaller size (median size 18 versus 23 mm), a lower stage (stages 0-2, 95 versus 83.2%) and histologic grade (grade 1-2, 71 versus 60%), with a higher incidence of DCIS (31.0 versus 14.3%) and had higher rates of breast conservation (45.6 versus 28.2%) (all p-values 20 mm, nodal involvement, cerbB2 overexpression, and advanced disease stage were independent poor prognostic factors for disease-free survival, whereas nodal involvement, advanced disease, and recurrence predicted poor cancer-specific survival. However, there was no statistically significant difference in disease-free survival or cancer-specific survival between the two groups at a median follow-up of 38 months. Screening mammography has allowed the detection of smaller and hence oncologically more favorable lesions in Asian women. Although no significant survival benefit was demonstrated in our study, a longer period of follow-up is essential before the benefit of mortality reduction, as a result of mammography screening becomes evident in our population.

  12. Mammographic texture resemblance generalizes as an independent risk factor for breast cancer

    DEFF Research Database (Denmark)

    Nielsen, Mads; Vachon, Celine M.; Scott, Christopher G.;

    2014-01-01

    density. We examine if these findings generalize to another population.METHODS:Texture patterns were recorded in digitalized pre-diagnosis (3.7years) film mammograms of a nested case-control study within the Dutch screening program (S1) comprising of 245 breast cancers and 250 matched controls...... and continuously for association with breast cancer using odds ratios (OR) and adjusting for known risk factors including age, body mass index (BMI), and hormone usage.RESULTS:The mean ages of S1 and S2 were 58.0+/-5.7years and 55.2+/-10.5years, respectively. The MTR scores on S1 showed significant capability...

  13. Adjuvant therapy, not mammographic screening, accounts for most of the observed breast cancer specific mortality reductions in Australian women since the national screening program began in 1991.

    Science.gov (United States)

    Burton, Robert C; Bell, Robin J; Thiagarajah, Geetha; Stevenson, Christopher

    2012-02-01

    There has been a 28% reduction in age-standardised breast cancer mortality in Australia since 1991 when the free national mammographic program (BreastScreen) began. Therefore, a comparative study between BreastScreen participation and breast cancer age specific mortality trends in Australia was undertaken for two time periods between 1991 and 2007, where women aged 50-59 and 60-69 years, who were invited to screen, were compared to women aged 40-49 and 70-79 years who were not invited, but who did have access to the program. There were mortality reductions in all four age groups between 1991-1992 and 2007, resulting in 5,849 (95% CI 4,979 to 6,718) fewer women dying of breast cancer than would have otherwise been the case. Women aged 40-49 years, who had the lowest BreastScreen participation (approximately 20%), had the largest mortality reduction: 44% (95% CI 34.8-51.2). Women aged 60-69 years, who had the highest BreastScreen participation (approximately 60%), had the smallest mortality reduction: 19% (95% CI 10.5-26.9). As BreastScreen participation by invited women aged 50-69 years only reached a maximum of about 55-60% in 1998-1999, a decline in mortality in Australian women cannot be attributed to BreastScreen prior to this time. Thus, almost 60% of the Australian decline in breast cancer mortality since 1991 cannot be attributed to BreastScreen. Therefore, mammographic screening cannot account for most of the reductions in breast cancer mortality that have occurred in Australian women since 1991 and may have contributed to over-diagnosis. Most, if not all, of the reductions can be attributed to the adjuvant hormonal and chemotherapy, which Australian women have increasingly received since 1986.

  14. Poland's Syndrome Complicated with Breast Cancer: Mammographic, Ultrasonographic, and Computed Tomographic Findings

    Energy Technology Data Exchange (ETDEWEB)

    Ji, J.; Zhang, S.; Shao, C.; Xu, M.; Chen, S.; Lu, C.; Wang, Z.; Zhao, Z.; Fan, X.; Tu, J. (Dept. of Radiology, Sir Run Run Shaw Hospital, Medical College of Zhejiang Univ., Hangzhou City (China))

    2008-05-15

    Poland's syndrome is a rare congenital anomaly characterized by unilateral chest wall hypoplasia and ipsilateral hand abnormalities. It has been reported in association with various malignancies and other developmental defects. We report here the case of a 58-year-old woman with Poland's syndrome who developed breast cancer in the ipsilateral normal breast. A review of the literature reveals that two studies of breast carcinoma associated with Poland's syndrome have been reported, but this paper is the first example of a carcinoma occurring in an otherwise normal breast associated with Poland's syndrome

  15. Breast cancer mammographic diagnosis performance in a public health institution: a retrospective cohort study.

    Science.gov (United States)

    Mello, Juliana M R B; Bittelbrunn, Fernando P; Rockenbach, Marcio A B C; May, Guilherme G; Vedolin, Leonardo M; Kruger, Marilia S; Soldatelli, Matheus D; Zwetsch, Guilherme; de Miranda, Gabriel T F; Teixeira, Saone I P; Arruda, Bruna S

    2017-10-04

    To evaluate the quality assurance of mammography results at a reference institution for the diagnosis and treatment of breast cancer in southern Brazil, based on the BIRADS (Breast Imaging Reporting and Data System) 5th edition recommendations for auditing purposes. Retrospective cohort and cross-sectional study with 4502 patients (9668 mammographies)) who underwent at least one or both breast mammographies throughout 2013 at a regional public hospital, linked to a federal public university. The results were followed until 31 December 2014, including true positives (TPs), true negatives (TNs), false positives (FPs), false negatives (FNs), positive predictive values (PPVs), negative predictive value (NPV), sensitivity and specificity, with a confidence interval of 95%. The study showed high quality assurance, particularly regarding sensitivity (90.22%) and specificity (92.31%). The overall positive predictive value (PPV) was 65.35%, and the negative predictive value (NPV) was 98.32%. The abnormal interpretation rate (recall rate) was 12.26%. The results are appropriate when compared to the values proposed by the BIRADS 5th edition. Additionally, the study provided self-reflection considering our radiological practice, which is essential for improvements and collaboration regarding breast cancer detection. It may stimulate better radiological practice performance and continuing education, despite possible infrastructure and facility limitations. • Accurate quality performance rates are possible despite financial and governmental limitations. • Low-income institutions should develop standardised teamwork to improve radiological practice. • Regular mammography audits may help to increase the quality of public health systems.

  16. Associated factors with mammographic changes in women undergoing breast cancer screening.

    Science.gov (United States)

    Sant'Ana, Ricardo Soares de; Mattos, Jacó Saraiva de Castro; Silva, Anderson Soares da; Mello, Luanes Marques de; Nunes, Altacílio Aparecido

    2016-01-01

    To evaluate association of sociodemographic, anthropometric, and epidemiological factors with result of mammogram in women undergoing breast cancer screening. This is a cross-sectional study with data obtained through interviews, anthropometric measurements, and mammography of 600 women aged 40 to 69 years at the Preventive Medicine Department of Hospital de Câncer de Barretos, Brazil, in 2014. The results of these examinations in the BI-RADS categories 1 and 2 were grouped and classified in this study as normal mammogram outcome, and those of BI-RADS categories 3, 4A, 4B, 4C, and 5 were grouped and classified as altered mammogram outcome. The statistical analysis included the Student's t-test to compare means, as well as odds ratios (OR), with their corresponding 95% confidence intervals (95%CI), to verify an association by means of the multivariate analysis. Of 600 women evaluated, 45% belonged to the age group of 40-49 years-old and 60.2% were classified as BI-RADS category 2. The multivariate analysis showed that women with blood hypertension (OR: 2.64; 95%CI: 1.07-6.49; pmama em relação às sedentárias.

  17. 隐匿性乳腺癌的诊断与治疗%Diagnosis and treatment of occult breast cancer

    Institute of Scientific and Technical Information of China (English)

    冯雪园; 杨克酩; 闫朝岐

    2016-01-01

    隐匿性乳腺癌多以同侧腋窝淋巴结肿大为首发症状,临床少见,诊断是其难点。诊断过程建议先行肿大淋巴结空芯针穿刺,并加做免疫组化,如支持乳腺癌转移,同时排除其他部位原发肿瘤后可确诊。治疗以全乳切除加腋窝淋巴结清扫术为标准,新辅助化疗是影响其预后的独立因素,术前推荐先行新辅助化疗,术后根据免疫组化结果,辅以化疗、放疗、内分泌治疗等。隐匿性乳腺癌的预后与同期其他类型的乳腺癌相似。%Occult breast cancer is a rare disease with the primary symptom of enlarged ipsilateral axillary lymph node. At present,it is still difficult to diagnose occult breast cancer. The diagnosis is based on the core needle biopsy and following immunohistochemical staining for the enlarged lymph nodes. If the results support,the diagnosis can be confirmed after the exclusion of other primary tumors. The standard treatment of occult breast cancer is still the mastectomy and axillary lymph node dissection. Neoadjuvant chemotherapy is an independent factor affecting the prognosis,which is also recommended before the oper-ation. Chemotherapy,radiotherapy and endocrine therapy could be chosen based on immunohistochemical results after surgical treatment. The prognosis of occult breast cancer is similar to the other types of breast cancer at the same staging.

  18. Can T2-weighted 3-T breast MRI predict clinically occult inflammatory breast cancer before pathological examination? A single-center experience.

    Science.gov (United States)

    Uematsu, Takayoshi; Kasami, Masako; Watanabe, Junichiro

    2014-01-01

    Occult inflammatory breast cancer (IBC) is defined as an invasive cancer without any clinical inflammatory signs but with pathologically proven dermal lymphovascular invasion. The purpose of this study is to evaluate the ability of 3-T breast MRI to predict occult IBC before pathological examination and compare its effectiveness with that of mammography (MMG) and ultrasound (US). A retrospective review of clinical, radiological, and pathological records of 460 consecutive breast cancers revealed five proved occult IBCs. We analyzed the findings of 3-T MRI, MMG, and US for these five occult IBCs. Primary breast lesions were detected by 3-T MRI, MMG, and US in all five breasts with occult IBCs. 3-T MRI revealed 40% mass type lesions and 60% non-mass-like type lesions. Kinetic curve analysis of the primary breast lesions showed a rapid initial kinetic phase in 80% of lesions and a delayed washout pattern in 60% of lesions. 3-T MRI showed slight skin thickness in 60% of breasts, whereas MMG and US showed slight skin thickness in 40 and 20% of breasts, respectively. Subcutaneous and prepectoral edema, as evaluated on T2-weighted images, was present in all five breasts with occult IBCs. The presence of subcutaneous and prepectoral edema on T2-weighted 3-T breast MRI is an important finding that should suggest the diagnosis of occult IBC before pathological examination.

  19. Excision of Nonpalpable Breast Cancer with Indocyanine Green Fluorescence-Guided Occult Lesion Localization (IFOLL).

    Science.gov (United States)

    Aydogan, Fatih; Ozben, Volkan; Aytac, Erman; Yilmaz, Halit; Cercel, Ali; Celik, Varol

    2012-02-01

    BACKGROUND: Currently employed techniques for the localization of nonpalpable breast lesions suffer from various limitations. In this paper, we report on 2 patients in order to introduce an alternative technique, indocyanine green fluorescence-guided occult lesion localization (IFOLL), and determine its applicability for the surgical removal of this type of breast lesions. CASE REPORTS: Preoperatively, one of the patients had a needle biopsy-proven diagnosis of breast cancer, and the other one had suspicious findings for malignancy. Lesion localization was performed within 1 h before surgery under ultrasonography control by injecting 2 ml and 0.2 ml of indocyanine green into the lesion and its subcutaneous tissue projection, respectively. During surgery, the site of skin incision and the resection margins were identified by observing the area of indocyanine-derived fluorescence under the guidance of a near-infrared-sensitive camera. In both cases, the breast lesion was correctly localized, and the area of fluorescence corresponded well to the site of the lesions. Subsequent surgical excision was successful with no complications. On histopathologic examination, the surgical margins were found to be clear. CONCLUSION: IFOLL seems to be a technically applicable and clinically acceptable procedure for the removal of nonpalpable breast cancer.

  20. Interaction of mammographic breast density with menopausal status and postmenopausal hormone use in relation to the risk of aggressive breast cancer subtypes.

    Science.gov (United States)

    Yaghjyan, Lusine; Tamimi, Rulla M; Bertrand, Kimberly A; Scott, Christopher G; Jensen, Matthew R; Pankratz, V Shane; Brandt, Kathy; Visscher, Daniel; Norman, Aaron; Couch, Fergus; Shepherd, John; Fan, Bo; Chen, Yunn-Yi; Ma, Lin; Beck, Andrew H; Cummings, Steven R; Kerlikowske, Karla; Vachon, Celine M

    2017-09-01

    We examined the associations of mammographic breast density with breast cancer risk by tumor aggressiveness and by menopausal status and current postmenopausal hormone therapy. This study included 2596 invasive breast cancer cases and 4059 controls selected from participants of four nested case-control studies within four established cohorts: the Mayo Mammography Health Study, the Nurses' Health Study, Nurses' Health Study II, and San Francisco Mammography Registry. Percent breast density (PD), absolute dense (DA), and non-dense areas (NDA) were assessed from digitized film-screen mammograms using a computer-assisted threshold technique and standardized across studies. We used polytomous logistic regression to quantify the associations of breast density with breast cancer risk by tumor aggressiveness (defined as presence of at least two of the following tumor characteristics: size ≥2 cm, grade 2/3, ER-negative status, or positive nodes), stratified by menopausal status and current hormone therapy. Overall, the positive association of PD and borderline inverse association of NDA with breast cancer risk was stronger in aggressive vs. non-aggressive tumors (≥51 vs. 11-25% OR 2.50, 95% CI 1.94-3.22 vs. OR 2.03, 95% CI 1.70-2.43, p-heterogeneity = 0.03; NDA 4th vs. 2nd quartile OR 0.54, 95% CI 0.41-0.70 vs. OR 0.71, 95% CI 0.59-0.85, p-heterogeneity = 0.07). However, there were no differences in the association of DA with breast cancer by aggressive status. In the stratified analysis, there was also evidence of a stronger association of PD and NDA with aggressive tumors among postmenopausal women and, in particular, current estrogen+progesterone users (≥51 vs. 11-25% OR 3.24, 95% CI 1.75-6.00 vs. OR 1.93, 95% CI 1.25-2.98, p-heterogeneity = 0.01; NDA 4th vs. 2nd quartile OR 0.43, 95% CI 0.21-0.85 vs. OR 0.56, 95% CI 0.35-0.89, p-heterogeneity = 0.01), even though the interaction was not significant. Our findings suggest that associations of mammographic

  1. Interval Colorectal Cancers following Guaiac Fecal Occult Blood Testing in the Ontario ColonCancerCheck Program

    Directory of Open Access Journals (Sweden)

    Lawrence Paszat

    2016-01-01

    Full Text Available Background. This work examines the occurrence of interval colorectal cancers (CRCs in the Ontario ColonCancerCheck (CCC program. We define interval CRC as CRC diagnosed within 2 years following normal guaiac fecal occult blood testing (gFOBT. Methods. Persons aged 50–74 who completed a baseline CCC gFOBT kit in 2008 and 2009, without a prior history of CRC, or recent colonoscopy, flexible sigmoidoscopy, or gFOBT, were identified. Rates of CRC following positive and normal results at baseline and subsequent gFOBT screens were computed and overall survival was compared between those following positive and normal results. Results. Interval CRC was diagnosed within 24 months following the baseline screen among 0.16% of normals and following the subsequent screen among 0.18% of normals. Interval cancers comprised 38.70% of CRC following the baseline screen and 50.86% following the subsequent screen. Adjusting for age and sex, the hazard ratio (HR for death following interval cancer compared to CRC following positive result was 1.65 (1.32, 2.05 following the first screen and 1.71 (1.00, 2.91 following the second screen. Conclusion. Interval CRCs following gFOBT screening comprise a significant proportion of CRC diagnosed within 2 years after gFOBT testing and are associated with a higher risk of death.

  2. Disentangling the roles of mammographic screening and HRT in recent breast cancer incidence trends in italy by analyses based on calendar time and time since screening activation.

    Science.gov (United States)

    Crocetti, Emanuele; Buzzoni, Carlotta; Falcini, Fabio; Cortesi, Laura; De Lisi, Vincenzo; Ferretti, Stefano; Tumino, Rosario; Russo, Antonio; Paci, Eugenio

    2010-01-01

    The aim of the study was to evaluate the roles of screening activation and hormone replacement therapy discontinuation on the recent declining breast cancer incidence trends in Italy. We analyzed 41,358 invasive female breast cancers incident during 1991-2004 in six Italian population-based cancer registries. Overall and age-specific incidence trends were evaluated using Joinpoint analysis. In addition to calendar years, data were analyzed on a years-since-screening-activation basis. Annual percentage change of standardized rates was computed. There were statistically significant increasing trends for women 40-44 and 45-49 years that did not change after screening activation. On the contrary, for women 50-69 years old and for those 70+ years, the increasing trends flattened around 2 years after screening activation. The prevalence of hormone replacement therapy use in Italy is and was rather low. In conclusion, the recent tendency toward stabilization observed in Italy for female breast cancer incidence rates in women aged 50 years or more follows the introduction of mammographic screening.

  3. Sentinel node detection and radioguided occult lesion localization in breast cancer.

    Science.gov (United States)

    Trifirò, Guiseppe; Lavinia Travaini, Laura; De Cicco, Concetta; Paganelli, Giovanni

    2006-01-01

    Sentinel lymph node biopsy might replace complete axillary dissection for staging of the axilla in clinically N0 breast cancer patients and represent a significant advantage as a minimally invasive procedure, considering that about 70% of patients are found to be free from metastatic disease, yet axillary node dissection can lead to significant morbidity. In our Institute, Radioguided Occult Lesion Localization is the standard method to locate non-palpable breast lesions and the gamma probes is very effective in assisting intra-operative localization and removal, as in sentinel node biopsy. The rapid spread of sentinel lymph node biopsy has led to its use in clinical settings previously considered contraindications to sentinel lymph node biopsy. In this contest, we evaluated in a large group of patients possible factors affecting sentinel node detection and the reliability of sentinel lymph node biopsy carried out after large excisional breast biopsy. Our data confirm that a previous breast surgery does not prohibit efficient sentinel lymph node localization and sentinel lymph node biopsy can correctly stage the axialla in these patients.

  4. Mammographic Breast Density and Serum Phytoestrogen Levels

    OpenAIRE

    Lowry, Sarah J.; Sprague, Brian L; Bowles, Erin J. Aiello; Hedman, Curtis J.; Hemming, Jocelyn; Hampton, John M.; Burnside, Elizabeth S.; Sisney, Gale A.; Buist, Diana S. M.; Trentham-Dietz, Amy

    2012-01-01

    Some forms of estrogen are associated with breast cancer risk as well as with mammographic density (MD), a strong marker of breast cancer risk. Whether phytoestrogen intake affects breast density, however, remains unclear. We evaluated the association between serum levels of phytoestrogens and MD in postmenopausal women. We enrolled 269 women, ages 55–70 yr, who received a screening mammogram and had no history of postmenopausal hormone use. Subjects completed a survey on diet and factors rel...

  5. POPULATION BASED COLORECTAL CANCER SCREENING: COMPARISON OF TWO FAECAL OCCULT BLOOD TESTS

    Directory of Open Access Journals (Sweden)

    Miren Begoña eZubero

    2014-01-01

    Full Text Available Background: The aim of screening for colorectal cancer is to improve prognosis by the detection of cancer at its early stages. In order to inform the decision on the specific test to be used in the population-based programme in the Basque Autonomous Region (Spain, we compared two immunochemical faecal occult blood quantitative tests (I-FOBT. Methods: Residents of selected study areas, aged 50-69 years, were invited to participate in the screening. Two tests based on latex agglutination (OC-Sensor and FOB Gold were randomly assigned to different study areas. A colonoscopy was offered to patients with a positive test result. The cut-off point used to classify a result as positive, according to manufacturer’s recommendations, was 100 ng/ml for both tests. Results: The invited population included 37,999 individuals. Participation rates were 61.8% (n=11,162 for OC-Sensor and 59.1% (n=11,786 for FOB Gold, (p=0.008. Positive rate for OC-Sensor was 6.6% (n=737 and 8.5% (n=1,002 for FOB Gold, (pConclusions: OC-Sensor test appears to be superior for I-FOBT based CRC screening, given its acceptance, ease of use, associated small number of errors and its screening accuracy. FOB-Gold on the other hand, has higher rate of positive values, with more colonoscopies performed, it shows higher detection incidence rates, but involves more false positives.

  6. 隐匿性乳腺癌的诊断与治疗%Diagnosis and Treatment of Occult Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    郭朝猛; 聂梦良

    2015-01-01

    Objective To investigate the clinical characteristics,diagnosis and treatment of occult breast cancer. Methods The data of 7 patients with occult breast cancer were retrospectively analyzed. Results Primary tumors were detected in 5 of the 7 patients,3 of the 5 patients treated by modified radical mastectomy for breast cancer sur-vived without local recurrence or distant metastases,2 patients occurred distant metastases;2 patients were treated by breast conserving surgery,all survived without diseases. Conclusion Occult breast cancer should be considered in female patients with metastatic adenocarcinoma of the axillary lymph nodes and without obvious primary cancer;treatment of the occult breast cancer could be modified radical mastectomy for breast cancer,breast conserving sur-gery and axillary lymph nodes dissection,followed by radiotherapy to the full-breast and drainage areas of regional lymph nodes ,and chemotherapy ,endocrine therapy and possibly targeted therapy.%目的:探讨隐匿性乳腺癌的临床特点及诊治方案。方法对7例隐匿性乳腺癌患者的临床资料进行回顾性分析。结果7例患者中,5例找到乳腺癌原发灶,并行乳腺癌改良根治术,3例未出现局部复发或远处转移,2例出现远处转移;2例行保乳术患者无局部复发或转移。结论对有腋窝淋巴结转移腺癌无明显原发灶的患者,应高度警惕隐匿性乳腺癌;治疗应采用乳腺癌改良根治术或保乳术及腋窝淋巴结清扫,并行全乳腺及区域淋巴结引流区放疗、化疗、内分泌治疗和可能的靶向治疗。

  7. Colorectal cancer screening for the natural population of Beijing with sequential fecal occult blood test: a multicenter study

    Institute of Scientific and Technical Information of China (English)

    李世荣; 聂昭华; 李楠; 李军祥; 章萍; 杨昭徐; 牟善坤; 杜亚萍; 胡继春; 袁申元; 屈汉庭; 张泰昌; 王世鑫; 董恩钰; 漆德芳

    2003-01-01

    Objective To assess the prevalence of colorectal cancer (CRC) in Beijing and the reliability of the sequential fecal occult blood test (SFOBT) for CRC screening. Methods Of the natural population (48 100 persons) in several Beijing communities, we screened 26@!827 persons with age over 30 using the SFOBT screening p rogram, Guaiacum Fecal Occult Blood Test (GFOBT), Immuno Fecal Occult Blood Test (IFOBT), and colonoscopies.Results The screening rate of the population was 74%. The positive rate of SFOBT was 5.6%. The prevalence of CRC in the entire population of Beijing was therefore c alculated to be 36.57/105. Of 12 CRC detected patients, 4 cases were in stage Dukes A (33.33%), 7 cases in stage Dukes B (58.33%), only 1 case (8.34% ) in stage Dukes C.Conclusions The prevalence of CRC in Beijing is one of the highest in China. Individuals at high risk for CRC or those over 50 years of age should be considered as primary candidates for screening. SFOBT screening is a cost-effective and reliable me thod for early detection of CRC.

  8. Increased peri-ductal collagen micro-organization may contribute to raised mammographic density

    OpenAIRE

    McConnell, James C; O’Connell, Oliver V.; Brennan, Keith; Weiping, Lisa; Howe, Miles; Joseph, Leena; Knight, David; O’Cualain, Ronan; Lim, Yit; Leek, Angela; Waddington, Rachael; Rogan, Jane; Astley, Susan M.; Gandhi, Ashu; Kirwan, Cliona C

    2016-01-01

    Background High mammographic density is a therapeutically modifiable risk factor for breast cancer. Although mammographic density is correlated with the relative abundance of collagen-rich fibroglandular tissue, the causative mechanisms, associated structural remodelling and mechanical consequences remain poorly defined. In this study we have developed a new collaborative bedside-to-bench workflow to determine the relationship between mammographic density, collagen abundance and alignment, ti...

  9. Radioguided occult lesion localisation in breast cancer using an intraoperative portable gamma camera: first results

    Energy Technology Data Exchange (ETDEWEB)

    Paredes, P. [Hospital Sant Pau, Nuclear Medicine Department, Barcelona (Spain); Vidal-Sicart, S.; Pavia, J.; Pons, F. [University of Barcelona, Nuclear Medicine Department, Hospital Clinic, Barcelona (Spain); Institut d' Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona (Spain); Zanon, G. [University of Barcelona, Obstetrics and Gynaecology Department, Hospital Clinic, Barcelona (Spain); Roe, N.; Rubi, S. [University of Barcelona, Nuclear Medicine Department, Hospital Clinic, Barcelona (Spain); Lafuente, S. [Hospital Joan XXIII, Nuclear Medicine Department, Tarragona (Spain)

    2008-02-15

    The role of the radioguided occult lesion localisation (ROLL) technique in breast cancer has been increasing in recent years. One of the important drawbacks of such a technique is radiotracer spillage within the mammary gland that makes the precise lesion resection difficult, and this requires the use of a hook-wire collocation to reach the lesion. The possibility of obtaining an intraoperative image of the specimen could help to confirm whether the lesion is correctly removed. Some types of portable gamma cameras have been designed, but up to now, intraoperative use has been confined to surgery of parathyroid adenomas and sentinel lymph node location. The aim of the study was to value the usefulness of an intraoperative gamma camera to assess the resection of non-palpable breast lesions. The study involved 42 women diagnosed with non-palpable early breast cancer. Lymphoscintigraphy was performed on the day before surgery by injection of {sup 99m}Tc-labelled nanocolloid. During surgery a gamma probe was used to guide the surgeon, and afterwards images of the surgical bed and the tumoral specimen were acquired by means of a portable gamma camera, fitted with a pinhole collimator. A {sup 99m}Tc pointer was used to draw an outline image around the specimen. On lymphoscintigraphy, radiotracer was concentrated in 31 cases. During surgery, all lesions were removed. In the images acquired by the portable gamma camera, the lesion was centred inside the surgical specimen in 23 of 42 cases, non-centred in 15 and in contact in 4 cases. Congruence of 60% was found between the intraoperative images and the histopathological results. The posterior margin was the most frequently involved. The whole acquisition time for the tumoral specimen with its margins was 5 min at most. The use of portable gamma cameras in theatre is in an early phase. The short period of time required during the surgical procedure will allow the surgical team to improve this technique until it can replace

  10. Sequential changes of the breast after partial mastectomy with irradiation in breast cancer: mammographic and ultrasonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Pyeong Ho; Oh, Ki Keun; Yoon, Choon Sik; Suh, Chang Ok; Lee, Hy De; Chung, Woo Hee [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-02-15

    The purpose of the study is to determine the mammographic and ultrasonographic features of the breasts with partial mastectomy and irradiation. The authors reviewed the serial studies of 23 patients who had partial mastectomy and irradiation. Mammogram and ultrasonogram were performed every 6 months after surgery in all patients. Sixteen of 23 patients took mammogram and ultrasonogram 1 month after surgery additionally. We evaluated skin thickening, edema, new calcification, and postoperative scar. Skin thickening was observed in all patients at initial study after surgery and were most pronounced 6 months after surgery. In the most of patients, increased breast density suggesting edema was seen at the initial study after surgery. Skin thickening and edema were most pronounced 6 months who had retuned to normal state 18 months after surgery in 3 of 5 patients who had serial studies until 18 months after surgery. Scars were noted in 20 of 23 patients and 9 of 20 patients had scars 6 months after surgery. The postoperative changes including skin thickening, edema, and scar were most pronounced at 6 months after surgery and had retuned to normal at 18 months after surgery. We conclude that postoperative imaging should be obtained 6 months after surgery, followed be every 6 month intervals, which can be effective in differentiating postoperative scar from recurrent carcinoma and can avoid invasive studies.

  11. The value of breast MRI in high‐risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: Is there a role to choose wisely patients for sentinel node biopsy?

    OpenAIRE

    Freitas, Vivianne; Crystal, Pavel; Kulkarni, Supriya R.; Ghai, Sandeep; Bukhanov, Karina; Escallon, Jaime; Scaranelo, Anabel M.

    2016-01-01

    Abstract The aim of this study was to evaluate the presence of clinically and mammographically occult disease using breast MRI in a cohort of cancer patients undergoing contralateral prophylactic mastectomy (CPM) and the utmost indication of axillary assessment (sentinel node biopsy (SLNB)) for this side. A retrospective review of patients with unilateral invasive breast cancer or ductal carcinoma in situ (DCIS) from institutional MRI registry data (2004–2010) was conducted. Characteristics o...

  12. Diagnosis and Treatment on the Occult Breast Cancer%隐匿性乳腺癌的诊治分析

    Institute of Scientific and Technical Information of China (English)

    王斌

    2013-01-01

    Objective To investigate the method for diagnosing and treating occult breast cancer(OBC).Methods] analysis was made on the clinical data of 1 cases of occult breast cancer.Conclusion Axil ary lymph node biopsy and immuohistochemical analysis play important roles in the diagnosis of OBC. PreBreferred treatment is modified radical mastectomy combined with radiotherapy and chemotherapy.%目的分析隐匿性乳腺癌的诊断、治疗情况。方法结合文献对我院收治2例隐匿性乳腺癌的临床资料进行诊治分析。结论腋窝淋巴结活检和免疫组化分析对隐匿性乳腺癌的诊断具有重要意义,治疗以乳腺癌改良根治术为主并辅以放疗、化疗、内分泌全身综合性治疗。

  13. DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS.

    Science.gov (United States)

    Pereira, Marina Alessandra; Ramos, Marcus Fernando Kodama Pertille; Dias, Andre Roncon; Yagi, Osmar Kenji; Faraj, Sheila Friedrich; Zilberstein, Bruno; Cecconello, Ivan; Mello, Evandro Sobroza de; Ribeiro-Jr, Ulysses

    2017-01-01

    The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However, their identification is limited by conventional methodology, since they can be overlooked after routine staining. To investigate the presence of occult tumor cells using cytokeratin (CK) AE1/AE3 immunostaining in gastric cancer patients histologically lymph node negative (pN0) by H&E. Forty patients (T1-T4N0) submitted to a potentially curative gastrectomy with D2 lymphadenectomy were evaluated. The results for metastases, micrometastases and isolated tumor cells were also associated to clinicopathological characteristics and their impact on stage grouping. Tumor deposits within lymph nodes were defined according to the tumor-node-metastases guidelines (7th TNM). A total of 1439 lymph nodes were obtained (~36 per patient). Tumor cells were detected by immunohistochemistry in 24 lymph nodes from 12 patients (30%). Neoplasic cells were detected as a single or cluster tumor cells. Tumor (p=0.002), venous (p=0.016), lymphatic (p=0.006) and perineural invasions (p=0.04), as well as peritumoral lymphocytic response (p=0.012) were correlated to CK-positive immunostaining tumor cells in originally negative lymph nodes by H&E. The histologic stage of two patients was upstaged from stage IB to stage IIA. Four of the 28 CK-negative patients (14.3%) and three among 12 CK-positive patients (25%) had disease recurrence (p=0.65). The CK-immunostaining is an effective method for detecting occult tumor cells in lymph nodes and may be recommended to precisely determine tumor stage. It may be useful as supplement to H&E routine to provide better pathological staging. A presença de metástase em linfonodos é um dos indicadores prognósticos mais importantes no câncer gástrico. As micrometástases têm sido

  14. Influence of lifestyle factors on mammographic density in postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Judith S Brand

    Full Text Available BACKGROUND: Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT, little is known about lifestyle factors that influence breast density. METHODS: We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI and HRT was studied. RESULTS: Overall, alcohol intake was positively associated with percent mammographic density (P trend  = 0.07. This association was modified by HRT use (P interaction  = 0.06: increasing alcohol intake was associated with increasing percent density in current HRT users (P trend  = 0.01 but not in non-current users (P trend  = 0.82. A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction  = 0.04. No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use. CONCLUSIONS: Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk.

  15. Childhood factors associated with mammographic density in adult women.

    Science.gov (United States)

    Lope, Virginia; Pérez-Gómez, Beatriz; Moreno, María Pilar; Vidal, Carmen; Salas-Trejo, Dolores; Ascunce, Nieves; Román, Isabel González; Sánchez-Contador, Carmen; Santamariña, María Carmen; Carrete, Jose Antonio Vázquez; Collado-García, Francisca; Pedraz-Pingarrón, Carmen; Ederra, María; Ruiz-Perales, Francisco; Peris, Mercé; Abad, Soledad; Cabanes, Anna; Pollán, Marina

    2011-12-01

    Growth and development factors could contribute to the development of breast cancer associated with an increase in mammographic density. This study examines the influence of certain childhood-related, socio-demographic and anthropometric variables on mammographic density in adult woman. The study covered 3574 women aged 45-68 years, participating in breast cancer-screening programmes in seven Spanish cities. Based on a craniocaudal mammogram, blind, anonymous measurement of mammographic density was made by a single radiologist, using Boyd's semiquantitative scale. Data associated with the early stages of life were obtained from a direct survey. Ordinal logistic regression and generalised linear models were employed to estimate the association between mammographic density and the variables covered by the questionnaire. Screening programme was introduced as a random effects term. Age, number of children, body mass index (BMI) and other childhood-related variables were used as adjustment variables, and stratified by menopausal status. A total of 811 women (23%) presented mammographic density of over 50%, and 5% of densities exceeded 75%. Our results show a greater prevalence of high mammographic density in women with low prepubertal weight (OR: 1.18; 95% CI: 1.02-1.36); marked prepubertal height (OR: 1.25; 95% CI: 0.97-1.60) and advanced age of their mothers at their birth (>39 years: OR: 1.28; 95% CI: 1.03-1.60); and a lower prevalence of high mammographic density in women with higher prepubertal weight, low birth weight and earlier menarche. The influence of these early-life factors may be explained by greater exposure to hormones and growth factors during the development of the breast gland, when breast tissue would be particularly susceptible to proliferative and carcinogenic stimulus.

  16. 隐匿性乳腺癌外科治疗%Surgical treatment of occult breast cancer

    Institute of Scientific and Technical Information of China (English)

    韩学东; 甄林林

    2008-01-01

    目的 探讨隐匿性乳腺癌的外科治疗方法.方法 对11例隐匿性乳腺癌患者的临床资料进行回顾性分析.结果11例均为女性,年龄44~70岁,中位年龄55岁.首发症状均为腋窝肿物,左侧4例,右侧7例.合并锁骨上淋巴结转移2例.行改良根治术4例,保留乳房仅行腋窝淋巴清扫术3例,腋窝肿物切除术2例,锁骨上淋巴结活检2例.术后按乳腺癌治疗规范行放、化疗和内分泌治疗.随访8个月至9年6个月,死亡3例,5年生存率54.5%(6/11).结论 隐匿性乳腺癌应根据乳腺癌治疗规范进行综合治疗.手术可行改良根治术或根治性保乳术,对于乳腺无原发癌证据者可保留乳房仅行腋窝淋巴清扫术.%Objective To investigate the surgical treatment of occult breast cancer.Methods The clinical data of 11 cases of occult breast cancer were analyzed retrospectively.Results In 11 female cases aged between 44and 70 years old,2 cases were accompanied with supraclavicular node metastasis.Axillary node enlargement was presented as the first sign,which was located in left side in 4 cases and right side in 7 cases.3 cases underwent axillary lymph lode desection,2 cases accepted axillary node excision and other 2 cases with supraclavicular node enlargement only underwent excisional biopsy.All patients received radiochemotherapy and endocrine therapy.All cases were followed-up from 8 months to 9 years and 6 months,during which 3 cases died,with the 5 years survival rate of 54.5%(6/11).Conclusion Combined treatment is suitable to occult breast cancer.Modified radical mastectomy or breast conserving surgery should be conducted,but axillary lymph node desection may be conducted when the diagnosis is established.

  17. Risk stratification and detection of new colorectal neoplasms after colorectal cancer screening with faecal occult blood test

    DEFF Research Database (Denmark)

    Bjerrum, Andreas; Milter, Maya Christel; Andersen, Ole

    2015-01-01

    BACKGROUND: Limited data exist on adenoma surveillance as recommended in the European guidelines for quality assurance in colorectal cancer (CRC) screening and diagnosis after faecal occult blood test (FOBT) screening. OBJECTIVE: To assess the European guidelines for adenoma surveillance after CRC...... screening with FOBT. MATERIALS AND METHODS: This was a population-based cohort-study of 176 782 Danish individuals aged 50-74 years invited for CRC screening in 2005-2006. Adenoma patients were stratified into risk groups (low A, medium B, high C) in accordance with the European guidelines and followed up......-detected adenomas. During a median follow-up period of 72.7 months, detection of new advanced adenomas (B+C) was significantly higher in risk group C than group A (RR 2.25, 95% confidence interval: 1.13-4.48). Nine patients were diagnosed with CRC: one in risk group A, two in B and six in C. The detection rate...

  18. The importance of mammographic screening relative to the treatment of women with carcinoma of the breast.

    Science.gov (United States)

    Solin, L J; Legorreta, A; Schultz, D J; Zatz, S; Goodman, R L

    1994-04-11

    The use of mammographic screening for the early detection of breast cancer has been shown to reduce the mortality from breast cancer. However, the impact of mammographic screening relative to the local treatment of the breast (ie, breast-conservation treatment vs mastectomy) is not well established. An analysis was performed of 206 newly diagnosed and treated breast cancers in 201 women identified in 1989 from a health maintenance organization (US Healthcare, Blue Bell, Pa). The 206 breast cancers were evaluated for eligibility for and actual local treatment of the breast with breast-conserving surgery and definitive breast irradiation as a function of mammographic screening for the early detection of breast cancer. Eligibility for local treatment of the breast with breast-conserving surgery and definitive breast irradiation was significantly increased for the breast cancers detected in women who had undergone mammographic screening compared with the breast cancers detected in women who had not undergone mammographic screening (88% vs 60%, respectively; P < .0001). For the breast cancers that were eligible on chart review for treatment with breast-conserving surgery and definitive breast irradiation, there was no significant difference in the actual local treatment of the breast with breast-conserving surgery and definitive breast irradiation for the eligible breast cancers detected in women who had undergone mammographic screening compared with the eligible breast cancers detected in women who had not undergone mammographic screening (44% vs 37%, respectively; P = .40); however, there was a statistically significant difference for the subgroup of women aged 50 years or more (49% vs 21%, respectively; P = .016). These results show that breast cancers detected in women who had undergone mammographic screening were more likely to be eligible for breast-conserving surgery and definitive breast irradiation compared with breast cancers detected in women who had not

  19. SNOLL. Sentinel node and occult (impalpable) lesion localization in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Thind, C.R., E-mail: thindr@aol.com [Radiology Department, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescott, Liverpool (United Kingdom); Tan, S.; Desmond, S.; Harris, O. [Radiology Department, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescott, Liverpool (United Kingdom); Ramesh, H.S.J.; Chagla, L.; Ray, A.; Audisio, R. [Department of Surgery, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescott, Liverpool (United Kingdom)

    2011-09-15

    Aim: To evaluate the efficacy and safety for use of dual radioisotopes for localization of occult (impalpable) breast lesions and sentinel node biopsy as a combined technique (SNOLL) using a lower dose than previous studies. Materials and methods: One hundred and twenty-seven SNOLL procedures were performed. The impalpable breast lesions were localized with an intra-lesion injection of 0.2 ml of {sup 99m}Tc MAA (1 MBq) with a particle size of 10-90 {mu}m (radio-guided occult lesion localization, or ROLL) 1 to 4 h before surgery. Sentinel node localization was performed using 0.2 mls of {sup 99}Tc nanocolloid (20 MBq) particle size no greater than 80 nm injected subdermally in the periareolar region within the index quadrant, the night before or the morning of surgery. Results: Lesion localization was consistently achieved with a lower dose than that described in other studies without the need to use scintigraphy or additional imaging with radioopaque contrast medium. One hundred percent lesion localization with a negative clearance margin of 94.8% and 100% sentinel node localization was achieved. The use of dual radioisotopes with the lower dose used for ROLL did not compromise the localization of the impalpable lesion or the sentinel nodes. Conclusion: The combined use of radioisotopes for lesion and sentinel node removal is feasible and reliable with the lower radioisotope dose suggested compared with previously published studies. This method should be recommended as a standard procedure for SNOLL.

  20. Fractal Dimension and Lacunarity analysis of mammographic patterns in assessing breast cancer risk related to HRT treated population

    DEFF Research Database (Denmark)

    Karemore, Gopal Raghunath; Nielsen, Mads

    2009-01-01

      Structural texture measures are used to address the aspect of breast cancer risk assessment in screening mammograms. The current study investigates whether texture properties characterized by local Fractal Dimension (FD) and Lacunarity contribute to asses breast cancer risk. FD represents...... the complexity while the Lacunarity characterize the gappiness of a fractal. Our cross-sectional case-control study includes mammograms of 50 patients diagnosed with breast cancer in the subsequent 2-4 years and 50 matched controls. The longitudinal double blind placebo controlled HRT study includes 39 placebo...... and 36 HRT treated volunteers for two years. ROIs with same dimension (250*150 pixels) were created behind the nipple region on these radiographs. Box counting method was used to calculate the fractal dimension (FD) and the Lacunarity. Paired t-test and Pearson correlation coefficient were calculated...

  1. Impact of the elimination of cost sharing for mammographic breast cancer screening among rural US women: A natural experiment.

    Science.gov (United States)

    Peppercorn, Jeffrey; Horick, Nora; Houck, Kevin; Rabin, Julia; Villagra, Victor; Lyman, Gary H; Wheeler, Stephanie B

    2017-07-01

    Rural US women experience disparities in breast cancer screening and outcomes. In 2006, a national rural health insurance provider, the National Rural Electric Cooperative Association (NRECA), eliminated out-of-pocket costs for screening mammography. This study evaluated the elimination of cost sharing as a natural experiment: it compared trends in screening before and after the policy change. NRECA insurance claims data were used to identify all women aged 40 to 64 years who were eligible for breast cancer screening, and mammography utilization from 1998 through 2011 was evaluated. Repeated measures regression models were used to evaluate changes in utilization over time and the association between screening and sociodemographic factors. The analysis was based on 45,738 women enrolled in the NRECA membership database for an average of 6.1 years and included 279,940 person-years of enrollment. Between 1998 and 2011, the annual screening rate increased from 35% to a peak of 50% among women aged 40 to 49 years and from 49% to 58% among women aged 50 to 64 years. The biennial screening rate increased from 56% to 66% for women aged 40 to 49 years and from 68% to 73% for women aged 50 to 64 years. Screening rates increased significantly (P < .0001) after the elimination of cost sharing and then declined slightly after changes to government screening guidelines in 2009. Younger women experienced greater increases in both annual screening (6.2%) and biennial screening (5.6%) after the elimination of cost sharing in comparison with older women (3.0% and 2.6%, respectively). In a multivariate analysis, rural residence, lower population income, and lower population education were associated with modestly lower screening. In a national sample of predominantly rural working-age women, the elimination of cost sharing correlated with increased breast cancer screening. Cancer 2017;123:2506-15. © 2017 American Cancer Society. © 2017 American Cancer Society.

  2. Colorectal cancer screening: a community case-control study of proctosigmoidoscopy, barium enema radiography, and fecal occult blood test efficacy.

    Science.gov (United States)

    Scheitel, S M; Ahlquist, D A; Wollan, P C; Hagen, P T; Silverstein, M D

    1999-12-01

    To examine the effectiveness of screening proctosigmoidoscopy, barium enema radiography, and the fecal occult blood test (FOBT) in decreasing colorectal cancer mortality in a community setting. In this population-based case-control study, cases comprised 218 Rochester, Minn, residents who died of colorectal cancer between 1970 and 1993. Controls were 435 age- and sex-matched residents who did not have a diagnosis of colorectal cancer. Screening proctosigmoidoscopy, barium enema radiography, and FOBT results were documented for the 10 years prior to and including the date of diagnosis of fatal colorectal cancer in cases and for the same period in matched controls. History of general medical examinations and hospitalizations was also recorded. Within the 10 years prior to diagnosis, the percentages of cases vs controls with at least 1 screening proctosigmoidoscopy were 23 (10.6%) of 218 cases vs 43 (9.9%) of 435 controls; at least 1 screening barium enema radiographic study was done in 12 (5.5%) of 218 vs 25 (5.7%) of 435. Within 3 years prior to diagnosis, the percentages of cases vs controls with at least 1 screening FOBT were 27 (12.4%) of 218 vs 44 (10.1%) of 435. Adjusted odds ratios were 1.04 (95% confidence interval [CI], 0.21-5.13) for proctosigmoidoscopy (distal rectosigmoid cancers only), 0.67 (95% CI, 0.31-1.48) for barium enema radiography, and 0.83 (95% CI, 0.45-1.52) for FOBT over the above time periods. In this case-control study within a community setting, a colorectal cancer-specific mortality benefit could not be demonstrated for screening by FOBT, proctosigmoidoscopy, or barium enema radiography. Screening frequency was low, which may have contributed to the lack of measurable effects.

  3. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  4. Evaluation of mammographic density patterns: reproducibility and concordance among scales

    OpenAIRE

    2010-01-01

    Abstract Background Increased mammographic breast density is a moderate risk factor for breast cancer. Different scales have been proposed for classifying mammographic density. This study sought to assess intra-rater agreement for the most widely used scales (Wolfe, Tabár, BI-RADS and Boyd) and compare them in terms of classifying mammograms as high- or low-density. Methods The study covered 3572 mammograms drawn from women included in the DDM-Spain study, carried-out in seven Spanish Autonom...

  5. Body mass index and participation in organized mammographic screening

    DEFF Research Database (Denmark)

    Hellmann, Sophie Sell; Njor, Sisse Helle; Lynge, Elsebeth;

    2015-01-01

    screening, but hardly addressed the influence of potential effect-modifiers. We studied the association between objective measures of BMI and participation in mammographic screening in a Danish prospective cohort, and explored the influence of menopausal status, hormone therapy (HT), previous screening...... participation, and morbidities on this relationship. METHODS: A total of 5,134 women from the Diet, Cancer, and Health cohort who were invited to population based mammographic screening in Copenhagen were included in analysis. Women were 50-64 years old at inclusion (1993-97) when their height and weight were...

  6. MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer

    Directory of Open Access Journals (Sweden)

    Sangeeta Taneja

    2012-01-01

    Full Text Available Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral breast cancer in patients undergoing MRI mammography for the evaluation of a malignant breast lesion. Materials and Methods: A total of 294 patients with recently diagnosed breast cancer who underwent MRI of the breast were evaluated for lesions in the opposite breast. Results: The incidence of synchronous contralateral malignancy detected by preoperative MRI mammography done for evaluation of extent of disease was 4.1%. Conclusion: Preoperative breast MRI may detect clinically and mammographically occult synchronous contralateral cancer, and can help the patient avoid an additional second surgery or a second course of chemotherapy later; also, as theoretically these lesions are smaller, there may be a survival benefit as well.

  7. Is There an Association Between Bone Mineral Density and Mammographic Density? A Systematic Review.

    Science.gov (United States)

    Lee, Jong Min; Holley, Susan; Appleton, Catherine; Toriola, Adetunji T

    2017-04-01

    Both bone mineral density (BMD) and breast density are related to reproductive hormone levels. This suggests that BMD and breast density could be meaningfully associated, and serve as surrogate markers for breast cancer risk. However, few studies have investigated the association of BMD with percent mammographic density, making it difficult to draw meaningful conclusions. We conducted a systematic review of studies published in electronic databases till April 2016 using the following search terms: "bone density," "bone mineral density," "mammographic breast density," "breast density," and "mammographic density." We identified 203 articles, of which 8 met the inclusion criteria for this review. BMD does not appear to be associated with percent mammographic density. BMD at the spine was weakly positively associated with percent mammographic density among postmenopausal women who were not hormone users, while BMD at the hip and legs was positively associated with percent mammographic density among premenopausal women. On the other hand, one study reported an inverse association of BMD at the spine and hip with percent mammographic density among perimenopausal women. In this review, we found no evidence of an association between BMD and percent mammographic density.

  8. Mammographic breast density in infertile and parous women.

    Science.gov (United States)

    Letizia, Meggiorini Maria; Rita, Vestri Anna; Grazia, De Stefano Maria; Valentina, Cipolla; Filippo, Bellati; Diana, Maffucci; Paola, Nusiner Maria; Cesare, Aragona; Carlo, De Felice

    2016-02-09

    Mammographic breast density is a useful marker for breast cancer risk, as breast density is considered one of the strongest breast cancer risk factors. The study objective was to evaluate and compare mammographic breast density in infertile and parous women, as infertility may be associated with high breast density and cancer occurrence. This study evaluated mammographic breast density using two different systems, BIRADS and Boyd. A selected patient population of 151 women with primary infertility (case group) was compared to 154 parous women who had at least one previous pregnancy (control group). Both groups were premenopausal women aged ≥ 35. Evaluation of mammographic features showed that 66.9% of case group patients and 53.9% of control group patients were classified BIRADS-3/BIRADS-4; p BIRADS-3/BIRADS-4 was 1.78 (95% CI: 1.10-2.89). Using the Boyd classification system, 53.6% of case group patients and 31.8% of control group patients were classified E/F; p BIRADS classification systems indicate to what extend breast cancer lesions may be missed on mammography due to masking by dense tissue. Therefore, patients with a high BIRADS or Boyd score should undergo further investigation.

  9. The impact of using weight estimated from mammographic images vs. self-reported weight on breast cancer risk calculation

    Science.gov (United States)

    Nair, Kalyani P.; Harkness, Elaine F.; Gadde, Soujanye; Lim, Yit Y.; Maxwell, Anthony J.; Moschidis, Emmanouil; Foden, Philip; Cuzick, Jack; Brentnall, Adam; Evans, D. Gareth; Howell, Anthony; Astley, Susan M.

    2017-03-01

    Personalised breast screening requires assessment of individual risk of breast cancer, of which one contributory factor is weight. Self-reported weight has been used for this purpose, but may be unreliable. We explore the use of volume of fat in the breast, measured from digital mammograms. Volumetric breast density measurements were used to determine the volume of fat in the breasts of 40,431 women taking part in the Predicting Risk Of Cancer At Screening (PROCAS) study. Tyrer-Cuzick risk using self-reported weight was calculated for each woman. Weight was also estimated from the relationship between self-reported weight and breast fat volume in the cohort, and used to re-calculate Tyrer-Cuzick risk. Women were assigned to risk categories according to 10 year risk (below average =8%) and the original and re-calculated Tyrer-Cuzick risks were compared. Of the 716 women diagnosed with breast cancer during the study, 15 (2.1%) moved into a lower risk category, and 37 (5.2%) moved into a higher category when using weight estimated from breast fat volume. Of the 39,715 women without a cancer diagnosis, 1009 (2.5%) moved into a lower risk category, and 1721 (4.3%) into a higher risk category. The majority of changes were between below average and average risk categories (38.5% of those with a cancer diagnosis, and 34.6% of those without). No individual moved more than one risk group. Automated breast fat measures may provide a suitable alternative to self-reported weight for risk assessment in personalized screening.

  10. Mammographic features of triple negative breast cancer%三阴性乳腺癌X线特征分析

    Institute of Scientific and Technical Information of China (English)

    梁晓燕; 马少君; 康晓丽; 王涛; 黄范利

    2014-01-01

    目的:探讨三阴性乳腺癌的 X 线特征。方法:收集经手术病理证实为乳腺癌的202例患者资料,根据雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体(HER -2)表达情况将其分为三阴性乳腺癌(TNBC)与非三阴性乳腺癌(NTNBC),比较两组病例腺体分型、病灶是否单发、肿块情况及有无钙化。结果:202例乳腺癌TNBC 有34例,NTNBC 有168例。两组病例肿块边缘及有无钙化差异有统计学意义(P均﹤0.05)。腺体分型、是否单发、肿块的大小、肿块的形态、肿块的密度差异无统计学意义。结论:TNBC 有一定特征,大多为单发肿块,与 NTNBC 相比肿块边缘更易表现为清晰光滑,钙化相对少见的征象。%To analyze the X - ray findings of triple negative breast cancer. Methods:The results of 202 cases of breast cancer identified by postoperative pathology were collected,which distinguished to triple negative breast cancer(TNBC)and non - triple negative breast cancer(NTNBC)by immunohistochemologic receptor status of estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER - 2). The re-sults of mammary gland type,mass's number,margin and calcification on mammograms were compared. Results:Of 202 cases breast cancer included 34 cases TNBC and 168 cases NTNBC,the differences between mass margins and calcification incidence were statistically significant(P ﹤ 0. 05),and there were no statistically significant differences among mass's number,size,shape,density and mammary gland type(P ﹥ 0. 05). Conclusion:TNBC shows merely a mass with indistinct margins and less calcifications than NTNBC.

  11. Does accelerated hypofractionated adjuvant whole-breast radiotherapy increase mammographic density or change mammographic features?

    Science.gov (United States)

    Milanesio, Luisella; Brachet Cota, Piero B; Berrino, Carla; Cataldi, Aldo; Gatti, Giovanni; Mondini, Guido; Paino, Ovidio; Comello, Erika G; Orlassino, Renzo; Pasquino, Massimo; Cante, Domenico; La Porta, Maria R; Patania, Sebastiano; La Valle, Giovanni

    2015-01-01

    Objective: To compare mammographic features before and after accelerated hypofractionated adjuvant whole-breast radiotherapy (AWB-RT) and to evaluate possible appearance of modifications. Methods: A retrospective review of 177 females before and after an AWB-RT treatment (follow-up ranging from 5 to 9 years) was performed by four radiologists focused in breast imaging who independently evaluated diffuse mammographic density patterns and reported on possible onset of focal alterations; modifications in density and fibrosis with parenchymal distortion were deemed as indicators of AWB-RT treatment impact in breast imaging. Results: Prevalent mammographic density (D) patterns in the 177 females evaluated were according to the American College of Radiology–Breast Imaging Reporting and Data System (ACR-BIRADS): D1, fibroadipose density (score percentage from 55.9% to 43.5%); and D2, scattered fibroglandular density (from 42.9% to 32.7%). No change in diffuse mammographic density and no significant difference in mammographic breast parenchymal structure were observed. “No change” was reported with score percentage from 87% to 79.6%. Appearance of fibrosis with parenchymal distortion was reported by all radiologists in only two cases (1.1%, p = 0.3); dystrophic calcification was identified with percentage score from 2.2% to 3.3% (small type) and from 9.6% to 12.9% (coarse type). Conclusion: No statistically significant changes in follow-up mammographies 5–9 years after AWB-RT were detected, justifying large-scale selection of AWB-RT treatment with no risk of altering radiological breast parameters of common use in tumour recurrence detection. Advances in knowledge: The hypofractionated radiotherapy (AWB-RT treatment) is a new proven, safe and effective modality in post-operative patients with early breast cancer with excellent local control and survival. In our study, the absence of changes in mammographic density patterns and in breast imaging before and after

  12. 三阴乳腺癌与非三阴乳腺癌X线及病理特征分析%Mammographic features and histopathological characteristics of triple negative breast cancer and non-triple negative breast cancer

    Institute of Scientific and Technical Information of China (English)

    李丽娟; 黎庶

    2012-01-01

    目的 与非三阴乳腺癌(non-TNBC)比较,探讨三阴乳腺癌(TNBC)的X线表现及病理特征.方法 回顾性分析经病理证实的574例乳腺癌患者资料,对比分析81例TNBC(TNBC组)与493例non-TNBC患者(non-TNBC组)的临床、病理特征及X线表现.结果 TNBC组织学分级以中、高级别为主,其中53.09%(43/81)发生腋窝淋巴结转移,高于non-TNBC组(39.96%,197/493,P<0.05).与non-TNBC组相比,TNBC病变体积较大,多为单纯肿块型,少见钙化(P<0.05),肿块型TNBC瘤体多为类圆形,边缘光滑,较少见不规则形及毛刺(P<0.05).结论 TNBC与non-TNBC在X线表现及病理特征方面存在一定差异,了解其特征有助于诊断TNBC.%Objective To explore the mammographic features and histpathological characteristics of triple negative breast cancer (TNBC) compared with non-triple negative breast cancer (non-TNBC). Methods A total of 574 patients with his-topathologieally confirmed breast cancer were analyzed retrospectively. The clinical, histopathological and mammographic imaging characteristics of TNBC patients (n=81) were analyzed and compared with those of non-TNBC patients (n = 493). Results Most of TNBC showed intermediate and high histological grade. The percentage of lymph node metastasis in TNBC group (43/81, 53. 09%) was higher than that of non-TNBC group (197/493, 39. 96%, P<0. 05). Tumors in TNBC group were larger than non-TNBC group, usually presented as a mass with less calcifications (P<0. 05). The masses of TNBC frequently presented as oval and smooth margin, with less irregular and burr (P<0. 05). Conclusion There are some differences between TNBC and non-TNBC in pathology and radiology. Understanding these characters might be useful to diagnose TNBC.

  13. Progestogen levels, Progesterone Receptor Gene polymorphisms, and mammographic density changes: results from the Postmenopausal Estrogen/Progestin Interventions Mammographic Density Study (PEPI-MDS)

    Science.gov (United States)

    Lee, Eunjung; Ingles, Sue A.; Van Den Berg, David; Wang, Wei; LaVallee, Chris; Huang, Mei-Hua; Crandall, Carolyn J.; Stanczyk, Frank Z.; Greendale, Gail A.; Ursin, Giske

    2015-01-01

    Objective Estrogen plus progestin therapy (EPT) in postmenopausal women increases breast cancer risk and mammographic density to a higher extent than does estrogen therapy (ET) alone. Data from the randomized placebo-controlled Postmenopausal Estrogen/Progestin Interventions (PEPI) trial showed that EPT-induced increases in serum estrone and estrone sulfate levels were positively correlated with increases in mammographic density. Here, after adjusting for serum estrone and estrone sulfate levels, we investigated the roles of post-treatment serum progestogen increase and of progesterone receptor gene (PGR) genetic variations on changes in mammographic density. Methods We measured percent mammographic density and serum progestogen levels in 280 PEPI participants randomized to EPT treatment. Analyses of genetic variations in PGR were limited to 260 white women for whom we successfully obtained PGR genotypes. We used linear regression analyses to determine how increase in progestogen levels and PGR genetic variations influenced mammographic density change following EPT. Results The increase in post-treatment serum progestogen level was positively associated with greater increases in mammographic density after adjustment for covariates (P-trend=0.044). Compared to women in the lowest quartile of serum progestogen, women in the highest quartile experienced a 3.5% greater increase in mammographic density (P=0.046). We did not find a strong indication that genetic variations in PGR were associated with mammographic density increase, or modified the association with serum progestogen, however confidence in these null findings is constrained by our small sample size. Conclusions Our results suggest that higher serum progestogen levels resulting from EPT treatment lead to greater increases in mammographic density. PMID:22105149

  14. Differences in mammographic density between Asian and Caucasian populations: a comparative analysis.

    Science.gov (United States)

    Rajaram, Nadia; Mariapun, Shivaani; Eriksson, Mikael; Tapia, Jose; Kwan, Pui Yoke; Ho, Weang Kee; Harun, Faizah; Rahmat, Kartini; Czene, Kamila; Taib, Nur Aishah Mohd; Hall, Per; Teo, Soo Hwang

    2017-01-01

    Mammographic density is a measurable and modifiable biomarker that is strongly and independently associated with breast cancer risk. Paradoxically, although Asian women have lower risk of breast cancer, studies of minority Asian women in predominantly Caucasian populations have found that Asian women have higher percent density. In this cross-sectional study, we compared the distribution of mammographic density for a matched cohort of Asian women from Malaysia and Caucasian women from Sweden, and determined if variations in mammographic density could be attributed to population differences in breast cancer risk factors. Volumetric mammographic density was compared for 1501 Malaysian and 4501 Swedish healthy women, matched on age and body mass index. We used multivariable log-linear regression to determine the risk factors associated with mammographic density and mediation analysis to identify factors that account for differences in mammographic density between the two cohorts. Compared to Caucasian women, percent density was 2.0% higher among Asian women (p density and risk to breast cancer may be accounted for by height, weight, and parity. Given that pre-menopausal Asian and Caucasian women have similar population risk to breast cancer but different dense volume, development of more appropriate biomarkers of risk in pre-menopausal women is required.

  15. Mammographic density and structural features can individually and jointly contribute to breast cancer risk assessment in mammography screening

    DEFF Research Database (Denmark)

    Winkel, Rikke Rass; von Euler-Chelpin, My Catarina; Nielsen, Mads

    2016-01-01

    in Denmark in 2007 (followed until 31 December 2010). Mammograms were assessed using the Breast Imaging-Reporting and Data System (BI-RADS) density classification, Tabár's classification on parenchymal patterns and a fully automated texture quantification technique. The individual and combined association...... with breast cancer was estimated using binary logistic regression to calculate Odds Ratios (ORs) and the area under the receiver operating characteristic (ROC) curves (AUCs). RESULTS: Cases showed significantly higher BI-RADS and texture scores on average than controls (p ... individually able to segregate women into different risk groups showing significant ORs for BI-RADS D3 and D4 (OR: 2.37; 1.32-4.25 and 3.93; 1.88-8.20), Tabár's PIII and PIV (OR: 3.23; 1.20-8.75 and 4.40; 2.31-8.38), and the highest quartile of the texture score (3.04; 1.63-5.67). AUCs for BI-RADS, Tabár...

  16. iROLL: does 3-D radioguided occult lesion localization improve surgical management in early-stage breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Bluemel, Christina; Kajdi, Georg W.; Schmid, Jan; Buck, Andreas K.; Herrmann, Ken [University Hospital of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Cramer, Andreas; Grossmann, Christoph; Grimminger, Hanns-Joerg [Missionsaerztliches Klinikum Wuerzburg, Department of Obstetrics and Gynecology, Wuerzburg (Germany); Malzahn, Uwe [University of Wuerzburg, Institute of Clinical Epidemiology and Biometry, Wuerzburg (Germany); Lamp, Nora [University of Wuerzburg, Institute of Pathology, Wuerzburg (Germany); Langen, Heinz-Jakob [Missionsaerztliches Klinikum Wuerzburg, Department of Radiology, Wuerzburg (Germany)

    2015-10-15

    To prospectively evaluate the feasibility of 3-D radioguided occult lesion localization (iROLL) and to compare iROLL with wire-guided localization (WGL) in patients with early-stage breast cancer undergoing breast-conserving surgery and sentinel lymph node biopsy (SLNB). WGL (standard procedure) and iROLL in combination with SLNB were performed in 31 women (mean age 65.1 ± 11.2 years) with early-stage breast cancer and clinically negative axillae. Patient comfort in respect of both methods was assessed using a ten point scale. SLNB and iROLL were guided by freehand SPECT (fhSPECT). The results of the novel 3-D image-based method were compared with those of WGL, ultrasound-based lesion localization, and histopathology. iROLL successfully detected the malignant primary and at least one sentinel lymph node in 97 % of patients. In a single patient (3 %), only iROLL, and not WGL, enabled lesion localization. The variability between fhSPECT and ultrasound-based depth localization of breast lesions was low (1.2 ± 1.4 mm). Clear margins were achieved in 81 % of the patients; however, precise prediction of clear histopathological surgical margins was not feasible using iROLL. Patients rated iROLL as less painful than WGL with a pain score 0.8 ± 1.2 points (p < 0.01) lower than the score for iROLL. iROLL is a well-tolerated and feasible technique for localizing early-stage breast cancer in the course of breast-conserving surgery, and is a suitable replacement for WGL. As a single image-based procedure for localization of breast lesions and sentinel nodes, iROLL may improve the entire surgical procedure. However, no advantages of the image-guided procedure were found with regard to prediction of complete tumour resection. (orig.)

  17. Características mamográficas do câncer de mama associadas aos polimorfismos GSTM1 e GSTT1 Polymorphisms GSTM1 and GSTT1 and sporadic breast cancer mammographic features

    Directory of Open Access Journals (Sweden)

    Lívia Martins Tavares Scianni Morais

    2008-02-01

    deletions have been associated to increased risk of many cancers, including breast cancer. OBJECTIVE: To evaluate the occurrence of homozygous deletions of the GSTM1 and GSTT1 genes in women with sporadic breast cancer and in women without cancer and to compare breast cancer mammographic features between patients with and without these deletions. METHODS: The study evaluated 100 patients with sporadic breast cancer treated from September 2004 to June 2005 and 169 women without cancer, determining the frequency of the above-mentioned deletions by PCR and calculating the odds ratios and their 95% confidence intervals. Medical files and mammograms of 100 patients with breast cancer were evaluated and correlated with mammographic features such as density, mammographic findings and the BI-RADS classification. These findings were correlated with the genetic deletions by the PR (Prevalence-Ratio with their respective 95% confidence intervals. RESULTS: The GSTM1 gene was deleted in 40% of the cancers and in 44.4% of controls (OR = 1.20; CI 95% 0.70 - 2.04; p=0.5659 while the GSTT1 gene was deleted in 20% and 19.5%, respectively (OR = 0.73; CI 95% 0.37-1.44; p=0.4124. High mammographic density had been associated with GSTM1 deletion (PR 2.43; CI 1.11 to 4.08. GST deletions were not associated with predominant mammographic findings and the BI-RADS classification. CONCLUSION: GSTM1 homozygous deletion was associated with high mammographic density.

  18. A predictive model combining fecal calgranulin B and fecal occult blood tests can improve the diagnosis of colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Byung Chang Kim

    Full Text Available AIM: Current fecal screening tools for colorectal cancer (CRC, such as fecal occult blood tests (FOBT, are limited by their low sensitivity. Calgranulin B (CALB was previously reported as a candidate fecal marker for CRC. This study investigated whether a combination of the FOBT and fecal CALB has increased sensitivity and specificity for a diagnosis of CRC. MATERIALS AND METHODS: Patients with CRC (n = 175, and healthy individuals (controls; n = 151 were enrolled into the development (81 cases and 51 controls and validation (94 cases and 100 controls sets. Stool samples were collected before bowel preparation. CALB levels were determined by western blotting. FOBT and fecal CALB results were used to develop a predictive model based on logistic regression analysis. The benefit of adding CALB to a model with only FOBT was evaluated as an increased area under the receiver operating curve (AUC, partial AUC, and reclassification improvement (RI in cases and controls, and net reclassification improvement (NRI. RESULTS: Mean CALB level was significantly higher in CRC patients than in controls (P<0.001. CALB was not associated with tumor stage or cancer site, but positivity on the FOBT was significantly higher in advanced than in earlier tumor stages. At a specificity of 90%, the cross-validated AUC and sensitivity were 89.81% and 82.72%, respectively, in the development set, and 92.74% and 79.79%, respectively, in the validation set. The incremental benefit of adding CALB to the model, as shown by the increase in AUC, had a p-value of 0.0499. RI in cases and controls and NRI all revealed that adding CALB significantly improved the prediction model. CONCLUSION: A predictive model using a combination of FOBT and CALB may have greater sensitivity and specificity and AUC for predicting CRC than models using a single marker.

  19. Sentinel Lymph Node Occult Metastases Have Minimal Survival Effect in Some Breast Cancer Patients

    Science.gov (United States)

    Detailed examination of sentinel lymph node tissue from breast cancer patients revealed previously unidentified metastases in about 16% of the samples, but the difference in 5-year survival between patients with and without these metastases was very small

  20. Reproductive factors associated with mammographic density: a Korean co-twin control study.

    Science.gov (United States)

    Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung; Lee, Donghun

    2011-07-01

    To determine the mechanism by which menstrual and reproductive factors are associated with the risk of breast cancer, we examined the relationships between mammographic density and known menstrual and reproductive risk factors for breast cancer. A co-twin control study was conducted with 122 pairs of monozygotic Korean female twins selected from the Healthy Twin study. Mammographic density was measured from digital mammograms using a computer-assisted method. Information on selected menstrual and reproductive factors was collected through a self-administered questionnaire. Within-pair differences for each mammographic measure were regressed against within-pair differences for each menstrual and reproductive risk factor with an adjustment for body mass index and other menstrual and reproductive factors. The percent dense area was inversely associated with the age at the first full-term childbirth (FFTB) and the number of live births, although the associations were marginally significant with an adjustment for BMI and other reproductive factors. The non-dense area was positively associated with the age at the FFTB and the number of live births. The absolute dense area was positively associated with the duration of breast feeding. The age at menarche was not associated with any component of the mammographic measures. This finding suggests that mammographic density can mediate the protective effect of greater parity against breast cancer, at least in part while age at menarche, age at the FFTB, and breast feeding do not exert their effects through mammographic density.

  1. Breast image pre-processing for mammographic tissue segmentation.

    Science.gov (United States)

    He, Wenda; Hogg, Peter; Juette, Arne; Denton, Erika R E; Zwiggelaar, Reyer

    2015-12-01

    During mammographic image acquisition, a compression paddle is used to even the breast thickness in order to obtain optimal image quality. Clinical observation has indicated that some mammograms may exhibit abrupt intensity change and low visibility of tissue structures in the breast peripheral areas. Such appearance discrepancies can affect image interpretation and may not be desirable for computer aided mammography, leading to incorrect diagnosis and/or detection which can have a negative impact on sensitivity and specificity of screening mammography. This paper describes a novel mammographic image pre-processing method to improve image quality for analysis. An image selection process is incorporated to better target problematic images. The processed images show improved mammographic appearances not only in the breast periphery but also across the mammograms. Mammographic segmentation and risk/density classification were performed to facilitate a quantitative and qualitative evaluation. When using the processed images, the results indicated more anatomically correct segmentation in tissue specific areas, and subsequently better classification accuracies were achieved. Visual assessments were conducted in a clinical environment to determine the quality of the processed images and the resultant segmentation. The developed method has shown promising results. It is expected to be useful in early breast cancer detection, risk-stratified screening, and aiding radiologists in the process of decision making prior to surgery and/or treatment.

  2. Enhanced bilateral somatostatin receptor expression in mediastinal lymph nodes (``chimney sign``) in occult metastatic medullary thyroid cancer: a typical site of tumour manifestation?

    Energy Technology Data Exchange (ETDEWEB)

    Behr, T.M. [Department of Nuclear Medicine, Georg-August-University of Goettingen (Germany); Gratz, S. [Department of Nuclear Medicine, Georg-August-University of Goettingen (Germany); Markus, P.M. [Department of Surgery (General and Endocrine Surgery), Georg-August-University of Goettingen (Germany); Dunn, R.M. [Garden State Cancer Center at the Center for Molecular Medicine and Immunology, Belleville (United States); Huefner, M. [Department of Internal Medicine (Endocrinology), Georg-August-University of Goettingen (Germany); Becker, H. [Department of Surgery (General and Endocrine Surgery), Georg-August-University of Goettingen (Germany); Becker, W. [Department of Nuclear Medicine, Georg-August-University of Goettingen (Germany)

    1997-02-01

    In medullary thyroid cancer (MTC), post-surgically elevated plasma calcitonin and/or carcinoembryonic antigen levels frequently indicate persisting metastatic disease, although conventional diagnostic procedures fail to localize the responsible lesions (occult disease). Somatostatin analogues have been used successfully in disease localization, but recently concerns have been raised that increased thoracic uptake of indium-111 pentetreotide in patients with previous external beam irradiation may represent a false-positive finding, caused by post-irradiation pulmonary fibrosis. We recently examined seven patients with metastatic MTC by somatostatin receptor scintigraphy (six with occult and one with established disease). In four patients, all of whom had stable or slowly rising tumour marker levels over several years, a chimney-like bilateral mediastinal uptake of indium-111 pentetreotide was found. In two patients with persisting hypercalcitonaemia immediately after primary surgery, supraclavicular lymph node metastases were identified as the responsible lesions. None of these seven patients had prior external beam radiation therapy. In two cases, histological confirmation was obtained. In one patient, disease progression could be shown during follow-up. These data suggest that bilateral mediastinal lymph node involvement is a typical site of disease in slowly progressing occult metastatic MTC; the ``chimney sign`` may represent a typical finding with somatostatin analogues in such cases. Therefore, we believe that even in the case of prior external beam irradiation, mediastinal uptake of octreotide might represent metastatic MTC rather than radiation fibrosis. (orig.). With 2 figs., 1 tab.

  3. Occult Breast Cancer Presenting as Metastatic Adenocarcinoma of Unknown Primary: Clinical Presentation, Immunohistochemistry, and Molecular Analysis

    Directory of Open Access Journals (Sweden)

    Jue Wang

    2012-01-01

    Full Text Available We report a rare presentation of a 66-year-old female with diffuse metastatic adenocarcinoma of unknown primary involving liver, lymphatic system and bone metastases. The neoplastic cells were positive for CK7 and OC125, while negative for CK20, thyroid transcription factor 1, CDX2, BRST-2, chromogranin, synaptophysin, estrogen receptor (ER, progesterone receptor (PR, and human epidermal growth factor receptor 2 (HER2/neu. Fluorescence in situ hybridization showed no amplification of the HER2/neu gene. Molecular profiling reported a breast cancer origin with a very high confidence score of 98%. The absence of immunohistochemistry staining for ER, PR, and HER2/neu further classified her cancer as triple-negative breast cancer. Additional studies revealed high expression levels of topoisomerase (Topo I, androgen receptor, and ribonucleoside-diphosphate reductase large subunit; the results were negative for thymidylate synthase, Topo II-α and O6-methylguanine-DNA methyltransferase. The patient was initially treated with a combination regimen of cisplatin and etoposide, and she experienced a rapid resolution of cancer-related symptoms. Unfortunately, her therapy was complicated by a cerebrovascular accident (CVA, which was thought to be related to cisplatin and high serum mucin. After recovery from the CVA, the patient was successfully treated with second-line chemotherapy based on her tumor expression profile. We highlight the role of molecular profiling in the diagnosis and management of this patient and the implication of personalized chemotherapy in this challenging disease.

  4. Intravenous Tissue Plasminogen Activator for an Ischemic Stroke with Occult Double Primary Cancer

    Directory of Open Access Journals (Sweden)

    Yukihiro Yoneda

    2014-10-01

    Full Text Available Background: In patients with advanced-stage cancer, systemic thrombolysis with tissue plasminogen activator (tPA for hyperacute ischemic stroke is not strictly off-label, but it is at higher risk of complications (including bleeding. Case Report: A 71-year-old male with unrecognizable malignancy developed a hemispheric ischemic stroke and received intravenous tPA within 4.5 h of onset, followed by anticoagulation treatment after 24 h of thrombolysis. Two days later, the patient had tarry stool and progressive anemia, receiving a blood transfusion. The systemic workup documented the presence of double primary cancers with advanced stage gastric and rectal cancers, and the patient subsequently received palliative care. The outcome at 3 months was a modified Rankin Scale of 5, and the patient died 6 months after the stroke. Discussion: Although systemic thrombolysis with tPA for ischemic stroke in patients with advanced-stage cancer may be performed relatively safely, optimal post-thrombolysis management is important to prevent the complications.

  5. Occult cancer in specimens of reduction mammaplasty aimed at symmetrization. A multicentric study of 2718 patients.

    Science.gov (United States)

    Sorin, T; Fyad, J P; Delay, E; Rouanet, P; Rimareix, F; Houpeau, J L; Classe, J M; Garrido, I; Tunon De Lara, C; Dauplat, J; Bendavid, C; Houvenaeghel, G; Clough, K B; Sarfati, I; Leymarie, N; Trudel, M; Salleron, J; Guillemin, F; Oldrini, G; Brix, M; Dolivet, G; Simon, E; Verhaeghe, J L; Marchal, F

    2015-06-01

    Women who have undergone surgical treatment for breast cancer often benefit from a contralateral reduction mammaplasty (CRM) aimed at symmetrization of the contralateral breast unaffected by the initial cancer. In our 7-year multicentric study (12 centers) of 2718 patients, incidence of CRM cancers (CRMc) was 1.47% (n = 40) [95% CI 1.05%-2.00%]. The CRMc group had significantly more initial mammary cancers of invasive lobular carcinoma (ILC, 22.5% vs 12.0%) and ductal carcinoma in situ (DCIS, 35.0% vs 21.6%) types than the healthy CRM group (p = 0.017). 35.0% (n = 14) of patients had en bloc resection; 25.0% (n = 10) of surgical specimens were correctly oriented. En bloc resection and orientation of surgical specimens enable precise pinpointing of the CRMc. A salvage lumpectomy may be proposed as an option when margins are invaded. The histological distribution of the 40 CRMc (mean size 12.7 mm) was carcinoma in situ (CIS) 70%, ILC 12.5%, invasive ductal carcinoma (IDC) 12.5% and tubular carcinoma (TC) 5.0%. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Bladder cancer: utility of MRI in detection of occult muscle-invasive disease

    Energy Technology Data Exchange (ETDEWEB)

    Rosenkrantz, Andrew B. [Dept. of Radiology, NYU Langone Medical Center, New York (United States)], E-mail: Andrew.rosenkrantz@nyumc.org; Mussi, Thais C. [Dept. of Radiology, NYU Langone Medical Center, New York (United States); Hospital Israelita Albert Einstein, Sao Paulo (Brazil); Melamed, Jonathan [Dept. of Pathology, NYU Langone Medical Center, New York (United States); Taneja, Samir S.; Huang, William C. [Dept. of Urology, Div. of Urologic Oncology, NYU Langone Medical Center, New York (United States)

    2012-07-15

    Background. The presence of muscularis propria invasion by bladder cancer is a key factor in prognosis and treatment decisions, although may be missed by biopsy due to sampling error. MRI has shown potential for detection of muscle invasion but has not specifically been evaluated for this purpose in the setting of bladder cancer patients without evidence of muscle invasion on initial biopsy. Purpose. To evaluate the role of MRI in detection of muscularis propria invasion by bladder cancer following a pathologic diagnosis of non-invasive tumor. Material and Methods. This retrospective study included 23 patients who underwent pelvic MRI following a pathologic diagnosis of bladder cancer without muscularis propria invasion and in whom additional histologic evaluation was performed following MRI. Two radiologists in consensus reviewed T2-weighted images to identify those cases suspicious for muscle invasion on MRI. The radiologists identified whether cases suspicious for invasion demonstrated disruption of the T2-hypointense muscularis layer of the bladder wall, peri-vesical fat stranding, and peri-vesical soft tissue nodularity. Findings were compared with pathologic results obtained after MRI. Results. Suspicion was raised for muscle invasion in eight of 23 cases, four of which exhibited invasion on follow-up pathology. No case without suspicion on MRI exhibited invasion on follow-up pathology. Therefore, sensitivity and specificity were 100% and 79%, respectively. Among individual findings, muscularis disruption on T2WI exhibited sensitivity of 100% and specificity of 79%, peri-vesical fat stranding exhibited sensitivity and specificity of 50% and 84%, and peri-vesical soft tissue nodularity exhibited sensitivity and specificity of 25% and 100%. Conclusion. MRI demonstrated high sensitivity for detection of muscle invasion in cases of bladder cancer without invasion on initial histologic assessment. Muscularis disruption on T2WI appeared to exhibit a better

  7. Breast tomosynthesis and digital mammography: a comparison of breast cancer visibility and BIRADS classification in a population of cancers with subtle mammographic findings.

    Science.gov (United States)

    Andersson, Ingvar; Ikeda, Debra M; Zackrisson, Sophia; Ruschin, Mark; Svahn, Tony; Timberg, Pontus; Tingberg, Anders

    2008-12-01

    The main purpose was to compare breast cancer visibility in one-view breast tomosynthesis (BT) to cancer visibility in one- or two-view digital mammography (DM). Thirty-six patients were selected on the basis of subtle signs of breast cancer on DM. One-view BT was performed with the same compression angle as the DM image in which the finding was least/not visible. On BT, 25 projections images were acquired over an angular range of 50 degrees, with double the dose of one-view DM. Two expert breast imagers classified one- and two-view DM, and BT findings for cancer visibility and BIRADS cancer probability in a non-blinded consensus study. Forty breast cancers were found in 37 breasts. The cancers were rated more visible on BT compared to one-view and two-view DM in 22 and 11 cases, respectively, (p BIRADS classification (p BIRADS classification (p < 0.01). The results indicate that the cancer visibility on BT is superior to DM, which suggests that BT may have a higher sensitivity for breast cancer detection.

  8. Breast tomosynthesis and digital mammography: a comparison of breast cancer visibility and BIRADS classification in a population of cancers with subtle mammographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Ingvar; Zackrisson, Sophia [Malmoe University Hospital, Diagnostic Centre of Imaging and Functional Medicine, Malmoe (Sweden); Ikeda, Debra M. [Stanford University, Stanford Advanced Medicine Center, Department of Radiology, Stanford, CA (United States); Ruschin, Mark [Lund University, Malmoe University Hospital, Department of Medical Radiation Physics, Malmoe (Sweden); University Health Network/Princess Margaret Hospital, Department of Radiation Physics, Toronto, ON (Canada); Svahn, Tony; Timberg, Pontus; Tingberg, Anders [Lund University, Malmoe University Hospital, Department of Medical Radiation Physics, Malmoe (Sweden)

    2008-12-15

    The main purpose was to compare breast cancer visibility in one-view breast tomosynthesis (BT) to cancer visibility in one- or two-view digital mammography (DM). Thirty-six patients were selected on the basis of subtle signs of breast cancer on DM. One-view BT was performed with the same compression angle as the DM image in which the finding was least/not visible. On BT, 25 projections images were acquired over an angular range of 50 degrees, with double the dose of one-view DM. Two expert breast imagers classified one- and two-view DM, and BT findings for cancer visibility and BIRADS cancer probability in a non-blinded consensus study. Forty breast cancers were found in 37 breasts. The cancers were rated more visible on BT compared to one-view and two-view DM in 22 and 11 cases, respectively, (p<0.01 for both comparisons). Comparing one-view DM to one-view BT, 21 patients were upgraded on BIRADS classification (p<0.01). Comparing two-view DM to one-view BT, 12 patients were upgraded on BIRADS classification (p<0.01). The results indicate that the cancer visibility on BT is superior to DM, which suggests that BT may have a higher sensitivity for breast cancer detection. (orig.)

  9. Potential biases in colorectal cancer screening using faecal occult blood test

    DEFF Research Database (Denmark)

    Riboe, Dea Grip; Dogan, Tilde Steen; Brodersen, John

    2013-01-01

    BACKGROUND: Colorectal cancer (CRC) is one of the most common types of cancer in European countries and associated with a high mortality rate. A 16% relative risk reduction (RRR) of mortality was found in a meta-analysis based on four randomized controlled trials (RCT) on CRC screening. The aim...... of this paper was to scrutinize these trials for potential biases and assess their influence on the screening trials. METHODS: The four RCTs were reviewed based on the principles of 'Critical Appraisal of the Medical Literature'. Principal investigators of the four RCTs were contacted to clarify uncertainties...... in their study. Data were collected from The Danish Data Archives. Authors of the Cochrane review were contacted. RESULTS: Six biases were identified, of which five favour screening. Three of the biases identified were specific to CRC screening: type of diagnostic method, place of surgery and diagnostic delay...

  10. Breast Cancers Found with Digital Breast Tomosynthesis: A Comparison of Pathology and Histologic Grade.

    Science.gov (United States)

    Wang, Wei-Shin; Hardesty, Lara; Borgstede, James; Takahashi, Jayme; Sams, Sharon

    2016-11-01

    To compare the pathology and histologic grading of breast cancers detected with digital breast tomosynthesis to those found with conventional digital mammography. The institutional review board approved this study. A database search for all breast cancers diagnosed from June 2012 through December 2013 was performed. Imaging records for these cancers were reviewed and patients who had screening mammography with tomosynthesis as their initial examination were selected. Five dedicated breast imaging radiologists reviewed each of these screening mammograms to determine whether the cancer was visible on conventional digital mammography or whether tomosynthesis was needed to identify the cancer. A cancer was considered mammographically occult if all five radiologists agreed that the cancer could not be seen on conventional digital mammography. The size, pathology and histologic grading for all diagnosed breast cancers were then reviewed. The Mann-Whitney U and Fisher exact tests were utilized to determine any association between imaging findings and cancer size, pathologic type and histologic grade. Sixty-five cancers in 63 patients were identified. Ten of these cancers were considered occult on conventional digital mammography and detected with the addition of tomosynthesis. These mammographically occult cancers were significantly associated with Nottingham grade 1 histologic pathology (p = 0.02), were smaller (median size: 6 mm versus 10 mm, p = 0.07) and none demonstrated axillary nodal metastases. Breast cancers identified through the addition of tomosynthesis are associated with Nottingham grade 1 histologic pathology and prognostically more favorable than cancers identified with conventional digital mammography alone.

  11. Occult Breast Cancer due to Multiple Calcified Hamartomas in a Patient with Cowden Syndrome

    Directory of Open Access Journals (Sweden)

    E. B. Gómez García

    2012-01-01

    Full Text Available Cowden syndrome (CS is an autosomal dominant disorder characterized by presence of multiple hamartomas, and other benign and malignant abnormalities of the breasts, skin, thyroid, endometrium, gastrointestinal tract, and central nervous system. Hamartomas are benign, developmentally disorganized tumors that can develop in any of the above mentioned organs. The presence of massive calcifications in the breasts in very young women is an indication to perform a breast MRI to exclude a neoplasm since, like in the current case report, presence of breast calcifications may obscure a neoplasm. Although fibrocystic disease and cooccurrence of fibrocystic disease and breast cancer are much more common than CS, the presence of massive calcifications in the breasts of very young women should elicit the possibility of an underlying genetic disease. Furthermore, breast cancer and macrocephaly are considered major criteria for the diagnosis of CS and the combination of both is enough to establish the clinical diagnosis of this entity. Fibrocystic disease of the breasts and multinodular goiter are minor criteria. Family history is also important for the diagnosis of (any hereditary disease.

  12. Occupation and mammographic density: A population-based study (DDM-Occup).

    Science.gov (United States)

    García-Pérez, Javier; Pollán, Marina; Pérez-Gómez, Beatriz; González-Sánchez, Mario; Cortés Barragán, Rosa Ana; Maqueda Blasco, Jerónimo; González-Galarzo, María Carmen; Alba, Miguel Ángel; van der Haar, Rudolf; Casas, Silvia; Vicente, Cándida; Medina, Pilar; Ederra, María; Santamariña, Carmen; Moreno, María Pilar; Casanova, Francisco; Pedraz-Pingarrón, Carmen; Moreo, Pilar; Ascunce, Nieves; García, Montse; Salas-Trejo, Dolores; Sánchez-Contador, Carmen; Llobet, Rafael; Lope, Virginia

    2017-11-01

    High mammographic density is one of the main risk factors for breast cancer. Although several occupations have been associated with breast cancer, there are no previous occupational studies exploring the association with mammographic density. Our objective was to identify occupations associated with high mammographic density in Spanish female workers. We conducted a population-based cross-sectional study of occupational determinants of high mammographic density in Spain, based on 1476 women, aged 45-68 years, recruited from seven screening centers within the Spanish Breast Cancer Screening Program network. Reproductive, family, personal, and occupational history data were collected. The latest occupation of each woman was collected and coded according to the 1994 National Classification of Occupations. Mammographic density was assessed from the cranio-caudal mammogram of the left breast using a semi-automated computer-assisted tool. Association between mammographic density and occupation was evaluated by using mixed linear regression models, using log-transformed percentage of mammographic density as dependent variable. Models were adjusted for age, body mass index, menopausal status, parity, smoking, alcohol intake, educational level, type of mammography, first-degree relative with breast cancer, and hormonal replacement therapy use. Screening center and professional reader were included as random effects terms. Mammographic density was higher, although non-statistically significant, among secondary school teachers (e(β) = 1.41; 95%CI = 0.98-2.03) and nurses (e(β) = 1.23; 95%CI = 0.96-1.59), whereas workers engaged in the care of people (e(β) = 0.81; 95%CI = 0.66-1.00) and housewives (e(β) = 0.87; 95%CI = 0.79-0.95) showed an inverse association with mammographic density. A positive trend for every 5 years working as secondary school teachers was also detected (p-value = 0.035). Nurses and secondary school teachers were the occupations with the highest

  13. The positive predictive value of guaiac faecal occult blood test in relation to the number of positive squares in two consecutive rounds of colorectal cancer screening.

    Science.gov (United States)

    Manfredi, Sylvain; Philip, Julie; Campillo, Boris; Piette, Christine; Durand, Gerard; Riou, Françoise; Bretagne, Jean François

    2011-07-01

    The aim of this study was to define the positive predictive values of a positive guaiac faecal occult blood test according to the number of positive squares, in two consecutive rounds of colorectal cancer mass screening in a French region. A total of 4172 colonoscopies were analyzed. Sex, age, number of positive squares, and colonoscopic and histopathologic findings were studied. In the results obtained, 76.6% of positive tests were positive with one or two squares. The number of positive squares was not related to sex, age and rank of participation. The positive predictive value for cancers and adenomas increased significantly with age, sex (male) and number of positive squares from 6.6% (one to two squares) to 27.6% (five to six squares) and from 15.2% to 22.2%, respectively. Cancer was diagnosed 211 times (54.1%) and advanced neoplasia was diagnosed 696 times (65.3%) following positive tests with one to two squares. The TNM stage of cancer increased significantly with the number of positive squares: 85.8% of stages 0-1-2 for one to two positive squares and 66.3% for five to six positive squares (P<0.001). Multivariate analysis showed an increased risk of cancer and advanced neoplasia for male patients and aged persons. The number of positive squares significantly increased the risk of cancer (odds ratio=4.6 for five to six positive squares) and the risk of advanced neoplasia (odds ratio=2.9). Age, sex and number of positive squares were independent predictive factors of positive guaiac faecal occult blood test. The proportion of TNM stages 3-4 was significantly higher in those with five to six positive squares. Performing a complete colonoscopy in every individual having a positive test, especially aged men with a high number of positive squares, should be a priority in any screening programme.

  14. Early breast cancer detection using techniques other than mammography

    Energy Technology Data Exchange (ETDEWEB)

    Kopans, D.B.

    1984-09-01

    X-ray mammography is the only imaging method currently available with any proven efficacy for screening to detect early-stage, clinically occult breast cancer. Sonography has a limited role in the differentiation of cystic from solid masses and as a guide for aspiration and preoperative localization of selected breast lesions. Computed tomography has a more limited role to determine the spatial orientation of a lesion detected only in the lateral mammographic position. All other imaging methods should be considered experimental at this time.

  15. The Occult Today: Why?

    Science.gov (United States)

    Kessler, Gary E.

    1975-01-01

    Author offered some reflections on the "why" of the contemporary interest in the occult. He attempted to convince the reader that, if he or she has been surprised by the recent rise of occultism, sober reflection will dispell some fears and, perhaps, even convince him or her that occultism is not merely superstition. (Author/RK)

  16. Radioimmunoscintigraphy of recurrent, metastatic, or occult colorectal cancer with technetium 99m-labeled totally human monoclonal antibody 88BV59: results of pivotal, phase III multicenter studies.

    Science.gov (United States)

    Serafini, A N; Klein, J L; Wolff, B G; Baum, R; Chetanneau, A; Pecking, A; Fischman, A J; Hoover, H C; Wynant, G E; Subramanian, R; Goroff, D K; Hanna, M G

    1998-05-01

    To assess the performance and potential clinical impact of a totally human monoclonal antibody, 88BV59 (HumaSPECT) (INTRACEL, Corp, Rockville, MD), in 202 assessable presurgical patients with recurrent, metastatic, or occult colorectal cancer. 88BV59, labeled with technetium Tc 99m (99mTc) (HumaSPECT-Tc), was injected intravenously, and planar and single photon emission tomography (SPECT) images were obtained 14 to 20 hours postinjection. Surgical and pathologic verification of tumor were used as the standard against which the performance of HumaSPECT-Tc imaging and computed tomography (CT) analysis were evaluated. All patients entered onto the recurrent disease study had at least one tumor site defined on CT. The sensitivity of HumaSPECT-Tc in those CT-positive patients was 87%. The specificity of HumaSPECT-Tc was 57% compared with 17% for CT and the difference was statistically significant (P HAHA) response (90 ng/mL) at 9 weeks postinfusion was observed. HumaSPECT-Tc can provide important and accurate information about the presence and location of disease in patients with a high clinical suspicion of metastatic or recurrent colorectal cancer and either positive (known disease) or negative (occult disease) CT scans.

  17. Mammographic density measurements are not affected by mammography system.

    Science.gov (United States)

    Damases, Christine N; Brennan, Patrick C; McEntee, Mark F

    2015-01-01

    Mammographic density (MD) is a significant risk factor for breast cancer and has been shown to reduce the sensitivity of mammography screening. Knowledge of a woman's density can be used to predict her risk of developing breast cancer and personalize her imaging pathway. However, measurement of breast density has proven to be troublesome with wide variations in density recorded using radiologists' visual Breast Imaging Reporting and Data System (BIRADS). Several automated methods for assessing breast density have been proposed, each with their own source of measurement error. The use of differing mammographic imaging systems further complicates MD measurement, especially for the same women imaged over time. The purpose of this study was to investigate whether having a mammogram on differing manufacturer's equipment affects a woman's MD measurement. Raw mammographic images were acquired on two mammography imaging systems (General Electric and Hologic) one year apart and processed using VolparaDensity™ to obtain the Volpara Density Grade (VDG) and average volumetric breast density percentage (AvBD%). Visual BIRADS scores were also obtained from 20 expert readers. BIRADS scores for both systems showed strong positive correlation ([Formula: see text]; [Formula: see text]), while the VDG ([Formula: see text]; [Formula: see text]) and AvBD% ([Formula: see text]; [Formula: see text]) showed stronger positive correlations. Substantial agreement was shown between the systems for BIRADS ([Formula: see text]; [Formula: see text]), however, the systems demonstrated an almost perfect agreement for VDG ([Formula: see text]; [Formula: see text]).

  18. Stress signaling from human mammary epithelial cells contributes to phenotypes of mammographic density.

    Science.gov (United States)

    DeFilippis, Rosa Anna; Fordyce, Colleen; Patten, Kelley; Chang, Hang; Zhao, Jianxin; Fontenay, Gerald V; Kerlikowske, Karla; Parvin, Bahram; Tlsty, Thea D

    2014-09-15

    Telomere malfunction and other types of DNA damage induce an activin A-dependent stress response in mortal nontumorigenic human mammary epithelial cells that subsequently induces desmoplastic-like phenotypes in neighboring fibroblasts. Some characteristics of this fibroblast/stromal response, such as reduced adipocytes and increased extracellular matrix content, are observed not only in tumor tissues but also in disease-free breast tissues at high risk for developing cancer, especially high mammographic density tissues. We found that these phenotypes are induced by repression of the fatty acid translocase CD36, which is seen in desmoplastic and disease-free high mammographic density tissues. In this study, we show that epithelial cells from high mammographic density tissues have more DNA damage signaling, shorter telomeres, increased activin A secretion and an altered DNA damage response compared with epithelial cells from low mammographic density tissues. Strikingly, both telomere malfunction and activin A expression in epithelial cells can repress CD36 expression in adjacent fibroblasts. These results provide new insights into how high mammographic density arises and why it is associated with breast cancer risk, with implications for the definition of novel invention targets (e.g., activin A and CD36) to prevent breast cancer.

  19. Mammographic parenchymal patterns as predictors for breast cancer risk%X-光照片上的乳腺组织结构特征和乳腺癌发生率的关系

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    从美国的很多研究结果显示:美国妇女的乳腺癌发病率和很多因素有关.这些因素包括妇女的年龄,乳腺癌的家史,个人乳腺癌病史,个人乳腺良性增生病史,以及第一次来月经的时间以及生产的年龄.同时研究还显示,反应在乳腺影像上的乳腺组织密度增加也会提高乳腺癌发病率的增长.本文使用计算机图像识别的方法研究乳腺组织结构,找出与乳腺癌发病率有关的X-光照片上影像的特征并用这些特征预测乳腺癌发病的几率.%Many factors have been identified to be associated with risk of developing breast caricer.These factors include a woman's age, her family history of breast cancer, personal history of breast cancer, biopsy-confirmed benign proliferative breast disease, age at first live birth and at menarche.Increased mammographic density has also been shown to associate with an increased risk of developing breast cancer. In this study, we identify radiographic markers tor breast cancer risk prediction using computerized analysis of digital mammograms.

  20. Circumscribed breast carcinoma: Mammographic and sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Soo Young; Lee, Yul; Park, Ki Soon; Lee, Ke Sook [College of Medicine, Hallym University, Seoul (Korea, Republic of)

    1992-03-15

    Circumscribe breast cancer is a well demarcated mass with or without a lobulated border simulating a benign tumor like fibroadenoma on mammography or breast US and is reported as approximate 10% of the incidence among primary breast carcinoma(1.2). Pathologically medullary, colloid, papillary, intraductal and rarely invasive ductal carcinomas are included in this group which show the less intense desmoplastic reaction than the scirrhous type cancer, resulting in the most favorable prognosis of all carcinoma of the breast. Among 214 primary breast carcinoma during the past 8 years, we experienced 6 case of pathologically proven circumscribed breast cancer(2 cases of medullary carcinoma, 1 of colloid carcinoma, 1 of intracystic papillary carcinoma, 2 of comedo type intraductal carcinoma). Clinically 2 cases showed bloody nipple discharge from one hole of a unilateral nipple orifice. Mammography showed a well circumscribed nodule with or without partial lobular contour and no pathologic calcification. Breast sonographic findings were a well defined heterogeneous hypoechoic nodule with weak posterior acoustic enhancement. Characteristically a thin dilated lactiferous duct between the mass and the nipple on US could be detected in 2 cases which clinically was accompanied by bloody nipple discharge. Although the mammographic criteria is promising as benign tumor, the possibility of circumscribed as benign tumor, the possibility of circumscribed breast carcinoma must be considered in heterogeneous hypoechoic nodule with weak posterior acoustic enhancement in US, especially in the presence of a dilated lactiferous duct between the mass and the nipple with bloody nipple discharge.

  1. 三阴性与非三阴性乳腺癌的X线特征探讨%Mammographic features of triple-negative and non-triple-negative breast cancer

    Institute of Scientific and Technical Information of China (English)

    程晓英; 张慧; 李巍; 孙艳红; 王秀兰; 高波

    2015-01-01

    目的:与非三阴性乳腺癌(non‐TNBC)比较,探讨三阴性乳腺癌(TNBC)的乳腺 X 线特征。方法根据 ER 、PR 、HER2表达情况,将737个乳腺癌肿块分成 TNBC 组(n =112)和 non‐TNBC 组(n =625),回顾性分析两组患者的 X线图像及临床病理资料。结果 TNBC 肿瘤组织学分级高,腋窝淋巴结转移率高于 non‐TNBC 组( P <0.05)。在钼靶 X线中,TNBC 主要表现肿块(69.7%),很少表现为肿块伴钙化(16.5%)、局限性非对称致密(4.6%)、单纯钙化(2.8%)和结构扭曲(6.4%) ;肿块形状多为圆形(30.9%)或椭圆形(38.3%),很少表现为不规则形(11.7%) ;肿块边缘多为清晰边缘(30.9%),毛刺肿块少见(19.1%) 。 non‐TNBC 通常表现为肿块伴钙化(43.5%),钙化多见(58.8%) ;肿块形态主要为分叶形(40.4%)和不规则形(28.9%),毛刺征多见(43.6%) 。 结论 TNBC 有其独特的影像表现,更倾向于良性肿瘤的特点,了解其 X 线特征有助于提高 TNBC 的诊断水平。%Objective To investigate the mammographic features of triple‐negative breast cancer (TNBC) in comparison to non‐triple‐negative breast cancer (non‐TNBC) .Methods According to the expression of ER ,PR ,and HER2 ,737 breast cancers were divided into TNBC group (n = 112) and non‐TNBC group (n = 625) .And then we retrospectively ana‐lyzed mammographic and clinicopathologic findings of the two groups .Results TNBC was associated with higher tumor grades and more axillary lymph node involvement ( P < 0 .05) .On mammography ,TNBCs frequently presented with mas‐ses (69 .7% ) and were less associated with masses with calcifications (16 .5% ) ,focal asymmetric density (4 .6% ) ,calcifi‐cations alone (2 .8% ) and architectural distortion (6 .4% ) . Masses were most frequently round (30 .9% ) or oval (38.3% ) in

  2. Amount of stroma is associated with mammographic density and stromal expression of oestrogen receptor in normal breast tissues.

    Science.gov (United States)

    Gabrielson, Marike; Chiesa, Flaminia; Paulsson, Janna; Strell, Carina; Behmer, Catharina; Rönnow, Katarina; Czene, Kamila; Östman, Arne; Hall, Per

    2016-07-01

    Following female sex and age, mammographic density is considered one of the strongest risk factors for breast cancer. Despite the association between mammographic density and breast cancer risk, little is known about the underlying histology and biological basis of breast density. To better understand the mechanisms behind mammographic density we assessed morphology, proliferation and hormone receptor status in relation to mammographic density in breast tissues from healthy women. Tissues were obtained from 2012-2013 by ultrasound-guided core needle biopsy from 160 women as part of the Karma (Karolinska mammography project for risk prediction for breast cancer) project. Mammograms were collected through routine mammography screening and mammographic density was calculated using STRATUS. The histological composition, epithelial and stromal proliferation status and hormone receptor status were assessed through immunohistochemical staining. Higher mammographic density was significantly associated with a greater proportion of stromal and epithelial tissue and a lower proportion of adipose tissue. Epithelial expression levels of Ki-67, oestrogen receptor (ER) and progesterone receptor (PR) were not associated with mammographic density. Epithelial Ki-67 was associated with a greater proportion of epithelial tissue, and epithelial PR was associated with a greater proportion of stromal and a lower proportion of adipose tissue. Epithelial ER was not associated with any tissues. In contrast, expression of ER in the stroma was significantly associated with a greater proportion of stroma, and negatively associated with the amount of adipose tissue. High mammographic density is associated with higher amount of stroma and epithelium and less amount of fat, but is not associated with a change in epithelial proliferation or receptor status. Increased expressions of both epithelial PR and stromal ER are associated with a greater proportion of stroma, suggesting hormonal involvement

  3. Size, node status and grade of breast tumours: association with mammographic parenchymal patterns

    Energy Technology Data Exchange (ETDEWEB)

    Sala, E.; Solomon, L.; McCann, J. [Department of Community Medicine, Strangeways Research Laboratory, Worts Causeway, Cambridge (United Kingdom); Warren, R. [Cambridge and Huntingdon Breast Screening Service, Rosie Maternity Hospital, Robinson Way, Cambridge (United Kingdom); Duffy, S. [MRC-Biostatistics Unit, Institute of Public Health, Cambridge (United Kingdom); Luben, R. [Department of Clinical Gerontology, Strangeways Research Laboratory, Cambridge (United Kingdom); Day, N. [Department of Community Medicine, Institute of Public Health, Robinson Way, Cambridge, CB2 2SR (United Kingdom)

    2000-01-01

    A case-control study was designed to assess the association of mammographic parenchymal patterns with the risk of in-situ and invasive breast cancer. In addition, the relationship between tumour characteristics and mammographic patterns were also investigated. A total of 875 patients with breast cancer were selected and matched with 2601 controls. Mammographic parenchymal patterns of breast tissue were assessed according to Wolfe's classification, and statistical analysis was by conditional logistic regression. Relative to the N1 pattern, the odds ratios of having an invasive breast cancer associated with the P2 and DY patterns were 1.8 and 1.4, respectively. In addition, the odd ratios of having an invasive grade 3 breast cancer associated with the P2 and DY patterns were 2.8 and 3.9, respectively. Relative to the combined N1/P1 pattern, the odd ratios of having a breast cancer smaller than 14 mm, 15-29 mm, or larger than 30 mm associated with the combined high-risk P2/DY pattern (P2 + DY) were 1.2, 1.6, and 2.0, respectively. Finally, women with the P2/DY pattern were twice as likely to have a breast cancer which had already spread to the axillary nodes, compared to women with women with the N1/P1 pattern (odds ratios of 2.1 and 1.4, respectively). Our results confirm previous findings suggesting that mammographic parenchymal patterns may serve as indicators of risk for breast cancer. Our results also suggest that mammographic parenchymal patterns are associated with the stage at which breast cancer is detected. (orig.)

  4. Quality assessment of the mammographic screening programme in the 'Azienda Sanitaria Locale Provincia Milano' 1 - Analysis of interval cancers and discussion of possible causes of diagnostic error; Controllo di qualita' del programma screening mammografico nella Azienda Sanitaria Locale Provincia Milano 1 - Analisi dei carcinomi di intervallo e discussione delle possibili cause di errore diagnostico

    Energy Technology Data Exchange (ETDEWEB)

    Burani, Rossella; Maggioni, Carlo; Pirola, Maria Elena [Azienda Sanitaria Locale Provincia Milano 1, Milano, (Italy); Caimi, Francesco; Marinoni, Guia [Azienda Ospedaliera Ospedali Civili, Legnano (Italy); Pellizzoni, Romana; Villa, Roberto [Azienda Ospedaliera Salvini, Garbignate Milanese (Italy); Ciatto, Stefano [Centro per lo Studio e la Prevenzione Oncologica, Firenze (Italy)

    2005-03-01

    Purpose: To evaluate the sensitivity of the mammographic screening programme and the causes of diagnostic fault in cases surfacing as interval cancers. Materials and methods: Interval cancers (CI) were identified by linkage of the screening databases for the years 2000-2002 to the database of hospital discharge records (HDR) for breast cancer during 2000-2002. Linkage between screening attenders during 2000-2001 and HDR (biennal follow-up for year 2000, one year follow-up for year 2001) was used to calculate the proportional rate of observed/expected IC. The observed/expected rate was compared with international standards and literature data. Screening mammograms followed by IC, randomly admixtured with negative controls, underwent blind review by an independent radiologist, using the recommended classification criteria to evaluate causes of error (occult, minimal signs, screening error). Results: The analysis of HDR during 2000-2002 allowed to identify 31 out of 89 expected IC. Proportional observed/expected IC rate in the first or second year of screening interval was 26 or 67%, respectively. Screening mammograms for radiological review were available in 38 of 61 total IC: 20 cases (52.6%) were classified as occult, whereas minimal signs or screening errors were 2 (5.2%) or 16 (42.1%), respectively. Diagnostic suspicion had been reported at screening in 7 of 16 cases classified as screening error, but were not diagnosed at the subsequent diagnostic assessment. Conclusions: Proportional IC rate was higher than reported in literature or currently recommended (<30% in the 1st., <50% in the 2nd year). The analysis of error causes shows an excess of screening errors with respect to current recommendations (<20% of IC should be classified as screening error at review), but also an excess of IC suspected at screening but misdiagnosed at assessment (7/38=18.4%). Overall the analysis revealed a reduced sensitivity of the screening programme , as often observed in service

  5. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer.

    Science.gov (United States)

    Lee, Carol H; Dershaw, D David; Kopans, Daniel; Evans, Phil; Monsees, Barbara; Monticciolo, Debra; Brenner, R James; Bassett, Lawrence; Berg, Wendie; Feig, Stephen; Hendrick, Edward; Mendelson, Ellen; D'Orsi, Carl; Sickles, Edward; Burhenne, Linda Warren

    2010-01-01

    Screening for breast cancer with mammography has been shown to decrease mortality from breast cancer, and mammography is the mainstay of screening for clinically occult disease. Mammography, however, has well-recognized limitations, and recently, other imaging including ultrasound and magnetic resonance imaging have been used as adjunctive screening tools, mainly for women who may be at increased risk for the development of breast cancer. The Society of Breast Imaging and the Breast Imaging Commission of the ACR are issuing these recommendations to provide guidance to patients and clinicians on the use of imaging to screen for breast cancer. Wherever possible, the recommendations are based on available evidence. Where evidence is lacking, the recommendations are based on consensus opinions of the fellows and executive committee of the Society of Breast Imaging and the members of the Breast Imaging Commission of the ACR.

  6. Test performance of faecal occult blood testing for the detection of bowel cancer in people with chronic kidney disease (DETECT protocol

    Directory of Open Access Journals (Sweden)

    Williams Narelle

    2011-06-01

    Full Text Available Abstract Background Cancer is a major cause of mortality and morbidity in patients with chronic kidney disease (CKD. In patients without kidney disease, screening is a major strategy for reducing the risk of cancer and improving the health outcomes for those who developed cancers by detecting treatable cancers at an early stage. Among those with CKD, the effectiveness, the efficacy and patients' preferences for cancer screening are unknown. Methods/Design This work describes the protocol for the DETECT study examining the effectiveness, efficiency and patient's perspectives of colorectal cancer screening using immunochemical faecal occult blood testing (iFOBT for people with CKD. The aims of the DETECT study are 1 to determine the test performance characteristics of iFOBT screening in individuals with CKD, 2 to estimate the incremental costs and health benefits of iFOBT screening in CKD compared to no screening and 3 to elicit patients' perspective for colorectal cancer screening in the CKD population. Three different study designs will be used to explore the uncertainties surrounding colorectal cancer screening in CKD. A diagnostic test accuracy study of iFOBT screening will be conducted across all stages of CKD in patients ages 35-70. Using individually collected direct healthcare costs and outcomes from the diagnostic test accuracy study, cost-utility and cost-effective analyses will be performed to estimate the costs and health benefits of iFOBT screening in CKD. Qualitative in-depth interviews will be undertaken in a subset of participants from the diagnostic test accuracy study to investigate the perspectives, experiences, attitudes and beliefs about colorectal cancer screening among individuals with CKD. Discussion The DETECT study will target the three major unknowns about early cancer detection in CKD. Findings from our study will provide accurate and definitive estimates of screening efficacy and efficiency for colorectal cancer, and

  7. International Consortium on Mammographic Density : Methodology and population diversity captured across 22 countries

    NARCIS (Netherlands)

    McCormack, Valerie A; Burton, Anya; Dos-Santos-Silva, Isabel; Hipwell, John H; Dickens, Caroline; Salem, Dorria; Kamal, Rasha; Hartman, Mikael; Lee, Charmaine Pei Ling; Chia, Kee-Seng; Ozmen, Vahit; Aribal, Mustafa Erkin; Flugelman, Anath Arzee; Lajous, Martín; Lopez-Riduara, Ruy; Rice, Megan; Romieu, Isabelle; Ursin, Giske; Qureshi, Samera; Ma, Huiyan; Lee, Eunjung; van Gils, Carla H; Wanders, Johanna O P; Vinayak, Sudhir; Ndumia, Rose; Allen, Steve; Vinnicombe, Sarah; Moss, Sue; Won Lee, Jong; Kim, Jisun; Pereira, Ana; Garmendia, Maria Luisa; Sirous, Reza; Sirous, Mehri; Peplonska, Beata; Bukowska, Agnieszka; Tamimi, Rulla M; Bertrand, Kimberly; Nagata, Chisato; Kwong, Ava; Vachon, Celine; Scott, Christopher; Perez-Gomez, Beatriz; Pollan, Marina; Maskarinec, Gertraud; Giles, Graham; Hopper, John; Stone, Jennifer; Rajaram, Nadia; Teo, Soo-Hwang; Mariapun, Shivaani; Yaffe, Martin J; Schüz, Joachim; Chiarelli, Anna M; Linton, Linda; Boyd, Norman F

    2015-01-01

    Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with

  8. A Computer Aided Detection system for mammographic images implemented on a GRID infrastructure

    CERN Document Server

    Bottigli, U; Delogu, P; Fantacci, M E; Fauci, F; Forni, G; Golosio, B; Indovina, P L; Lauria, A; Magro, R; Masala, G L; Oliva, P R; Palmiero, R; Raso, G; Retico, A; Stefanini, A; Stumbo, S; Tangaro, S; Torres, E L

    2003-01-01

    The use of an automatic system for the analysis of mammographic images has proven to be very useful to radiologists in the investigation of breast cancer, especially in the framework of mammographic-screening programs. A breast neoplasia is often marked by the presence of microcalcification clusters and massive lesions in the mammogram: hence the need for tools able to recognize such lesions at an early stage. In the framework of the GPCALMA (GRID Platform for Computer Assisted Library for MAmmography) project, the co-working of italian physicists and radiologists built a large distributed database of digitized mammographic images (about 5500 images corresponding to 1650 patients) and developed a CAD (Computer Aided Detection) system, able to make an automatic search of massive lesions and microcalcification clusters. The CAD is implemented in the GPCALMA integrated station, which can be used also for digitization, as archive and to perform statistical analyses. Some GPCALMA integrated stations have already b...

  9. ErbB2 overexpression on occult metastatic cells in bone marrow predicts poor clinical outcome of stage I-III breast cancer patients.

    Science.gov (United States)

    Braun, S; Schlimok, G; Heumos, I; Schaller, G; Riethdorf, L; Riethmüller, G; Pantel, K

    2001-03-01

    Occult hematogenous micrometastases are the major cause for metastatic relapse and cancer-related death in patients with operable primary breast cancer. Although sensitive immunocytochemical and molecular methods allow detection of individual breast cancer cells in bone marrow (BM), a major site of metastatic relapse, current detection techniques cannot discriminate between nonviable shed tumor cells and seminal metastatic cells. To address this problem, we analyzed the relevance of erbB2 overexpression on disseminated cytokeratin-18-positive breast cancer cells in the BM of 52 patients with locoregionally restricted primary breast cancer using immunocytochemical double labeling with monoclonal antibody 9G6 to the p185erbB2 oncoprotein. Expression of p185erbB2 on BM micrometastases was detected in 31 of 52 (60%) patients independent of established risk factors such as lymph node involvement, primary tumor size, differentiation grade, or expression of p185erbB2 on primary tumor cells. After a median follow-up of 64 months, patients with p185erbB2-positive BM micrometastases had developed fatal metastatic relapses more frequently than patients with p185erbB2-negative micrometastases (21 versus 7 events; P = 0.032). In multivariate analysis, the presence of p185erbB2-positive micrometastases was an independent prognostic factor with a hazard ratio of 2.78 (95% confidence interval, 1.11-6.96) for overall survival (P = 0.029). We therefore conclude that erbB2 overexpression characterizes a clinically relevant subset of breast cancer micrometastases.

  10. Towards an automatic tool for resolution evaluation of mammographic images

    Energy Technology Data Exchange (ETDEWEB)

    De Oliveira, J. E. E. [FUMEC, Av. Alfonso Pena 3880, CEP 30130-009 Belo Horizonte - MG (Brazil); Nogueira, M. S., E-mail: juliae@fumec.br [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Pte. Antonio Carlos 6627, 31270-901, Belo Horizonte - MG (Brazil)

    2014-08-15

    Medical images are important for diagnosis purposes as they are related to patients medical history and pathology. Breast cancer represents a leading cause of death among women worldwide, and its early detection is the most effective method of reducing mortality. In a way to identify small structures with low density differences, a high image quality is required with the use of low doses of radiation. The analysis of the quality of the obtained image from a mammogram is performed from an image of a simulated breast and this is a fundamental key point for a program of quality control of mammography equipment s. In a control program of mammographic equipment s, besides the analysis of the quality of mammographic images, each element of the chain which composes the formation of the image is also analyzed: X-rays equipment s, radiographic films, and operating conditions. This control allows that an effective and efficient exam can be provided to the population and is within the standards of quality required for the early detection of breast cancer. However, according to the State Program of Quality Control in Mammography of Minas Gerais, Brazil, only 40% of the mammographies have provided a simulated image with a minimum level of quality, thus reinforcing the need for monitoring the images. The reduction of the morbidity and mortality indexes, with optimization and assurance of access to diagnosis and breast cancer treatment in the state of Minas Gerais, Brazil, may be the result of a mammographic exam which has a final image with good quality and which automatic evaluation is not subjective. The reason is that one has to consider the hypothesis that humans are subjective when performing the image analysis and that the evaluation of the image can be executed by a computer with objectivity. In 2007, in order to maintain the standard quality needed to mammography, the State Health Secretariat of Minas Gerais, Brazil, established a Program of Monthly Monitoring the

  11. Screening for colorectal cancer: random comparison of guaiac and immunochemical faecal occult blood testing at different cut-off levels

    Science.gov (United States)

    Hol, L; Wilschut, J A; van Ballegooijen, M; van Vuuren, A J; van der Valk, H; Reijerink, J C I Y; van der Togt, A C M; Kuipers, E J; Habbema, J D F; van Leerdam, M E

    2009-01-01

    Immunochemical faecal occult blood testing (FIT) provides quantitative test results, which allows optimisation of the cut-off value for follow-up colonoscopy. We conducted a randomised population-based trial to determine test characteristics of FIT (OC-Sensor micro, Eiken, Japan) screening at different cut-off levels and compare these with guaiac-based faecal occult blood test (gFOBT) screening in an average risk population. A representative sample of the Dutch population (n=10 011), aged 50–74 years, was 1 : 1 randomised before invitation to gFOBT and FIT screening. Colonoscopy was offered to screenees with a positive gFOBT or FIT (cut-off 50 ng haemoglobin/ml). When varying the cut-off level between 50 and 200 ng ml−1, the positivity rate of FIT ranged between 8.1% (95% CI: 7.2–9.1%) and 3.5% (95% CI: 2.9–4.2%), the detection rate of advanced neoplasia ranged between 3.2% (95% CI: 2.6–3.9%) and 2.1% (95% CI: 1.6–2.6%), and the specificity ranged between 95.5% (95% CI: 94.5–96.3%) and 98.8% (95% CI: 98.4–99.0%). At a cut-off value of 75 ng ml−1, the detection rate was two times higher than with gFOBT screening (gFOBT: 1.2%; FIT: 2.5%; P<0.001), whereas the number needed to scope (NNscope) to find one screenee with advanced neoplasia was similar (2.2 vs 1.9; P=0.69). Immunochemical faecal occult blood testing is considerably more effective than gFOBT screening within the range of tested cut-off values. From our experience, a cut-off value of 75 ng ml−1 provided an adequate positivity rate and an acceptable trade-off between detection rate and NNscope. PMID:19337257

  12. GSTM1, GSTT1, and GSTP1 polymorphisms, breast cancer risk factors and mammographic density in women submitted to breast cancer screening Polimorfismos GSTM1, GSTT1 e GSTP1, fatores de risco para câncer de mama e densidade mamográfica em mulheres submetidas a rastreamento mamográfico

    Directory of Open Access Journals (Sweden)

    Ernestina Silva de Aguiar

    2012-06-01

    Full Text Available Genetic polymorphisms in genes related to the metabolism of xenobiotics, such as genes of the glutathione S-transferases (GSTM1, GSTT1, and GSTP1 superfamily have been associated with an increased risk for breast cancer (BC. Considering the high incidence of BC in the city of Porto Alegre in southern Brazil, the purpose of this study was to characterize genotypic and allelic frequencies of polymorphisms in GSTM1, GSTT1, and GSTP1, and correlate these molecular findings with established risk factors for breast cancer including mammographic density, in a sample of 750 asymptomatic women undergoing mammographic screening. Molecular tests were performed using the multiplex polymerase chain reaction (PCR for GSTM1 and GSTT1, and quantitative PCR for GSTP1 polymorphisms. Overall, the frequencies of GSTM1 and GSTT1 null genotypes were 45% and 21%, respectively. For GSTP1 polymorphism, genotypic frequencies were 44% for the Ile/Ile genotype, 44% for the Ile/Val genotype, and 12% for Val/Val genotype, with an allelic frequency of 66% for the wild type allele in this population, similar to results of previous international publications. There was a statistically significant association between the combined GSTM1 and GSTT1 null genotypes (M-/T- and mammographic density in post menopausal women (p = 0.031. When the GSTT1 null (T- genotype was analyzed isolated, the association with mammographic density in post menopausal women and in the overall sample was also statistically significant (p = 0.023 and p = 0.027, respectively. These findings suggest an association of GSTM1 and GSTT1 null genotypes with mammographic density.Polimorfismos genéticos em genes relacionados com o metabolismo de xenobióticos, como os genes da superfamília das glutationa S-transferases (GSTM1, GSTT1 e GSTP1 têm sido associados com o aumento do risco para câncer de mama (CM. Considerando a alta incidência de CM na cidade de Porto Alegre, região Sul do Brasil, a proposta deste

  13. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification predicts occult lymph node metastasis in clinically mediastinal node-negative lung adenocarcinoma

    Science.gov (United States)

    Yeh, Yi-Chen; Kadota, Kyuichi; Nitadori, Jun-ichi; Sima, Camelia S.; Rizk, Nabil P.; Jones, David R.; Travis, William D.; Adusumilli, Prasad S.

    2016-01-01

    OBJECTIVES We investigated the role of the 2011 International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) classification in predicting occult lymph node metastasis in clinically mediastinal node-negative lung adenocarcinoma. METHODS We reviewed lung adenocarcinoma patients who had clinically N2-negative status, were evaluated by preoperative positron emission tomography combined with computed tomography (PET/CT) and had undergone lobectomy or pneumonectomy at Memorial Sloan Kettering Cancer Center (n = 297). Tumours were classified according to the 2011 IASLC/ATS/ERS classification. The associations between occult lymph node metastasis and clinicopathological variables were analysed using Fisher's exact test and logistic regression analysis. RESULTS Thirty-two (11%) cN0-1 patients had occult mediastinal lymph node metastasis (pN2) whereas 25% of cN1 patients had pN2 disease. Increased micropapillary pattern was associated with increased risk of pN2 disease (P = 0.001). On univariate analysis, high maximum standard uptake value of the primary tumour on PET/CT (P = 0.019) and the presence of micropapillary (P = 0.014) and solid pattern (P = 0.014) were associated with occult pN2 disease. On multivariable analysis, micropapillary pattern was positively associated with risk of pN2 disease (odds ratio = 3.41; 95% confidence intervals = 1.42–8.19; P = 0.006). CONCLUSIONS The presence of micropapillary pattern is an independent predictor of occult mediastinal lymph node metastasis. Our observations have potential therapeutic implications for management of early-stage lung adenocarcinoma. PMID:26377636

  14. 隐匿性乳腺癌的诊断和治疗%Diagnosis and treatment of occult breast cancer: report of 23 cases

    Institute of Scientific and Technical Information of China (English)

    钟颖; 孙强; 黄汉源; 周易冬; 关竞红; 茅枫; 林燕; 徐雅莉

    2010-01-01

    目的 探讨隐匿性乳腺癌的诊断、治疗及预后.方法 收集23例隐匿性乳腺癌患者的临床和随访资料,并进行分析.结果 23例患者均为女性,平均57.7岁.术前行影像学检查22例,其中行乳腺超声检查17例,8例发现可疑结节;行乳腺钼靶摄片9例,阳性3例;行乳腺MRI检查2例,1例发现异常钙化.20例行同侧乳腺癌改良根治术,16例进行化疗,4例放疗.随访期间,2例患者发生肺转移,其中1例多处转移.结论 术前排除其他部位原发癌的可能后,表现为腋窝淋巴结转移癌的患者即可诊断隐匿性乳腺癌.对隐匿性乳腺癌,乳腺必须进行治疗,可行乳腺癌改良根治术或腋窝淋巴结清扫+全乳放疗.%Objective To explore the presenting clinical features, management approach and treatment outcomes for occult breast cancer. Methods Twenty-three patients with occult breast cancer presenting with axillary nodal metastases treated in our department between 1986 and 2007 were included in this study. The clinicopathological, imaging and follow-up data of the 23 cases were retrospectively analyzed. Results All patients were female. The mean age of diagnosis was 57.7 years with a range of 27-73 years. The mean follow-up was 15.70 months (range 1-62 months). Eight cases in 17 patients were positive by breast ultrasound, three cases in 9 patients were positive by mammography, one case in 2 patients was positive by breast MRI. 20 patients underwent modified radical mastectomy and three patients did not receive the mastectomy treatment. 16 patients had chemotherapy, four patients had radiotherapy, two patients had both chemotherapy and radiotherapy. Two patients had pulmonary metastasis, one patient had recurrence of axillary nodes, pulmonary metastasis and bone metastasis during follow-up. Conclusions A normal check before operation to exclude a cancer of other origin can help to diagnose occult breast cancer.The breast must be treated. Axillary nodal

  15. Missed diagnosis analysis of occult lung cancer by X-ray and the clinical significance of CT scans%隐匿型肺癌X线胸片漏诊分析及CT扫描的临床意义

    Institute of Scientific and Technical Information of China (English)

    温栋梁

    2014-01-01

    目的:分析 X 线胸片漏诊隐匿性肺癌的原因,并评价 CT 扫描对隐匿性肺癌的诊断价值。方法选择 X 线漏诊的隐匿性肺癌43例患者为研究对象。通过比较 X 线和 CT 检查结果,分析 X 线漏诊原因。结果43例患者正位 X 线胸片结果显示无异常,行侧位 X 线胸片检查后,30例患者依然未见异常。CT 扫描证实43例患者全为隐匿性肺癌。CT 扫描对支气管腔内、肺门区肿块及纵隔淋巴结肿大的显示情况优于 X 线胸片检查,差异有统计学意义(P ﹤0.05)。结论 X 线诊断隐匿性肺癌的漏诊率高。对于疑似隐匿性肺癌的患者,有必要行 CT 扫描,及早发现隐匿性肺癌,进一步确定病情,并采取针对性治疗。%Objective To analyze the missed diagnosis causes of occult lung cancer by X-ray, and evaluate the diagnosis value of CT scans on occult lung cancer. Methods Forty-three patients with occult lung cancer missed diagnosed by X-ray were chose as study objects. By comparing the results of X-ray and CT examination,the missed diagnosis causes of occult lung cancer by X-ray were analyzed. Re-sults The anteroposterior chest X-ray results were not abnormal in all of the 43 patients,and the lateral chest X-ray results were not abnormal in 30 patients. All of the 43 patients were confirmed with occult lung cancer by CT scans. CT scan was superior to the chest X-ray in display the bronchial lumen,lung hilar tumor and mediastinal lymph nodes enlargement,there were significant differences( P ﹤ 0. 05). Conclusions The missed diagnosis rate of occult lung cancer by X-ray is high. For patients with suspec-ted occult lung cancer,CT scan is necessary to early detection of occult lung cancer,further define the disease,and take targeted treatment.

  16. Efficacy of Mammographic Evaluation of Breast Cancer in Women Less Than 40 Years of Age: Experience from a Single Medical Center in Taiwan

    Directory of Open Access Journals (Sweden)

    Jane Wang

    2007-09-01

    Conclusion: Mammography has an acceptable sensitivity for the detection of breast cancer in women aged less than 40 years, regardless of different breast composition. Breast ultrasound can offer a higher sensitivity for such a population.

  17. Outcomes and cost evaluation of the first two rounds of a colorectal cancer screening program based on immunochemical fecal occult blood test in northern Italy.

    Science.gov (United States)

    Parente, F; Boemo, C; Ardizzoia, A; Costa, M; Carzaniga, P; Ilardo, A; Moretti, R; Cremaschini, M; Parente, E M; Pirola, M E

    2013-01-01

    Colorectal cancer (CRC) screening aims to reduce mortality by detecting cancers at an early stage and removing adenomatous polyps at an acceptable cost. The aim of the current study were to assess the outcomes and costs of the first two biennial rounds of a population-based CRC screening program using the immunochemical fecal occult blood test (i-FOBT) in a northern Italian province. All residents aged 50 - 69 years were invited to take part in a biennial screening program using a 1-day i-FOBT, followed by colonoscopy in positive individuals. The i-FOBT uptake, compliance to colonoscopy, detection rate for cancer or advanced adenomas according to age and sex, and direct cost analysis were carried out separately for the 1st and 2nd rounds of screening. In 78 083 (1st round) and 81 619 (2nd round) individuals who were invited to screening, the participation rates were 49.7 % and 54.4 % and i-FOBT positivity rates were 6.2 % and 5.8 %, respectively. Detection rates for cancer and advanced adenomas were lower in the 2nd screening compared with the 1st one (1.6‰ vs. 2.5‰ for cancers and 15.8‰ vs. 17.9‰ for advanced adenomas, respectively), whereas positive predictive values for cancer and advanced adenoma were similar in both rounds. In 165 adenocarcinomas detected, 52 % were Dukes' stage A and 21 % were stage B. All cost indicators were slightly higher in the 1st round of screening compared with the 2nd. The direct cost per cancer or advanced adenoma detection was similar in the two rounds (€ 1252 and € 1260, respectively). Compliance and diagnostic yield of i-FOBT screening were satisfactory. Most detected cancers were at a very early stage. Program costs were reasonable and did not increase with repeat screening. Screening could contribute to decreasing the cost of CRC care by improving the stage at diagnosis. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Psychological distress following fecal occult blood test in colorectal cancer screening--a population-based study

    DEFF Research Database (Denmark)

    Brasso, Klaus; Ladelund, Steen; Frederiksen, Birgitte Lidegaard

    2010-01-01

    To evaluate the possible psychological side-effect of participating in a colorectal cancer (CRC)-screening program.......To evaluate the possible psychological side-effect of participating in a colorectal cancer (CRC)-screening program....

  19. Stratification of mammographic computerized analysis by BI-RADS categories

    Energy Technology Data Exchange (ETDEWEB)

    Lederman, Richard [Department of Radiology, Hadassah University Hospital, Ein Kerem, Jerusalem (Israel); Leichter, Isaac [Department of Electro-Optics, Jerusalem College of Technology, P.O.B. 16031, Jerusalem (Israel); Buchbinder, Shalom [Department of Radiology of The Montefiore Medical Center, The University Hospital for the Albert Einstein College of Medicine, Bronx, New York (United States); Novak, Boris [Department of Applied Mathematics, Jerusalem College of Technology, P.O.B. 16031, Jerusalem 91160 (Israel); Bamberger, Philippe [Department of Electronics, Jerusalem College of Technology, POB 16031, Jerusalem (Israel); Fields, Scott [Department of Radiology, Hadassah University Hospital, Mt. Scopus, Jerusalem (Israel)

    2003-02-01

    The Breast Imaging Reporting and Data System (BI-RADS) was implemented to standardize characterization of mammographic findings. The purpose of the present study was to evaluate in which BI-RADS categories the changes recommended by computerized mammographic analysis are most beneficial. Archival cases including, 170 masses (101 malignant, 69 benign) and 63 clusters of microcalcifications (MCs; 36 malignant, 27 benign), were evaluated retrospectively, using the BI-RADS categories, by several radiologists, blinded to the pathology results. A computerized system then automatically extracted from the digitized mammogram features characterizing mammographic lesions, which were used to classify the lesions. The results of the computerized classification scheme were compared, by receiver operating characteristics (ROC) analysis, to the conventional interpretation. In the ''low probability of malignancy group'' (excluding BI-RADS categories 4 and 5), computerized analysis improved the A{sub z}of the ROC curve significantly, from 0.57 to 0.89. In the ''high probability of malignancy group'' (mostly category 5) the computerized analysis yielded an ROC curve with an A {sub z}of 0.99. In the ''intermediate probability of malignancy group'' computerized analysis improved the A {sub z}significantly, from 0.66 for to 0.83. Pair-wise analysis showed that in the latter group the modifications resulting from computerized analysis were correct in 83% of cases. Computerized analysis has the ability to improve the performance of the radiologists exactly in the BI-RADS categories with the greatest difficulties in arriving at a correct diagnosis. It increased the performance significantly in the problematic group of ''intermediate probability of malignancy'' and pinpointed all the cases with missed cancers in the ''low probability'' group. (orig.)

  20. Impact of deprivation on breast cancer survival among women eligible for mammographic screening in the West Midlands (UK) and New South Wales (Australia): Women diagnosed 1997-2006.

    Science.gov (United States)

    Woods, Laura M; Rachet, Bernard; O'Connell, Dianne; Lawrence, Gill; Coleman, Michel P

    2016-05-15

    Women diagnosed with breast cancer in the UK display marked differences in survival between categories defined by socio-economic deprivation. Timeliness of diagnosis is one of the possible explanations for these patterns. Women whose cancer is screen-detected are more likely to be diagnosed at an earlier stage. We examined deprivation and screening-specific survival in order to evaluate the role of early diagnosis upon deprivation-specific survival differences in the West Midlands (UK) and New South Wales (Australia). We estimated net survival for women aged 50-65 years at diagnosis and whom had been continuously eligible for screening from the age of 50. Records for 5,628 women in West Midlands (98.5% of those eligible, mean age at diagnosis 53.7 years) and 6,396 women in New South Wales (99.9% of those eligible, mean age at diagnosis 53.8 years). In New South Wales, survival was similar amongst affluent and deprived women, regardless of whether their cancer was screen-detected or not. In the West Midlands, there were large and persistent differences in survival between affluent and deprived women. Deprivation differences were similar between the screen-detected and non-screen detected groups. These differences are unlikely to be solely explained by artefact, or by patient or tumour factors. Further investigations into the timeliness and appropriateness of the treatments received by women with breast cancer across the social spectrum in the UK are warranted.

  1. 乳腺X线致密度与激素受体和人表皮生长因子受体2的相关性探讨%Research between mammographic breast density and expression status of ER.PR and HER2 in breast cancer

    Institute of Scientific and Technical Information of China (English)

    崔春晓; 林青

    2012-01-01

    Objective To evaluate the relationship between mammographic density and estrogen receptor (ER). progesterone receptor (PR) and human epidermal growth factor 2 (HER2) status in breast cancer. Methods 615 cases of primary breast cancer confirmed by pathology were retrospectively collected. All the patients had undergone mammography. and the mammographic densities were classified into four types according the breast imaging report and data system (BI-RADS). ER. PR and HER2 status of breast cancer were measured by immunohistochemistry. Differences between mammographic density and ER. PR and HER2 were statistically analysed. Results Mammographic density turns from high density into low density gradually ( r =-0. 529. P 0. 05) or HER2 ( r =0.077. P =0.057>0. 05)in breast cancer. Conclusion Mammographic density was positive correlated with PR status in breast cancer, and was negative correlated with age.%目的 探讨乳腺X线致密度与乳腺癌中雌激素受体、孕激素受体及人表皮生长因子受体2之间是否具有相关性.方法 回顾性收集了615例经手术证实的原发性乳腺癌患者.就诊时均行乳腺X线摄影,并根据美国放射学会制定的乳腺影像报告及数据系统(BI-RADS)对乳腺X线致密度进行分型.所有病例术后或穿刺后标本均行免疫组织化学染色检测雌激素受体、孕激素受体及人表皮生长因子受体2表达水平,并分析乳腺X线致密度与激素受体、HER2表达及年龄因素之间的相关性.结果 乳腺X线致密度随年龄增长逐渐由高向低过渡(r =-0.629,P<0.001).乳腺X线致密度与孕激素受体表达呈正相关(r =0.099,P=0.014<0.05),与雌激素受体(r=0.016,P=0.699>0.05)及人表皮生长因子受体2表达(r =0.077,P=0.057>0.05)未见明显相关性.结论 乳腺X线致密度与乳腺癌孕激素受体表达呈正相关,与患者发病年龄呈负相关.

  2. Mammographic dose survey in the Czech Republic

    Energy Technology Data Exchange (ETDEWEB)

    Novak, Leos [National Radiation Protection Institute, Prague (Czech Republic); Rada, Jiri [National Radiation Protection Institute, Ostrava (Czech Republic)

    2006-07-01

    At present, it is generally accepted that the average dose to the glandular tissue is the most reasonable dose descriptor in mammography with regard to the risk of breast cancer induced by ionizing radiation. It is advantageous to use the quantity mean glandular dose M.G.D. for setting of diagnostic reference levels (D.R.L.) as well, although the quantity is not directly measurable as it is the case of D.R.L. quantities for other imaging modalities. The reason is that a directly measurable quantity suitable for mammography, incident air kerma Ki, depends a lot on a beam quality. The influence of the beam quality (expressed by tube voltage, half value layer and combination of anode/filter material) is already included in calculation of mean glandular dose. To assess a radiation burden of patients due to mammography at a national level a representative dose survey is needed to carry out. Such a study provides statistically significant dose data for setting of the national diagnostic reference levels. National Radiation Protection Institute is performing the study in the Czech Republic since the year 2005.On a basis of presented data, it could be concluded, that the situation in the Czech Republic with respect to patient doses in mammography is encouraging and that the requirements of European Commission are well fulfilled. However, it is obvious, that the obtained results can not be considered as statistically significant at the moment, because the data were not collected from a representative sample of centers, which should observe a distribution of X-ray unit types, type of a mammographic center (screening/non screening ones) and also a locality of a center. The dose survey still continues to cover the whole Czech Republic with the main task to determine new national diagnostic reference levels and to find out optimized standards for carrying out the examinations with respect to patient doses and image quality. (authors)

  3. Fluid biopsy for circulating tumor cells in an occult ovarian cancer patient exhibiting bilateral supraclavicular lymph node metastases: A case report.

    Science.gov (United States)

    He, Shizhi; Li, Pingdong; Chen, Xiaohong; Yu, Zhenkun

    2013-08-01

    Metastases to the supraclavicular region usually originate from the head and neck or from infraclavicular tumors. Ovarian primaries of supraclavicular metastases are extremely rare. The present study reports the case of a 60-year-old patient with a bilateral supraclavicular mass that was diagnosed as a poorly-differentiated squamous cell carcinoma of unknown primary, following a fine-needle aspiration biopsy (FNAB) and comprehensive clinical investigation. The analysis of a peripheral blood sample using the CellSearch system revealed the presence of circulating tumor cells (CTCs) that were positive for epithelial cell adhesion molecule (EpCAM) and cytokeratin (CK) expression. Since EpCAM is usually expressed in adenocarcinoma, an excisional biopsy of the right supraclavicular lymph node was performed. The patient was diagnosed with occult ovarian low-grade serous carcinoma by immunohistochemistry. To the best of our knowledge, this is the first report to demonstrate that CTCs may be detected in the peripheral blood of a patient with cancer of unknown primary (CUP) by using the CellSearch system. A literature review was performed to analyze the diagnostic procedures of CUP metastatic to the cervical lymph nodes and the clinical features of CTCs.

  4. A comparative study of faecal occult blood kits in a colorectal cancer screening program in a cohort of healthy construction workers.

    LENUS (Irish Health Repository)

    Shuhaibar, M

    2012-02-01

    BACKGROUND: The incidence of colorectal cancer (CRC) has been increasing. We evaluated uptake rates and outcomes of faecal immunochemical test (FIT) and Guaiac test (gFOBT) kits as part of a two-step CRC screening. METHODS: A 3-year CRC screening program for a defined population of construction workers was conducted. Those satisfying the inclusion criteria were provided with gFOBT or FIT kits. Individuals testing positive were invited for a colonoscopy. RESULTS: A total of 909 faecal testing kits were distributed. Age range was 53-60 years. Compliance rate was higher for FIT (58.3%) as compared to gFOBT (46.7%) (p = 0.0006). FIT detected adenomatous polyps and CRC in 37.5 and 25%, respectively, whereas; gFOBT detected 23.5 and 18%. Colonoscopies were normal in 53 and 25% tested positive by gFOBT and FIT, respectively (p = 0.016). CONCLUSION: The FIT was more cost-effective when compared with gFOBT with higher return rate, sensitivity and specificity. A comparative study of faecal occult blood kits in a CRC screening program in a healthy cohort of construction workers.

  5. Using CT colonography as a triage technique after a positive faecal occult blood test in colorectal cancer screening

    Science.gov (United States)

    Liedenbaum, M H; van Rijn, A F; de Vries, A H; Dekker, H M; Thomeer, M; van Marrewijk, C J; Hol, L; Dijkgraaf, M G W; Fockens, P; Bossuyt, P M M; Dekker, E; Stoker, J

    2009-01-01

    Objective: The purpose of this study was to evaluate the effectiveness of CT colonography (CTC) as a triage technique in faecal occult blood test (FOBT)-positive screening participants. Methods: Consecutive guaiac (G-FOBT) and immunochemical (I-FOBT) FOBT-positive patients scheduled for colonoscopy underwent CTC with iodine tagging bowel preparation. Each CTC was read independently by two experienced observers. Per patient sensitivity, specificity and positive and negative predictive values (PPV and NPV) were calculated based on double reading with different CTC cut-off lesion sizes using segmental unblinded colonoscopy as the reference standard. The acceptability of the technique to patients was evaluated with questionnaires. Results: 302 FOBT-positive patients were included (54 G-FOBT and 248 I-FOBT). 22 FOBT-positive patients (7%) had a colorectal carcinoma and 211 (70%) had a lesion ⩾6 mm. Participants considered colonoscopy more burdensome than CTC (p<0.05). Using a 6 mm CTC size cut-off, per patient sensitivity for CTC was 91% (95% CI 85% to 91%) and specificity was 69% (95% CI 60% to 89%) for the detection of colonoscopy lesions ⩾6 mm. The PPV of CTC was 87% (95% CI 80% to 93%) and NPV 77% (95% CI 69% to 85%). Using CTC as a triage technique in 100 FOBT-positive patients would mean that colonoscopy could be prevented in 28 patients while missing ⩾10 mm lesions in 2 patients. Conclusion: CTC with limited bowel preparation has reasonable predictive values in an FOBT-positive population and a higher acceptability to patients than colonoscopy. However, due to the high prevalence of clinically relevant lesions in FOBT-positive patients, CTC is unlikely to be an efficient triage technique in a first round FOBT population screening programme. PMID:19625276

  6. 隐匿性乳腺癌的临床分析%Clinical analysis of occult breast cancer

    Institute of Scientific and Technical Information of China (English)

    李晓刚; 王玲; 汪江平

    2011-01-01

    Objective To investigate the diagnosis, treatment and prognosis of occult breast car cinoma(OBC). Methods The clinical data of 29 cases of OBC treated in our hospital from 2000 to 2009 were analyzed retrospectively. Results Sixteen cases of primary tumor were diagnosed by mammography, 6 cases by MRI scan, and 2 cases by PET scan. Twenty- five cases underwent modified radical mastecto my,and 4 cases underwent axillary lymph node dissection. Three patients had recurrence and i patient died. Conclusion Mammography and MRI scan are important diagnostic methods for primary tumor. Mod flied radical mastectomy is the primary treatment for OBC, while the breast - conserving approach should be carried out selectively.%目的 探讨隐匿性乳腺癌的诊断、治疗及预后.方法 回顾性分析2000年1月至2009年1月我科行手术治疗的29例隐匿性乳腺癌患者的临床资料.结果 乳腺钼靶X线检查出原发灶16例,6例由MRI检查出原发灶,2例行PET检查出原发灶.行乳腺癌改良根治术治疗25例,腋窝淋巴结清扫术4例.3例患者术后出现复发,1例死亡.结论 乳腺钼靶及MRI是发现原发灶的重要检查方法.乳腺癌改良根治术是主要的治疗方法,保乳手术治疗选择性施行.

  7. Increasing cancer detection yield of breast MRI using a new CAD scheme of mammograms

    Science.gov (United States)

    Tan, Maxine; Aghaei, Faranak; Hollingsworth, Alan B.; Stough, Rebecca G.; Liu, Hong; Zheng, Bin

    2016-03-01

    Although breast MRI is the most sensitive imaging modality to detect early breast cancer, its cancer detection yield in breast cancer screening is quite low (women) to date. The purpose of this preliminary study is to test the potential of developing and applying a new computer-aided detection (CAD) scheme of digital mammograms to identify women at high risk of harboring mammography-occult breast cancers, which can be detected by breast MRI. For this purpose, we retrospectively assembled a dataset involving 30 women who had both mammography and breast MRI screening examinations. All mammograms were interpreted as negative, while 5 cancers were detected using breast MRI. We developed a CAD scheme of mammograms, which include a new quantitative mammographic image feature analysis based risk model, to stratify women into two groups with high and low risk of harboring mammography-occult cancer. Among 30 women, 9 were classified into the high risk group by CAD scheme, which included all 5 women who had cancer detected by breast MRI. All 21 low risk women remained negative on the breast MRI examinations. The cancer detection yield of breast MRI applying to this dataset substantially increased from 16.7% (5/30) to 55.6% (5/9), while eliminating 84% (21/25) unnecessary breast MRI screenings. The study demonstrated the potential of applying a new CAD scheme to significantly increase cancer detection yield of breast MRI, while simultaneously reducing the number of negative MRIs in breast cancer screening.

  8. Intramammary metastases: Comparison of mammographic and ultrasound features

    Energy Technology Data Exchange (ETDEWEB)

    Abbas, Jasmin, E-mail: Jasmin_Abbas@web.de [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany); Wienke, Andreas, E-mail: andreas.wienke@medizin.uni-halle.de [Department of Epidemiology, Biometry and Informatics, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany); Spielmann, Rolf Peter, E-mail: rolf.spielmann@medizin.uni-halle.de [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany); Bach, Andreas Gunter [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany); Surov, Alexey, E-mail: alex.surow@medizin.uni-halle.de [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany)

    2013-09-15

    Purpose: To describe the mammographical and ultrasound features of IM, and to compare radiological patterns of IM arising from different malignancies. Materials and methods: A retrospective search in the statistical database of our institution from January 2000 to December 2009 revealed 51 cases of intramammary metastases from solid malignancies. Additionally, a retrospective search in the Pubmed database was performed. Publications in the time interval from 1980 to 2010 were considered. After thorough analysis, 119 articles with 229 patients were involved in the study. Therefore, together with our cases our analysis comprises 280 patients. Mammographic and ultrasound findings of different IM were analyzed. Results: The detected metastases showed two main radiological patterns: intramammary masses (81.5%) and architectural distortion (18.5%). Carcinomas of the stomach caused more frequently an architectural distortion, whereas other malignancies tended to present as intramammary masses. The size of the masses ranged from 2 to 104 mm. The largest lesions occurred in rhabdomyosarcoma, followed by hepatocellular carcinoma and squamous cell carcinomas of the head and neck region. The smallest lesions arose from malignancies of the thyroid gland carcinoma. Most IM showed circumscribed margins, while breast lesions in rhabdomyosarcoma were rather microlobulated. On ultrasound, IM from lung cancer were usually inhomogenously hypoechoic with circumscribed margins and showed posterior shadowing in almost 50% of the cases. Breast metastases from ovarian carcinoma had typically microlobulated margins and posterior enhancement. Conclusion: IM can present with a broad spectrum of radiological features. Their imaging findings vary depending on the primary tumor.

  9. Cost-effectiveness of population-based screening for colorectal cancer: a comparison of guaiac-based faecal occult blood testing, faecal immunochemical testing and flexible sigmoidoscopy.

    Science.gov (United States)

    Sharp, L; Tilson, L; Whyte, S; O'Ceilleachair, A; Walsh, C; Usher, C; Tappenden, P; Chilcott, J; Staines, A; Barry, M; Comber, H

    2012-02-28

    Several colorectal cancer-screening tests are available, but it is uncertain which provides the best balance of risks and benefits within a screening programme. We evaluated cost-effectiveness of a population-based screening programme in Ireland based on (i) biennial guaiac-based faecal occult blood testing (gFOBT) at ages 55-74, with reflex faecal immunochemical testing (FIT); (ii) biennial FIT at ages 55-74; and (iii) once-only flexible sigmoidoscopy (FSIG) at age 60. A state-transition model was used to estimate costs and outcomes for each screening scenario vs no screening. A third party payer perspective was adopted. Probabilistic sensitivity analyses were undertaken. All scenarios would be considered highly cost-effective compared with no screening. The lowest incremental cost-effectiveness ratio (ICER vs no screening euro 589 per quality-adjusted life-year (QALY) gained) was found for FSIG, followed by FIT euro 1696) and gFOBT (euro 4428); gFOBT was dominated. Compared with FSIG, FIT was associated with greater gains in QALYs and reductions in lifetime cancer incidence and mortality, but was more costly, required considerably more colonoscopies and resulted in more complications. Results were robust to variations in parameter estimates. Population-based screening based on FIT is expected to result in greater health gains than a policy of gFOBT (with reflex FIT) or once-only FSIG, but would require significantly more colonoscopy resources and result in more individuals experiencing adverse effects. Weighing these advantages and disadvantages presents a considerable challenge to policy makers.

  10. Clinical analysis of 12 Patients with occult breast cancer%隐匿性乳腺癌12例临床分析

    Institute of Scientific and Technical Information of China (English)

    赵明一; 肖晖; 高峰

    2009-01-01

    目的 探讨隐匿性乳腺癌(occult breast cancer,OBC)的诊断、治疗和愈后.方法 回顾分析首都医科大学附属大兴区人民医院与首都医科大学附属北京同仁医院1995年6月~2006年6月共12例OBC临床资料.结果 本组OBC共12例女性患者,平均年龄52.7岁,均单侧发病,绝经前4例,绝经后8例;左侧病变1O例,右侧病变2例,占同期诊治各型乳腺癌患者0.5%(12/2385);12例均以腋下肿块为首发症状;10例行腋下肿块切除活检证实淋巴结转移性腺癌,2例术前行细针穿刺检查为淋巴结转移性腺癌;12例中3例行淋巴结转移性腺癌的雌激素受体(estrogen receptor,ER)测定,均为阳性;10例术前行乳腺X线钼靶照相检查,2例可见有细小钙化灶,不除外乳腺癌;11例行乳腺B超检查、10例行近红外线扫描,均未发现乳腺内病灶;10例术前胸片、腹部B超,5例胸腹部CT及全身骨扫描和2例胃镜检查未发现全身其他部位病变;10例行乳腺癌改良根治术,1例行乳腺癌根治术,1例患者行姑息手术;9例术后病理检查发现乳腺原发病灶,浸润性导管癌6例、导管内癌3例;术后均予以放射治疗和化疗;3例雌激素受体阳性患者化疗后接受口服三苯氧胺内分泌治疗;随访3~10年,11例均生存且未见复发或转移,1例死亡,其中5例已生存5年以上,5年生存率为41.66%(5/12).结论 OBC是临床较为少见的特殊类型乳腺癌之一;左侧乳腺多见,比一般原发癌浸润能力强,早期即出现腋窝淋巴结肿大或远处转移;对肿大淋巴结进行细针穿刺细胞学检查或切除行组织学检查有助于诊断;乳腺癌改良根治术为常用治疗方法.%Objective To evaluate the diagnosis, treatment and prognosis of occult breast cancer(OBC). Methods Clinical data of 12 OBC cases from June 1995 to June 2006 were retrospectively analyzed.Results There were 12 female; the mean age was 52.7 years(39~66). Tumor of all cases was in one of breasts

  11. Incremental clinical value of ultrasound in men with mammographically confirmed gynecomastia

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Po-Hao, E-mail: howard_chen@post.harvard.edu [Harvard Medical School, 25 Shattuck Street, Boston, MA 02115 (United States); Department of Radiology, Hospital of University of Pennsylvania, 3400 Spruce Street, Philadlephia, PA 19104 (United States); Slanetz, Priscilla J., E-mail: pslanetz@bidmc.harvard.edu [Harvard Medical School, 25 Shattuck Street, Boston, MA 02115 (United States); Beth Israel Deaconess Medical Center, Department of Radiology, 330 Brookline Avenue, Boston, MA 02215 (United States)

    2014-01-15

    Purpose: To determine whether ultrasound is of any value in male patients presenting with focal symptoms who have classic features of gynecomastia but no concerning findings on mammography. Materials and Methods: Over a 3-year period, all male patients who underwent mammographic evaluation were identified in this retrospective study. Patients with a mammographic diagnosis of gynecomastia and subsequent breast ultrasound at a large tertiary academic medical center comprised the study cohort. Men whose ultrasound diagnosis differed from the initial mammographic evaluation were analyzed for both additional benign findings as well as findings that warranted biopsy. Results: A total of 353 mammograms were obtained from 327 unique patients (ages 18–95, mean 51 years). Of all mammographic examinations, gynecomastia was the sole finding in 73% (259). In those 259 studies, 85% were further evaluated with ultrasound, in which 6 (2.7%) showed additional benign findings, and 4 (1.8%) showed suspicious findings for which biopsy was recommended. No malignancies were detected in those patients. Furthermore, no malignancies were detected in patients whose mammogram revealed only normal fatty parenchyma or only gynecomastia. In all cases of cancer, mammography revealed visible masses. Conclusion: Judicious use of breast ultrasound in men improves outcome. Our data suggest that targeted ultrasound is of limited value in symptomatic male patients where mammography is negative or reveals only gynecomastia and leads to unnecessary benign biopsies in these patients. When mammography reveals concerning findings, ultrasound adds positively to clinical management.

  12. Mammographic density descriptors of novel phantom images: effect of clustered lumpy backgrounds

    Science.gov (United States)

    Li, Yanpeng; Brennan, Patrick C.; Ryan, Elaine

    2014-03-01

    Mammographic breast density (MBD) is a risk factor for breast cancer. Both qualitative and quantitative methods have been used to evaluate MBD. However as it is impossible to measure the actual weight or volume of fibroglandular tissue evident on a mammogram, therefore it is hard to know the true correlation between measured mammographic density and the fibroglandular tissue volume. A phantom system has been developed that represents glandular tissue within an adipose tissue structure. Although a previous study has found strong correlation between the synthesised glandular mass and several image descriptors, it is not known if the correlation is still present when a high level of background noise is introduced. The background noise is required to more realistically simulate clinical image appearance. The aim of this study is to investigate if the correlation between percentage density, integrated density, and standard deviation of mean grey value of the whole phantom and simulated glandular tissue mass is affected by background noise being added to the phantom images. For a set of one hundred phantom mammographic images, clustered lumpy backgrounds were synthesised and superimposed onto phantom images. The correlation between the synthesised glandular mass and the image descriptors were calculated. The results showed the correlation is strong and statistically significant for the above three descriptors with r is 0.7597, 0.8208, and 0.7167 respectively. This indicates these descriptors may be used to assess breast fibroglandular tissue content of the breast using mammographic images.

  13. Mammographic density and markers of socioeconomic status: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Moss Sue M

    2010-02-01

    Full Text Available Abstract Background Socioeconomic status (SES is known to be positively associated with breast cancer risk but its relationship with mammographic density, a marker of susceptibility to breast cancer, is unclear. This study aims to investigate whether mammographic density varies by SES and to identify the underlying anthropometric, lifestyle and reproductive factors leading to such variation. Methods In a cross-sectional study of mammographic density in 487 pre-menopausal women, SES was assessed from questionnaire data using highest achieved level of formal education, quintiles of Census-derived Townsend scores and urban/rural classification of place of residence. Mammographic density was measured on digitised films using a computer-assisted method. Linear regression models were fitted to assess the association between SES variables and mammographic density, adjusting for correlated variables. Results In unadjusted models, percent density was positively associated with SES, with an absolute difference in percent density of 6.3% (95% CI 1.6%, 10.5% between highest and lowest educational categories, and of 6.6% (95% CI -0.7%, 12.9% between highest and lowest Townsend quintiles. These associations were mainly driven by strong negative associations between these SES variables and lucent area and were attenuated upon adjustment for body mass index (BMI. There was little evidence that reproductive factors explained this association. SES was not associated with the amount of dense tissue in the breast before or after BMI adjustment. The effect of education on percent density persisted after adjustment for Townsend score. Mammographic measures did not vary according to urban/rural place of residence. Conclusions The observed SES gradients in percent density paralleled known SES gradients in breast cancer risk. Although consistent with the hypothesis that percent density may be a mediator of the SES differentials in breast cancer risk, the SES gradients

  14. 隐匿性乳腺癌62例临床分析%Occult breast cancer, report of 62 cases

    Institute of Scientific and Technical Information of China (English)

    郭丰丽; 林秋生; 魏丽娟; 赵晶; 刘俊田

    2012-01-01

    Objective To analyze the clinical features and prognostic factors of occult breast cancer. Methods The clinical features and prognostic factors of 62 occult breast cancer patients,who were treated in Tianjin Cancer Hospital from October 1997 to October 2011,were retrospectively analyzed.Results The 3-year,5-year and 10-year overall survival rates of 62 cases were 87.4%,76.4%,73.2% respectively,a median of 53 months.The 3-,5-,and 10-year overall survival rates of the patients with >4 positive lymph nodes are lower than that of patients with ≤4 nodes (77.8%,64.8%,38.9% vs.90.7%,86.7%,86.7%,P =0.015 ) ;The 3-year and 5-year overall survival rates of patients with primary cancer found in removed breast tissue are lower than that in those primary tumor was not found (60.0%,40.0%,40.0% vs.92.0%,83.6%,79.2%,P =0.023).The 3-year,5-year and 10-year overall survival rates in patients with recurrence and metastasis are lower than that of patients without (63.5%,28.6%,19.0% vs.97.1%,97.1 %,97.1%,P =0.000). Conclusions The prognosis of occult breast cancer is related with the number of positive lymph node,pathology,recurrence and metastasis.%目的 分析隐匿性乳腺癌的临床特征及预后影响因素.方法 回顾性分析天津市肿瘤医院1997年10月至2011年10月收治的62例隐匿性乳腺癌的临床病理资料,对其临床特征及影响预后的因素进行分析.结果 62例隐匿性乳腺癌患者3、5、10年总生存率分别为87.4%、76.4%、73.2%;中位生存期为53个月.阳性淋巴结数目>4个的患者3、5、10年总生存率低于阳性淋巴结数目≤4个者(77.8%、64.8%、38.9%比90.7%、86.7%、86.7%,P=0.015).乳腺癌根治术后病理切片发现原发灶组3、5、10年总生存率低于未发现原发灶组(60.0%、40.0%、40.0%比92.0%、83.6%、79.2%,P=0.023).有复发转移组总生存率低于无复发转移组(63.5%、28.6%、19.0%比97.1

  15. Association of Catechol-O-methyltransferase polymorphism Val158Met and mammographic density: A meta-analysis.

    Science.gov (United States)

    Kallionpää, Roope A; Uusitalo, Elina; Peltonen, Juha

    2017-08-15

    The Val158Met polymorphism in catechol-O-methyltransferase (COMT) enzyme reduces the methylation of catechol estrogens, which may affect mammographic density. High mammographic density is a known risk factor of breast cancer. Our aim was to perform meta-analysis of the effect of COMT Val158Met polymorphism on mammographic density. Original studies reporting data on mammographic density, stratified by the presence of COMT Val158Met polymorphism, were identified and combined using genetic models Met/Val vs. Val/Val, Met/Met vs. Val/Val, Val/Met+Met/Met vs. Val/Val (dominant model) and Met/Met vs. Val/Met+Val/Val (recessive model). Subgroup analyses by breast cancer status, menopausal status and use of hormone replacement therapy (HRT) were also performed. Eight studies were included in the meta-analysis. The overall effect in percent mammographic density was -1.41 (CI -2.86 to 0.05; P=0.06) in the recessive model. Exclusion of breast cancer patients increased the effect size to -1.93 (CI -3.49 to -0.37; P=0.02). The results suggested opposite effect of COMT Val158Met for postmenopausal users of HRT versus premenopausal women or postmenopausal non-users of HRT. COMT Val158Met polymorphism may be associated with mammographic density at least in healthy women. Menopausal status and HRT should be taken into account in future studies to avoid masking of the underlying effects. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Unsupervised deep learning applied to breast density segmentation and mammographic risk scoring

    DEFF Research Database (Denmark)

    Kallenberg, Michiel Gijsbertus J.; Petersen, Peter Kersten; Nielsen, Mads

    2016-01-01

    Mammographic risk scoring has commonly been automated by extracting a set of handcrafted features from mammograms, and relating the responses directly or indirectly to breast cancer risk. We present a method that learns a feature hierarchy from unlabeled data. When the learned features are used...... as the input to a simple classifier, two different tasks can be addressed: i) breast density segmentation, and ii) scoring of mammographic texture. The proposed model learns features at multiple scales. To control the models capacity a novel sparsity regularizer is introduced that incorporates both lifetime...... and population sparsity. We evaluated our method on three different clinical datasets. Our state-of-the-art results show that the learned breast density scores have a very strong positive relationship with manual ones, and that the learned texture scores are predictive of breast cancer. The model is easy...

  17. Serial monitoring of circulating tumor DNA in patients with primary breast cancer for detection of occult metastatic disease.

    Science.gov (United States)

    Olsson, Eleonor; Winter, Christof; George, Anthony; Chen, Yilun; Howlin, Jillian; Tang, Man-Hung Eric; Dahlgren, Malin; Schulz, Ralph; Grabau, Dorthe; van Westen, Danielle; Fernö, Mårten; Ingvar, Christian; Rose, Carsten; Bendahl, Pär-Ola; Rydén, Lisa; Borg, Åke; Gruvberger-Saal, Sofia K; Jernström, Helena; Saal, Lao H

    2015-05-18

    Metastatic breast cancer is usually diagnosed after becoming symptomatic, at which point it is rarely curable. Cell-free circulating tumor DNA (ctDNA) contains tumor-specific chromosomal rearrangements that may be interrogated in blood plasma. We evaluated serial monitoring of ctDNA for earlier detection of metastasis in a retrospective study of 20 patients diagnosed with primary breast cancer and long follow-up. Using an approach combining low-coverage whole-genome sequencing of primary tumors and quantification of tumor-specific rearrangements in plasma by droplet digital PCR, we identify for the first time that ctDNA monitoring is highly accurate for postsurgical discrimination between patients with (93%) and without (100%) eventual clinically detected recurrence. ctDNA-based detection preceded clinical detection of metastasis in 86% of patients with an average lead time of 11 months (range 0-37 months), whereas patients with long-term disease-free survival had undetectable ctDNA postoperatively. ctDNA quantity was predictive of poor survival. These findings establish the rationale for larger validation studies in early breast cancer to evaluate ctDNA as a monitoring tool for early metastasis detection, therapy modification, and to aid in avoidance of overtreatment.

  18. Influence of estrogen receptor alpha and progesterone receptor polymorphisms on the effects of hormone therapy on mammographic density.

    NARCIS (Netherlands)

    Duijnhoven, F.J.B. van; Peeters, P.H.; Warren, R.M.; Bingham, S.; Uitterlinden, A.G.; Noord, P.A.H. van; Monninkhof, E.M.; Grobbee, D.E.; Gils, C.H. van

    2006-01-01

    Postmenopausal hormone therapy increases mammographic density, a strong breast cancer risk factor, but effects vary across women. We investigated whether the effect of hormone therapy use is modified by polymorphisms in the estrogen receptor (ESR1) and progesterone receptor (PGR) genes in the Dutch

  19. Mammographic features of calcifications in DCIS: correlation with oestrogen receptor and human epidermal growth factor receptor 2 status

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Min Sun; Moon, Woo Kyung; Chang, Jung Min; Cho, Nariya [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, So Yeon; Won, Jae-Kyung; Jeon, Yoon-Kyung; Park, In Ae [Seoul National University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Moon, Hyeong-Gon; Han, Wonshik [Seoul National University College of Medicine, Department of Surgery, Seoul (Korea, Republic of)

    2013-08-15

    This study investigated the correlation of oestrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) status with the probability of malignancy (POM) of mammographic calcifications in ductal carcinoma in situ (DCIS). A total of 101 women (age range, 27-83 years) with pure DCIS that presented as mammographic calcifications were included. Three radiologists independently reviewed mammograms according to the BI-RADS lexicon and provided 100-point POM scores and a BI-RADS category. ER, HER2 and breast cancer subtypes were determined using immunohistochemistry (IHC) and fluorescence in situ hybridisation. Pairwise correlations between POM and IHC biomarker scores were calculated, and mammographic features were compared between breast cancer subtypes. HER2 level positively correlated with the POM score (P < 0.0001) and BI-RADS category (P < 0.0001), and ER level inversely correlated with the POM score (P < 0.013) and BI-RADS category (P < 0.010). Fine linear branching (P = 0.004) and segmental (P = 0.014) calcifications were significantly associated with HER2-positive cancers, and clustered calcifications were more frequently observed in ER-positive cancers (P = 0.014). HER2 status in DCIS correlated positively with the POM of mammographic calcifications, as determined by radiologists on the basis of the BI-RADS lexicon. (orig.)

  20. Occult intrasacral meningoceles

    Energy Technology Data Exchange (ETDEWEB)

    Vogelsang, H.

    1985-03-01

    The author reports on 8 patients with cystic enlargements of the canalis sacralis (occult intrasacral maningocele). The clinical pattern of signs, x-ray findings (plain radiography, myelography, computed tomography) and possible treatment are discussed in comparison with the cases published to date.

  1. Evaluation of mammographic density patterns: reproducibility and concordance among scales

    Directory of Open Access Journals (Sweden)

    Garrido-Estepa Macarena

    2010-09-01

    Full Text Available Abstract Background Increased mammographic breast density is a moderate risk factor for breast cancer. Different scales have been proposed for classifying mammographic density. This study sought to assess intra-rater agreement for the most widely used scales (Wolfe, Tabár, BI-RADS and Boyd and compare them in terms of classifying mammograms as high- or low-density. Methods The study covered 3572 mammograms drawn from women included in the DDM-Spain study, carried-out in seven Spanish Autonomous Regions. Each mammogram was read by an expert radiologist and classified using the Wolfe, Tabár, BI-RADS and Boyd scales. In addition, 375 mammograms randomly selected were read a second time to estimate intra-rater agreement for each scale using the kappa statistic. Owing to the ordinal nature of the scales, weighted kappa was computed. The entire set of mammograms (3572 was used to calculate agreement among the different scales in classifying high/low-density patterns, with the kappa statistic being computed on a pair-wise basis. High density was defined as follows: percentage of dense tissue greater than 50% for the Boyd, "heterogeneously dense and extremely dense" categories for the BI-RADS, categories P2 and DY for the Wolfe, and categories IV and V for the Tabár scales. Results There was good agreement between the first and second reading, with weighted kappa values of 0.84 for Wolfe, 0.71 for Tabár, 0.90 for BI-RADS, and 0.92 for Boyd scale. Furthermore, there was substantial agreement among the different scales in classifying high- versus low-density patterns. Agreement was almost perfect between the quantitative scales, Boyd and BI-RADS, and good for those based on the observed pattern, i.e., Tabár and Wolfe (kappa 0.81. Agreement was lower when comparing a pattern-based (Wolfe or Tabár versus a quantitative-based (BI-RADS or Boyd scale. Moreover, the Wolfe and Tabár scales classified more mammograms in the high-risk group, 46.61 and 37

  2. Clinical Study on 17 Cases of Occult Breast Cancer%隐匿性乳腺癌17例临床诊治分析

    Institute of Scientific and Technical Information of China (English)

    王新昇; 董晓强; 曹辉; 万岱维; 毛宗磊

    2013-01-01

      目的探讨隐匿性乳腺癌(occult breast cancer,OBC)的诊断、治疗和预后。方法选择2006年11月~2012年6月在苏大附一院普外科收治的17例OBC的临床资料进行回顾行分析。结果所有病例均为女性,占同期乳腺癌的0.65%,临床症状以腋下肿块为首发症状,双乳触诊均未触及明显肿块。术前行腋下肿块或细针穿刺,均找到癌细胞。5例术前行乳腺X线钼靶照相检查,2例可见有细小钙化灶,不除外乳腺癌;5例行乳腺B超检查、7例行红外线扫描,均未发现乳腺内病灶。该组5例行Halsted根治术,12例行改良根治术,术后10例在乳腺大体标本找到原发病灶,7例为浸润性导管癌,2例为导管内癌,1例为髓样癌。9例予辅助化疗、5例放疗加化疗、3例予口服三苯氧胺治疗。该组全部随访,均仍生存,9例生存已超过2年半,最长1例生存已达5年。结论临床上对女性腋窝肿块应高度警惕OBC的可能,术前予细针穿刺、腋下肿块活检有助于诊断,乳腺钼靶照片、红外线扫描、乳腺B超对乳腺原发病灶的检出率较低,多需术后乳腺大体标本病理切片确诊。确诊为OBC后,仍应按乳腺癌的处理原则进行治疗,宜选择根治术或改良根治术,术后继续行化疗,ER、PR阳性者行序贯内分泌治疗。术后要密切随诊。%Objective To investigate the diagnosis and treatment of the patients with occult breast cancer(OBC).Methods Clinical data of 17 OBC cases from June 2006 to June 2012 were retrospectively analyzed. Results All cases were female and account for 0.65% of the total breast cancer treated in the same period.All cases were found because of lump in axillary fossa.No breast mass is found from physical examination.Fine needle aspiration or excisional biopsy revealed metastatic adenocarcinoma before surgery.2 cases,suspecting breast cancer,could be found fine calcification in the

  3. Statistical Segmentation of Regions of Interest on a Mammographic Image

    Science.gov (United States)

    Adel, Mouloud; Rasigni, Monique; Bourennane, Salah; Juhan, Valerie

    2007-12-01

    This paper deals with segmentation of breast anatomical regions, pectoral muscle, fatty and fibroglandular regions, using a Bayesian approach. This work is a part of a computer aided diagnosis project aiming at evaluating breast cancer risk and its association with characteristics (density, texture, etc.) of regions of interest on digitized mammograms. Novelty in this paper consists in applying and adapting Markov random field for detecting breast anatomical regions on digitized mammograms whereas most of previous works were focused on masses and microcalcifications. The developed method was tested on 50 digitized mammograms of the mini-MIAS database. Computer segmentation is compared to manual one made by a radiologist. A good agreement is obtained on 68% of the mini-MIAS mammographic image database used in this study. Given obtained segmentation results, the proposed method could be considered as a satisfying first approach for segmenting regions of interest in a breast.

  4. GPCALMA, a mammographic CAD in a GRID connection

    CERN Document Server

    Bottigli, U; Delogu, P; Fantacci, M E; Fauci, F; Golosio, B; Lauria, A; Torres, E L; Magro, R; Masala, G L; Oliva, P R; Palmiero, R; Raso, G; Retico, A; Stumbo, S; Tangaro, S

    2003-01-01

    Purpose of this work is the development of an automatic system which could be useful for radiologists in the investigation of breast cancer. A breast neoplasia is often marked by the presence of microcalcifications and massive lesions in the mammogram: hence the need for tools able to recognize such lesions at an early stage. GPCALMA (Grid Platform Computer Assisted Library for MAmmography), a collaboration among italian physicists and radiologists, has built a large distributed database of digitized mammographic images (at this moment about 5500 images corresponding to 1650 patients). This collaboration has developed a CAD (Computer Aided Detection) system which, installed in an integrated station, can also be used for digitization, as archive and to perform statistical analysis. With a GRID configuration it would be possible for the clinicians tele- and co-working in new and innovative groupings ('virtual organisations') and, using the whole database, by the GPCALMA tools several analysis can be performed. ...

  5. Decision trees and integrated features for computer aided mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Kegelmeyer, W.P. Jr.; Groshong, B.; Allmen, M.; Woods, K.

    1997-02-01

    Breast cancer is a serious problem, which in the United States causes 43,000 deaths a year, eventually striking 1 in 9 women. Early detection is the only effective countermeasure, and mass mammography screening is the only reliable means for early detection. Mass screening has many shortcomings which could be addressed by a computer-aided mammographic screening system. Accordingly, we have applied the pattern recognition methods developed in earlier investigations of speculated lesions in mammograms to the detection of microcalcifications and circumscribed masses, generating new, more rigorous and uniform methods for the detection of both those signs. We have also improved the pattern recognition methods themselves, through the development of a new approach to combinations of multiple classifiers.

  6. A centrally generated primary care physician audit report does not improve colonoscopy uptake after a positive result on a fecal occult blood test in Ontario's ColonCancerCheck program.

    Science.gov (United States)

    Stock, D; Rabeneck, L; Baxter, N N; Paszat, L F; Sutradhar, R; Yun, L; Tinmouth, J

    2017-02-01

    Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. In the present study, we evaluated the effectiveness of centrally generated, physician-targeted audit and feedback to improve colonoscopy uptake after a positive fecal occult blood test (fobt) result within Ontario's population-wide ColonCancerCheck Program. This prospective cohort study used data sets from Ontario's ColonCancerCheck Program (2008-2011) that were linked to provincial administrative health databases. Cox proportional hazards regression was used to estimate the effect of centralized, physician-targeted audit and feedback on colonoscopy uptake in an Ontario-wide fobt-positive cohort. A mailed physician audit and feedback report identifying individuals outstanding for colonoscopy for 3 or more months after a positive fobt result did not increase the likelihood of colonoscopy uptake (hazard ratio: 0.95; 95% confidence interval: 0.79 to 1.13). Duration of positive fobt status was strongly inversely associated with the hazard of follow-up colonoscopy (p for linear trend: result outstanding for 3 or more months. Mailed physician-targeted screening audit and feedback reports alone are unlikely to improve compliance with follow-up colonoscopy in Ontario. Other interventions such as physician audits or automatic referrals, demonstrated to be effective in other jurisdictions, might be warranted.

  7. Metabolic syndrome and mammographic density in Mexican women.

    Science.gov (United States)

    Rice, Megan S; Biessy, Carine; Lajous, Martin; Bertrand, Kimberly A; Tamimi, Rulla M; Torres-Mejía, Gabriela; López-Ridaura, Ruy; Romieu, Isabelle

    2013-07-01

    Metabolic syndrome has been associated with an increased risk of breast cancer; however, little is known about the association between metabolic syndrome and percent mammographic density, a strong predictor of breast cancer. We analyzed cross-sectional data from 789 premenopausal and 322 postmenopausal women in the Mexican Teacher's Cohort (ESMaestras). Metabolic syndrome was defined according to the harmonized definition. We measured percent density on mammograms using a computer-assisted thresholding method. Multivariable linear regression was used to estimate the association between density and metabolic syndrome, as well as its components by state (Jalisco, Veracruz) and menopausal status (premenopausal, postmenopausal). Among premenopausal women in Jalisco, women with metabolic syndrome had higher percent density than those without after adjusting for potential confounders including BMI [difference = 4.76; 95% confidence interval (CI), 1.72-7.81]. Among the metabolic syndrome components, only low high-density lipoprotein levels (women in Jalisco (difference = 4.62; 95% CI, 1.73-7.52). Metabolic syndrome was not associated with percent density among premenopausal women in Veracruz (difference = -2.91; 95% CI, -7.19 to 1.38), nor among postmenopausal women in either state. Metabolic syndrome was associated with higher percent density among premenopausal women in Jalisco, Mexico, but was not associated with percent density among premenopausal women in Veracruz, Mexico, or among postmenopausal women in either Jalisco or Veracruz. These findings provide some support for a possible role of metabolic syndrome in mammographic density among premenopausal women; however, results were inconsistent across states and require further confirmation in larger studies.

  8. Urinary cadmium and mammographic density in premenopausal women.

    Science.gov (United States)

    Adams, Scott V; Newcomb, Polly A; Shafer, Martin M; Atkinson, Charlotte; Bowles, Erin J Aiello; Newton, Katherine M; Lampe, Johanna W

    2011-08-01

    Mammographic density (MD), a strong marker of breast cancer risk, is influenced by genetic, environmental, and hormonal factors. Cadmium, a persistent and widespread environmental pollutant, has been associated with risk of breast cancer, and laboratory evidence suggests cadmium is a carcinogen in the breast. We investigated the hypothesis that cadmium exposure is associated with higher MD. In a cross-sectional study of MD and urinary cadmium concentration, percentage MD (MD%) and Breast Imaging-Reporting and Data Systems (BI-RADS®) density category were determined from screening mammograms of 190 premenopausal women ages 40-45 years. Women completed a health questionnaire, and the cadmium content of spot urine samples was measured with inductively coupled plasma mass spectrometry and corrected for urine creatinine. Urinary cadmium concentrations are thought to reflect exposure to cadmium during a period of 20-30 years. Multivariable linear regression and logistic regression were used to estimate the strength of association between urinary cadmium and mammographic breast density. Adjusted mean MD% among women in the upper tertile of creatinine-corrected urinary cadmium was 4.6% higher (95% CI: -2.3 to 11.6%) than in women in the lowest cadmium tertile. Each twofold increase in urinary cadmium was associated with higher odds of MD% in the upper tertile (OR: 1.29, 95% CI: 0.82-2.02) or a BI-RADS category rating of "extremely dense" (OR: 1.75, 95% CI: 1.14-2.70). Stronger associations were observed among nulliparous women, and current or former smokers. Exposure to cadmium may be associated with increased breast density in premenopausal women.

  9. Ultrasound screening of contralateral breast after surgery for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Ja [Department of Radiology, Seoul Metropolitan Government Seoul National University, Boramae Medical Center (Korea, Republic of); Chung, Se-Yeong; Chang, Jung Min; Cho, Nariya [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Han, Wonshik [Department of Surgery, Seoul National University Hospital (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University Hospital (Korea, Republic of)

    2015-01-15

    Highlights: • The addition of supplemental US to mammography depicted additional 5.0 cancers per 1000 postoperative women. • Positive biopsy rate of mammography-detected lesions was 66.7% (4 of 6) and that of US-detected lesions was 40.0% (6 of 15). • US can be helpful to detect mammographically occult breast cancer in the contralateral breast in women with previous history of cancer and dense breast. - Abstract: Objective: To determine whether supplemental screening ultrasound (US) to mammography could improve cancer detection rate of the contralateral breast in patients with a personal history of breast cancer and dense breasts. Materials and methods: During a one-year study period, 1314 screening patients with a personal history of breast cancer and dense breasts simultaneously underwent mammography and breast US. BI-RADS categories were given for mammography or US-detected lesions in the contralateral breast. The reference standard was histology and/or 1-year imaging follow-up, and the cancer rate according to BI-RADS categories and cancer detection rate and positive biopsy rate according to detection modality were analyzed. Results: Of 1314 patients, 84 patients (6.4%) were categorized as category 3 with one interval cancer and one cancer which was upgraded to category 4A after 6-month follow-up US (2.5% cancer rate, 95% CIs 1.5–9.1%). Fifteen patients (1.1%) had category 4A or 4B lesions in the contralateral breast. Four lesions were detected on mammography (two lesions were also visible on US) and 11 lesions were detected on US and 5 cancers were confirmed (33.3%, 95% CIs 15.0–58.5%). Six patients (0.5%) had category 4C lesions, 2 detected on mammography and 4 on US and 4 cancers were confirmed (66.7%, 95% CIs 29.6–90.8%). No lesions were categorized as category 5 in the contralateral breast. Cancer detection rate by mammography was 3.3 per 1000 patients and that by US was 5.0 per 1000 patients, therefore overall cancer detection rate by

  10. Computer-aided detection of breast carcinoma in standard mammographic projections with digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Destounis, S.; Hanson, S. [Elizabeth Wende Breast Clinic, Rochester (United States)

    2007-06-15

    This study was conducted to retrospectively evaluate a computer-aided detection system's ability to detect breast carcinoma in multiple standard mammographic projections. Forty-five lesions in 44 patients imaged with digital mammography (Selenia {sup registered}, Hologic, Bedford, MA; Senographe {sup registered}, GE, Milwaukee, WI) and had computer-aided detection (CAD, Image-checker {sup registered} V 8.3.15, Hologic/R2, Santa Clara, CA) applied at the time of examination were identified for review; all were subsequently recommended to biopsy where cancer was revealed. These lesions were determined by the study Radiologist to be visible in both standard mammographic images (mediolateral oblique, MLO; craniocaudal, CC). For each patient, case data included patient age, tissue density, lesion type, BIRADS {sup registered} assessment, lesion size, lesion visibility-visible on MLO and/or CC view, ability of CAD to correctly mark the cancerous lesion, number of CAD marks per image, needle core biopsy results and surgical pathologic correlation. For this study cohort. CAD lesion/case sensitivity of 87% (n = 39) was found and image sensitivity was found to be 69% (n = 31) for MLO view and 78% (n = 35) for the CC view. For the study cohort, cases presented with a median of four marks per cases (range 0-13). Eighty-four percent (n = 38) of lesions proceeded to excision; initial needle biopsy pathology was upgraded at surgical excision from in situ disease to invasive for 24% (n = 9) lesions. CAD has demonstrated the potential to detect mammographically visible cancers in multiple standard mammographic projections in all categories of lesions in this study cohort. (orig.)

  11. The significance of circumscribed malignant mammographic masses in the surveillance of BRCA 1/2 gene mutation carriers

    Energy Technology Data Exchange (ETDEWEB)

    Kaas, R. [Department of Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek ziekenhuis Plesmanlaan 121, 1066 CX, Amsterdam (Netherlands); Kroger, R.; Besnard, A.P.E.; Koops, W.; Pameijer, F.A.; Prevoo, W.; Loo, C.E.; Muller, S.H. [Department of Radiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek ziekenhuis Plesmanlaan 121, 1066 CX, Amsterdam (Netherlands); Hendriks, J.H.C.L. [Dutch Reference Center for Breast Cancer Screening, Nijmegen (Netherlands)

    2004-09-01

    Breast cancers in gene mutation carriers may escape mammographic detection because of rapid growth and tumor expansion. Therefore, they may mimic benign lesions on the mammogram. Twenty-nine BRCA 1/2 mutation carriers under surveillance developed 31 breast cancers between 1994 and 2001 at a mean age of 44.2 years. Controls were 63 women with 67 breast cancers in the same period at a mean age of 53.8 years, also under surveillance because of a life time risk of at least 15%. In 26% of the carriers vs. 48% of the controls, mammography was the method that first suspected a malignancy. Seven radiologists performed a retrospective review of the original mammograms to establish technical assessment, with special attention for circumscribed lesions and estimated probability of malignancy. In the mutation carriers seven (23%) circumscribed non-calcified mammographic masses were found and three in the controls (4.5%) P=0.01. These masses were proven to be malignant. In both groups around 70% of these fast-growing circumscribed lesions were detected by the patients. The masses were situated in breasts with a good interpretable breast pattern. BRCA 1/2 mutation carriers had a significantly higher percentage of circumscribed non-calcified mammographic masses that proved to be malignant. These mammographic lesions in women at high risk should be described as at least Birads 0 and worked-up with ultrasound and needle biopsy. (orig.)

  12. Occult Macular Dystrophy

    Directory of Open Access Journals (Sweden)

    Işıl Sayman Muslubaş

    2016-04-01

    Full Text Available Occult macular dystrophy is an inherited macular dystrophy characterized by a progressive decline of bilateral visual acuity with normal fundus appearance, fluorescein angiogram and full-field electroretinogram. This case report presents a 20-year-old female patient with bilateral progressive decline of visual acuity for six years. Her visual acuity was 3-4/10 in both eyes. Anterior segment and fundus examination, fluorescein angiogram and full-field electroretinogram were normal. She could read all Ishihara pseudoisochromatic plates. Fundus autofluorescence imaging was normal. There was a mild central hyporeflectance on fundus infrared reflectance imaging in both eyes. Reduced foveal thickness and alterations of the photoreceptor inner and outer segment junction were observed by optical coherence tomography in both eyes. Central scotoma was also found by microperimetry and reduced central response was revealed by multifocal electroretinogram in both eyes. These findings are consistent with the clinical characteristics of occult macular dystrophy

  13. [Clinical and mammographic screening in a district of Milan: organization, social influence and results].

    Science.gov (United States)

    Pravettoni, A; Cescon, S; Moro, G; Verga, M; Saibene, F; Micheli, A

    1993-12-01

    A reduction in the mortality rate for breast cancer in women over 50 years undergoing mammographic screening has been reported in many studies. Since the first experience in Florence in 1970, mammographic screenings on a population from different areas of Italy began. We report the experience carried out in the 16th District of Milan among women from 50 to 60 years of age. A promotional activity with the use of local media supported the program. The screening was based on two-view conventional mammography and clinical examination. Immediate response was given to the women. The compliance was 60%. Mainly immigrants, with only primary school education, mothers of several children and freelancers seem to be the main features of the women in the non-attenders group.

  14. The detection of the methylated Wif-1 gene is more accurate than a fecal occult blood test for colorectal cancer screening

    KAUST Repository

    Amiot, Aurelien

    2014-07-15

    Background: The clinical benefit of guaiac fecal occult blood tests (FOBT) is now well established for colorectal cancer screening. Growing evidence has demonstrated that epigenetic modifications and fecal microbiota changes, also known as dysbiosis, are associated with CRC pathogenesis and might be used as surrogate markers of CRC. Patients and Methods: We performed a cross-sectional study that included all consecutive subjects that were referred (from 2003 to 2007) for screening colonoscopies. Prior to colonoscopy, effluents (fresh stools, sera-S and urine-U) were harvested and FOBTs performed. Methylation levels were measured in stools, S and U for 3 genes (Wif1, ALX-4, and Vimentin) selected from a panel of 63 genes; Kras mutations and seven dominant and subdominant bacterial populations in stools were quantified. Calibration was assessed with the Hosmer-Lemeshow chi-square, and discrimination was determined by calculating the C-statistic (Area Under Curve) and Net Reclassification Improvement index. Results: There were 247 individuals (mean age 60.8±12.4 years, 52% of males) in the study group, and 90 (36%) of these individuals were patients with advanced polyps or invasive adenocarcinomas. A multivariate model adjusted for age and FOBT led to a C-statistic of 0.83 [0.77-0.88]. After supplementary sequential (one-by-one) adjustment, Wif-1 methylation (S or U) and fecal microbiota dysbiosis led to increases of the C-statistic to 0.90 [0.84-0.94] (p = 0.02) and 0.81 [0.74-0.86] (p = 0.49), respectively. When adjusted jointly for FOBT and Wif-1 methylation or fecal microbiota dysbiosis, the increase of the C-statistic was even more significant (0.91 and 0.85, p<0.001 and p = 0.10, respectively). Conclusion: The detection of methylated Wif-1 in either S or U has a higher performance accuracy compared to guaiac FOBT for advanced colorectal neoplasia screening. Conversely, fecal microbiota dysbiosis detection was not more accurate. Blood and urine testing could be

  15. Clinical analysis of 9 occult breast cancer cases%隐匿性乳腺癌九例临床病理分析

    Institute of Scientific and Technical Information of China (English)

    张昉; 徐虎; 孙林德; 梁妍; 寇德强; 邱镜丹; 钟立森; 高灵灵; 千年松

    2016-01-01

    目的 隐匿性乳腺癌(occult breast cancer,OBC)是一种少见类型的乳腺癌,OBC发病率较低,缺乏大样本的临床研究,因而在诊断和治疗上存在较多争议.本研究回顾性分析9例OBC患者的临床资料,探讨OBC的诊断、治疗及预后.方法 选取解放军总医院2013-08-27-2015-01-23收治的OBC患者9例.患者均为女性,平均年龄50.7岁,中位年龄52岁.本组均因腋下无痛性肿块而就诊,穿刺病理确诊为淋巴结转移性腺癌.6例行乳腺癌改良根治术,3例行腋窝淋巴结清除术.结果 9例患者术后病理均确诊为OBC,3例经全乳连续切片发现原发癌灶.TNM分期:T0N1M05例,T0N2M01例,T0N3M03例.全组9例均获随访,随访时间为11~28个月.除1例死亡外均无瘤生存至今,未见局部复发和远处转移.结论 OBC是乳腺癌的一种特殊类型,发病隐匿,但预后好.以腋下无痛性肿物而就诊的中老年女性应考虑OBC的可能.穿刺病理结合免疫组化可以帮助确诊.乳腺MR是术前筛查乳腺内原发灶的最敏感方法.治疗应以手术为主,术后加做全身的辅助综合治疗.

  16. Ethnic differences in mammographic densities: an Asian cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Shivaani Mariapun

    Full Text Available BACKGROUND: Mammographic density is a strong risk factor for breast cancer and is highly variable, but, to date, few studies have examined density in Asian women, particularly those in low and middle-income Asian countries where genetic and lifestyle determinants may be significantly different. METHODS: A total of 1,240 women who attended an opportunistic mammogram screening programme were eligible for analysis. Mammographic density was estimated using a fully-automated thresholding method and differences across ethnic groups were examined using linear regression in 205 randomly selected Chinese women, 138 Malay and 199 Indian women. RESULTS: Percent density was significantly higher in Chinese women (28.5%; 95% CI 27.0%, 30.0% compared to Malay (24.2%; 95% CI 22.5%, 26.0% and Indian (24.3%; 95% CI 22.8%, 25.7% women (p<0.001, after adjustment for age, BMI, menopausal status, parity and age at first full term pregnancy. Correspondingly, adjusted nondense area was significantly lower in Chinese (72.2cm2; 95% CI 67.9cm2, 76.5cm2 women compared to Malay (92.1cm2; 95% CI 86.9cm2, 97.2cm2 and Indian (97.7cm2; 95% CI 93.4cm2, 101.9cm2 women (p<0.001, but dense area did not differ across the three ethnic groups. CONCLUSIONS: Our study shows that higher percent density and lower nondense area reflect the higher incidence of breast cancer in Chinese compared to Malay and Indian women in Malaysia. Known lifestyle determinants of mammographic density do not fully account for the ethnic variations observed in mammographic density in this Asian cohort.

  17. Application analysis of breast magnetic resonance imaging in occult breast cancer and breast-conserving surgery%乳腺 MRI 在隐匿性乳腺癌和保乳手术中的应用分析

    Institute of Scientific and Technical Information of China (English)

    王芹; 马行天; 石岚

    2014-01-01

    Objective: To discuss application values of breast magnetic resonance imaging (MRI) in occult breast cancer and breast-conserving surgery. Methods: Breast MRI was performed in 120 grouped patients. The examination results were analyzed and summarized. Results: In the 58 cases of occult breast cancer patients with breast MRI, 32 cases were found with breast lesions, in which 19 cases were confirmed by pathology as the original site; the diagnosis rate was 32. 7% . In the 62 cases of breast cancer being performed breast-conserving surgery with breast MRI, multiple lesions was found in 25 cases, in which 23 cases gave up breast-con-serving surgery. Conclusions: Breast MRI has a higher resolution in finding the primary lesion of occult breast cancer, and has impor-tant value in the display of breast cancers with multicentric lesions and the indication of breast-conserving surgery.%目的::探讨乳腺核磁共振成像(MRI)在隐匿性乳腺癌和保乳手术中的应用价值。方法:对120例隐匿性乳腺癌及早期患者进行 MRI 检查,对检查结果进行分析和归纳。结果:入组的58例隐匿性乳腺癌患者 MRI 检查,发现乳腺病灶32例,其中19例经病理证实为原发灶,确诊率为32.7%;入组的62例拟行保乳手术的乳腺癌患者 MRI 检查,有25例发现多中心病灶,其中23例放弃保乳手术。结论:MRI 检查对检出隐匿性乳腺癌原发灶有着有较高的分辨率,对多中心乳腺癌的显示以及明确乳腺癌的保乳适应症,有着重要的临床价值。

  18. Mammographic compression – A need for mechanical standardization

    Energy Technology Data Exchange (ETDEWEB)

    Branderhorst, Woutjan, E-mail: w.branderhorst@amc.nl [Academic Medical Center, Department of Biomedical Engineering & Physics, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Sigmascreening B.V., Meibergdreef 45, 1105 BA Amsterdam (Netherlands); Groot, Jerry E. de, E-mail: jerry.degroot@sigmascreening.com [Academic Medical Center, Department of Biomedical Engineering & Physics, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Highnam, Ralph, E-mail: ralph.highnam@volparasolutions.com [Volpara Solutions Limited, P.O. Box 24404, Manners St Central, Wellington 6142 (New Zealand); Chan, Ariane, E-mail: ariane.chan@volparasolutions.com [Volpara Solutions Limited, P.O. Box 24404, Manners St Central, Wellington 6142 (New Zealand); Böhm-Vélez, Marcela, E-mail: marcelabvelez@gmail.com [Weinstein Imaging Associates, 5850 Centre Avenue, Pittsburgh, PA 15206 (United States); Broeders, Mireille J.M., E-mail: mireille.broeders@radboudumc.nl [Radboud University Medical Center, Department for Health Evidence, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); LRCB Dutch Reference Center for Screening, P.O. Box 6873, 6503 GJ Nijmegen (Netherlands); Heeten, Gerard J. den, E-mail: g.denheeten@lrcb.nl [Academic Medical Center, Department of Radiology, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); LRCB Dutch Reference Center for Screening, P.O. Box 6873, 6503 GJ Nijmegen (Netherlands); Grimbergen, Cornelis A., E-mail: c.a.grimbergen@amc.uva.nl [Academic Medical Center, Department of Biomedical Engineering & Physics, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Sigmascreening B.V., Meibergdreef 45, 1105 BA Amsterdam (Netherlands)

    2015-04-15

    Highlights: •We studied mechanical breast compression practice in two different clinical sites. •We visualized the distributions of not only the applied force but also the pressure. •The applied pressure was highly variable, both within and between the data sets. •The average applied pressure and the variation were higher for smaller breasts. •A proposal for improved individualization, by standardizing pressure, is discussed. -- Abstract: Background: A lack of consistent guidelines regarding mammographic compression has led to wide variation in its technical execution. Breast compression is accomplished by means of a compression paddle, resulting in a certain contact area between the paddle and the breast. This procedure is associated with varying levels of discomfort or pain. On current mammography systems, the only mechanical parameter available in estimating the degree of compression is the physical entity of force (daN). Recently, researchers have suggested that pressure (kPa), resulting from a specific force divided by contact area on a breast, might be a more appropriate parameter for standardization. Software has now become available which enables device-independent cross-comparisons of key mammographic metrics, such as applied compression pressure (force divided by contact area), breast density and radiation dose, between patient populations. Purpose: To compare the current compression practice in mammography between different imaging sites in the Netherlands and the United States from a mechanical point of view, and to investigate whether the compression protocols in these countries can be improved by standardization of pressure (kPa) as an objective mechanical parameter. Materials and methods: We retrospectively studied the available parameters of a set of 37,518 mammographic compressions (9188 women) from the Dutch national breast cancer screening programme (NL data set) and of another set of 7171 compressions (1851 women) from a breast imaging

  19. Presentation of Axillary Metastases from Occult Breast Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Xin Wang

    2007-01-01

    Axillary presentation from occult breast cancer is uncommon and continues to be a diagnostic and therapeutic challenge to physicians.Once the diagnosis of adenocarcinoma metastatic to an axillary lymph node has been confirmed,a preoperative workup should be done.The current experience is based on several relatively small retrospective reviews and case reports.It is difficult to determine the best management of occult breast cancer.However,treatmenl of axillary Iymph node dissection is recommended for local control and complete staging information.Treatment of breast should be a choice between breast conservation with whole-breast radiotherapy and mastectomy.Adjuvant systemic treatment should be offered.

  20. A study of mammographic and thermographic findings in breast diseases

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Won Sik; Jeon, Woo Ki; Kim, Jeong Sook; Han, Chang Yul [Inje University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    The ideal diagnostic methods in breast diseases consist of the physical examination and complementary radiologic examination. In radiologic examination mammography is the most popular screening methods and the older simple complementary method is thermography which is efficient under the conditions of elevated skin temperature in inflammatory and malignant lesions. From Jan. 1st 1987 through Jan. 30th, 1988, 110 pts. with complaints of mammary problems were examined by mammography and thermography at Paik Hospital, Inje University. The authors selected and analyzed 97 cases had been pathologically proved through the operation and the fine needle aspiration biopsy. The results were as follows: 1. The most prevalent age group was 5th decade (40%) in cancer, 4th decade (47%) in mammary dysplasia and followed by fibroadenoma (63%) in 4th decade. 2. The mammographic and thermographic findings were compared between the mammary dysplasia and the infiltrating ductal cancer. In mammary dysplasia abnormal hot emissions were appeared in 9/44 (17%) correlated with atypical hyperchromatic cytoplasm relates to pre-malignant group. 3. We hope and expect the early detection of breast cancer through the follow-up study in pre-malignant group of mammary dysplasia.

  1. Association of occult metastases in sentinel lymph nodes and bone marrow with survival of women with early-stage invasive breast cancer

    Science.gov (United States)

    Giuliano, Armando E.; Hawes, Debra; Ballman, Karla V.; Whitworth, Pat W.; Blumencranz, Peter W.; Reintgen, Douglas S.; Morrow, Monica; Leitch, A. Marilyn; Hunt, Kelly K.; McCall, Linda M.; Abati, Andrea; Cote, Richard

    2017-01-01

    Context Immunochemical staining of sentinel lymph nodes (SLNs) and bone marrow identifies breast cancer metastases not seen with routine pathologic or clinical examination. Objective To determine the association between survival and metastases detected by immunochemical staining of SLNs and bone marrow from patients with early-stage breast cancer. Design, Setting, and Patients From May 1999 to May 2003, 126 sites in the American College of Surgeons Oncology Group Z0010 trial enrolled women with clinical T1–T2, N0, M0 invasive breast carcinoma in a prospective observational study. Interventions All patients underwent breast-conserving surgery and SLN dissection; bone marrow aspiration at the time of operation was initially optional and subsequently mandatory (March 2001). SLN specimens (hematoxylin-eosin negative) and bone marrow specimens were sent to a central laboratory for immunochemical staining; treating clinicians were blinded to results. Main Outcome Measures Overall survival (primary end point) and disease-free survival (a secondary end point). Results Of 5119 (98.3%) SLN specimens, 3904 (76.3%) were tumor-negative by hematoxylin-eosin staining. Of 3326 SLN specimens examined by immunohistochemistry, 349 (10.5%) were tumor-positive. Of 3413 bone marrow specimens examined by immunocytochemistry, 104 (3.0%) were positive. At a median follow-up of 6.3 years (through April 2010), 435 patients had died and 376 had disease recurrence. Immunohistochemical evidence of SLN metastases was not significantly associated with overall survival (5-year rates: 95.7% (95% CI, 95.0%–96.5%) for immunohistochemical positive and 95.1% (95% CI, 92.7%–97.5% for immunohistochemical negative disease, P=0.64), unadjusted hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.59–1.39; P=.64). Bone marrow metastases were associated with decreased overall survival (5-year rates: 95.0% (95% CI, 94.3%–95.8%) and 90.1% (95% CI, 84.5%–96.1%), respectively (P=.01) (unadjusted

  2. Automated effect-specific mammographic pattern measures

    DEFF Research Database (Denmark)

    Raundahl, Jakob; Loog, Marco; Pettersen, Paola;

    2008-01-01

    We investigate the possibility to develop methodologies for assessing effect specific structural changes of the breast tissue using a general statistical machine learning framework. We present an approach of obtaining objective mammographic pattern measures quantifying a specific biological effect......, such as hormone replacement therapy (HRT). We compare results using this approach to using standard density measures. We show that the proposed method can quantify both age related effects and effects caused by HRT. Age effects are significantly detected by our method where standard methodologies fail...

  3. Automated effect-specific mammographic pattern measures.

    Science.gov (United States)

    Raundahl, Jakob; Loog, Marco; Pettersen, Paola; Tanko, Laszlo B; Nielsen, Mads

    2008-08-01

    We investigate the possibility to develop methodologies for assessing effect specific structural changes of the breast tissue using a general statistical machine learning framework. We present an approach of obtaining objective mammographic pattern measures quantifying a specific biological effect, such as hormone replacement therapy (HRT). We compare results using this approach to using standard density measures. We show that the proposed method can quantify both age related effects and effects caused by HRT. Age effects are significantly detected by our method where standard methodologies fail. The separation of HRT subpopulations using our approach is comparable to the best methodology, which is interactive.

  4. BI-RADS CATEGORIZATION AND POSITIVE PREDICTIVE VALUE OF MAMMOGRAPHIC FEATURES

    Institute of Scientific and Technical Information of China (English)

    TANG; Rui-ying

    2001-01-01

    [1]American College of Radiology (ACR). Breast imaging reporting and data system (BI-RADS) [M]. 3rd ed. Reston, VA: American College of Radiology, 1998.[2]Laura L, Andrea FA, Fredric BS, et al. The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories [J]. AJR 1998; 171:35.[3]Susan GO, Nicole K, Carol R, et al. BI-RADS categorization as a predictor of malignancy [J]. Radiology 1999; 211:845.[4]Jay AB, Phyllis JK, Carey EF. Breast imaging reporting and data system standardized mammography lexicon: observer variability in lesion description [J]. AJR 1996; 166:773.[5]Berg WA, Campassi, Sexton MJ, et al. Analysis of sources of variation in mammographic interpretation [J]. Radiology 1997; 205:447.[6]Daniel BK. Standardized mammography reporting [J]. Radiologic Clinics of North America 1992; 30:257.[7]Jay AB, Phyllis JK, Joseph YL, et al. Breast cancer: prediction with artificial neural network based on BI-RADS standardized lexicon [J]. Radiology 1995; 196:817.[8]Berube M, Curpen B, Ugolini P, et al. Level of suspicion of a mammographic lesion: use of features defined by BI-RADS lexicon and correlation with large core breast biopsy [J]. Can Assoc Radiol J 1998; 49:223.

  5. A novel phantom system facilitating better descriptors of density within mammographic images

    Science.gov (United States)

    Li, Yanpeng; Brennan, Patrick C.; Nickson, Carolyn; Pietrzyk, Mariusz W.; Al Mousa, Dana; Ryan, Elaine

    2013-03-01

    High mammographic density is a risk factor for breast cancer. As it is impossible to measure actual weight or volume of fibroglandular tissue evident within a mammogram, it is hard to know the correlation between measured mammographic density and the actual fibroglandular tissue volume. The aim of this study is to develop a phantom that represents glandular tissue within an adipose tissue structure so that correlations between image feature descriptors and the synthesised glandular structure can be accurately quantified. In this phantom study, ten different weights of fine steel wool were put into gelatine to simulate breast structure. Image feature descriptors are investigated for both the whole phantom image and the simulated density. Descriptors included actual area and percentage area of density, mean pixel intensity for the whole image and dense area, standard deviation of mean intensity, and integrated pixel density which is the production of area and mean intensity. The results show high level correlation between steel-wool weight and percentage density measured on images (r = 0.8421), and the integrated pixel density of dense area (r = 0.8760). The correlation is significant for mean intensity standard deviation for the whole phantom (r = 0.8043). This phantom study may help identify more accurate descriptors of mammographic density, thus facilitating better assessments of fibroglandular tissue appearances.

  6. Discussion on occult breast cancer in diagnosis and treatment with 17 cases%隐匿性乳腺癌17例患者的诊治分析

    Institute of Scientific and Technical Information of China (English)

    崔伟; 宋振迪; 崔童星; 李杨

    2012-01-01

    Objective: To explore the method of clinical features, diagnosis and treatment of occult breast cancer. Methods: The treatment effectiveness of 17 occult breast cancer patients data were analyzed retrospectively. Results: There were 5 suspicious patients in 17 who have received ultrasound examination, 4 suspicious patients in 7 who have received enhanced MRI of breast examination. Only 1 suspicious case in the patients who accepted PET-CT at the same time. Post-operatively 10 in 13 patients found breast cancer original nidus (3-9mm). During 7 years follow-up, 9 months later, 1 patient who only received axillary lymph nodes dissection found the original nidus which diameter was 11mm, when receive the B-ultrasound examination. Because the patient had received radiotherapy, she only received mastectomy without chemotherapy. 13 months later, she found liver metastasis, 7 months later she died. 1 patient was died of brain metastasis. Conelu sion: As special type, occult breast cancer had the characteristics in the diagnosis. Looking for primary tumors was still difficult. Enhanced MRI has certain advantages in diagnose. PET-CT did not appear certain advantages compared with the MRI.For those who could not be found primary tumors, the better surgy therapy is modified radical mastectomy .Although occult breast cancer prognosis is better, its treatment should base on the NCCN guidelines- advances in multimodaiity therapy of breast cancer.%目的:探讨隐匿性乳腺癌的临床特点及诊治方法.方法:对17例隐匿性乳腺癌患者的临床资料及疗效进行回颜性分析.结果:17例超声检查中5例发现可疑病灶.7例接受乳腺强化MRI检查者4例发现可疑病灶.同时接受的PET-CT检查者仅1例发现可疑病灶.术后13例患者中10例找到乳腺癌原发灶(3 ~9 mm),随访1~7年,1例仅行腋窝淋巴结清除的患者于术后9个月超声检查时发现乳腺原发病灶,病灶直径11 mm,由于患者接受过全乳放疗,因此行

  7. 全数字化乳腺X线摄影诊断临床隐匿型乳腺癌的价值%Full-field Digital Mammography Diagnosis of the Clinical Value of Occult Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    刘明霞; 张蕾; 刘琳; 韩英

    2011-01-01

    Objective: To explore the digital mammography X-ray photography of occult breast cancer diagnosis. Methods: A retrospective analysis of 21 cases of pathologically confirmed, clinical palpation-negative breast cancer. All patients were using the all-digital breast X-ray image. Results: 21 cases were found in 23 lesions, including malignant calcification in 6 cases of pure, micro-nodules or asymmetric dense shadow with calcification in 11 cases, micro-nodules with glitches in 2 cases, 2 cases of asymmetric dense shadow and partial structural disorder and two cases. Conclusion: The all-digital breast X-ray photography to clearly show the structure at all levels of the breast, in particular, malignant calcification was found high sensitivity for occult breast cancer was found of great value.%目的:探讨全数字化乳腺X线摄影对临床隐匿性乳癌的诊断价值.方法:回顾性分析临床扪诊阴性,手术病理证实乳腺癌12例.全部病例均使用全数字化乳腺X线摄影.结果:12例病例发现病灶12个,其中单纯钙化7例,微结节或结构紊乱伴微钙化3例,微结节伴毛刺1例,局部结构紊乱1例.结论:全数字化乳腺X线摄影能清晰显示乳房各个层次结构,尤其发现恶性钙化敏感性高,对发现临床隐匿型乳腺癌具有重大价值.

  8. Kuiper Belt Occultation Predictions

    CERN Document Server

    Fraser, Wesley C; Trujillo, Chad; Stephens, Andrew W; Kavelaars, JJ; Brown, Michael E; Bianco, Federica B; Boyle, Richard P; Brucker, Melissa J; Hetherington, Nathan; Joner, Michael; Keel, William C; Langill, Phil P; Lister, Tim; McMillan, Russet J; Young, Leslie

    2013-01-01

    Here we present observations of 7 large Kuiper Belt Objects. From these observations, we extract a point source catalog with $\\sim0.01"$ precision, and astrometry of our target Kuiper Belt Objects with $0.04-0.08"$ precision within that catalog. We have developed a new technique to predict the future occurrence of stellar occultations by Kuiper Belt Objects. The technique makes use of a maximum likelihood approach which determines the best-fit adjustment to cataloged orbital elements of an object. Using simulations of a theoretical object, we discuss the merits and weaknesses of this technique compared to the commonly adopted ephemeris offset approach. We demonstrate that both methods suffer from separate weaknesses, and thus, together provide a fair assessment of the true uncertainty in a particular prediction. We present occultation predictions made by both methods for the 7 tracked objects, with dates as late as 2015. Finally, we discuss observations of three separate close passages of Quaoar to field star...

  9. The Halogen Occultation Experiment

    Science.gov (United States)

    Russell, James M., III; Gordley, Larry L.; Park, Jae H.; Drayson, S. R.; Hesketh, W. D.; Cicerone, Ralph J.; Tuck, Adrian F.; Frederick, John E.; Harries, John E.; Crutzen, Paul J.

    1993-01-01

    The Halogen Occultation Experiment (HALOE) uses solar occultation to measure vertical profiles of O3, HCl, HF, CH4, H2O, NO, NO2, aerosol extinction, and temperature versus pressure with an instantaneous vertical field of view of 1.6 km at the earth limb. Latitudinal coverage is from 80 deg S to 80 deg N over the course of 1 year and includes extensive observations of the Antarctic region during spring. The altitude range of the measurements extends from about 15 km to about 60-130 km, depending on channel. Experiment operations have been essentially flawless, and all performance criteria either meet or exceed specifications. Internal data consistency checks, comparisons with correlative measurements, and qualitative comparisons with 1985 atmospheric trace molecule spectroscopy (ATMOS) results are in good agreement. Examples of pressure versus latitude cross sections and a global orthographic projection for the September 21 to October 15, 1992, period show the utility of CH4, HF, and H2O as tracers, the occurrence of dehydration in the Antarctic lower stratosphere, the presence of the water vapor hygropause in the tropics, evidence of Antarctic air in the tropics, the influence of Hadley tropical upwelling, and the first global distribution of HCl, HF, and NO throughout the stratosphere. Nitric oxide measurements extend through the lower thermosphere.

  10. Occult pneumothorax, revisited

    Directory of Open Access Journals (Sweden)

    Mangar Devanand

    2010-10-01

    Full Text Available Abstract Pneumothorax is a recognized cause of preventable death following chest wall trauma where a simple intervention can be life saving. In cases of trauma patients where cervical spine immobilization is mandatory, supine AP chest radiograph is the most practical initial study. It is however not as sensitive as CT chest for early detection of a pneumothorax. "Occult" pneumothorax is an accepted definition of an existing but usually a clinically and radiologically silent disturbance that in most patients can be tolerated while other more urgent trauma needs are attended to. However, in certain patients, especially those on mechanical ventilation (with subsequent increase of intrapleural air with positive pressure ventilation, missing the diagnosis of pneumothorax can be deleterious with fatal consequences. This review will discuss the occult pneumothorax in the context of 3 radiological examples, which will further emphasize the entity. Because a negative AP chest radiograph can dangerously delay its recognition, we recommend that any trauma victim presenting to the emergency department with symptoms of respiratory distress should be screened with either thoracic ultrasonography or chest CT scan to avoid missing a pneumothorax.

  11. Application of breast mammography in the diagnosis and treatment of occult breast cancer%浅谈乳腺钼靶X线检查在诊治隐性乳腺癌中的应用

    Institute of Scientific and Technical Information of China (English)

    李文志; 段海瑜; 邱红玲

    2014-01-01

    目的:探讨分析乳腺钼靶X线检查在诊治隐性乳腺癌中的临床应用价值。方法:选取2009年9月至2010年9月间我院收治的隐性乳腺癌患者15例作为研究对象,对其进行乳腺钼靶X线检查,并将检查结果及所有患者的临床资料进行回顾性的分析。结果:经乳腺钼靶X线检查,在这15例患者中,被确诊患有乳腺癌的患者有10例,确诊率为66.7%。术后,对所有患者进行随访,随访的时间为6个月~4年,其中死亡的患者有6例,存活期为3年的患者有9例,患者的生存率为60.0%。在6例死亡患者中,有2例患者在术后半年死于肺部感染,另外4例患者死于癌转移。结论:乳腺钼靶X线检查在诊治隐性乳腺癌中具有非常重要的临床应用价值,值得在临床上进一步推广应用。%Objective: To observe and analyze the breast mammography clinical value in the diagnosis and treatment of occult breast cancer . Methods: Our hospital from September 2009 to September 2010 were treated 15 cases of occult breast cancer patients for the study, its molybdenum target X-ray photography data were retrospectively analyzed .Results: Patients diagnosed with breast mammography has 10 cases , the diagnosis was 66.7%. And glandular mammography image clarity and excellent quality. Outpatient surgery for all patients followed up for a minimum of six months and up to four years , of which 6 died , survived 3 years in 9 patients , the survival rate was 60.0%. 6 deaths of patients , 2 patients died of lung infection at six months after surgery , and four patients died of cancer metastasis.Conclusion: The incidence of clinically occult breast cancer is low , prone to misdiagnosis and missed diagnosis of the situation , breast mammography in the diagnosis and treatment of occult breast cancer , with a high clinical value for the further treatment of the disease can provide important reference .

  12. Association between Mammographic Breast Density and Lifestyle in Japanese Women

    Directory of Open Access Journals (Sweden)

    Komoike,Yoshifumi

    2013-06-01

    Full Text Available A high mammographic breast density is considered to be a risk factor for breast cancer. However, only a small number of studies on the association between breast density and lifestyle have been performed. A cross-sectional study was performed using a survey with 29 questions on life history and lifestyle. The breast density on mammography was classified into 4 categories following the BI-RADS criteria. The subjects were 522 women with no medical history of breast cancer. The mean age was 53.3 years old. On multivariate analysis, only BMI was a significant factor determining breast density in premenopausal women (parameter estimate, -0.403;p value, 0.0005, and the density decreased as BMI rose. In postmenopausal women, BMI (parameter estimate, -0.196;p value, 0.0143 and number of deliveries (parameter estimate, -0.388;p value, 0.0186 were significant factors determining breast density;breast density decreased as BMI and number of deliveries increased. Only BMI and number of deliveries were identified as factors significantly influencing breast density. BMI was inversely correlated with breast density before and after menopause, whereas the influence of number of deliveries on breast density was significant only in postmenopausal women in their 50 and 60s.

  13. Calcified trichinosis of pectoral muscle: mammographic appearance

    Energy Technology Data Exchange (ETDEWEB)

    Apesteguia, L. [Servicio de Radiologia, Hospital Virgen del Camino, Pamplona (Spain); Murillo, A. [Servicio de Radiologia, Hospital Virgen del Camino, Pamplona (Spain); Biurrun, J. [Servicio de Radiologia, Hospital Virgen del Camino, Pamplona (Spain); Garcia-Rostan, G. [Servicio Anatomia Patologica, Hospital Virgen del Camino, Pamplona (Spain); Reta, A. [Servicio de Analisis Clinicos, Hospital Virgen del Camino, Pamplona (Spain); Dominguez, F. [Servicio Cirugia, Hospital Virgen del Camino, Pamplona (Spain)

    1995-12-31

    By mammographic screening we had detected six asymptomatic women who showed numerious tiny and well-delineated round to ovoid microcalcification superimposed on pectoral shadows, in the oblique medio-lateral (OML) view. Our objective was to achieve a better evaluation of these calcifications and investigate their origin. Magnified mammograms of pectoral muscles were done in the six women. A questionnaire concerning the patients` diets was also administered. Trichinella antibody titres were quantified by sero-agglutination. Microcalcifications within pectoral muscle fibres were demonstrated in all the cases. Five women admitted to having eaten home-made pork products in the past. One of them showed a slightly elevated antibody titre. We confirmed the suspected diagnosis of calcified trichinosis by a surgical biopsy of the pectoral muscle performed on one of the patients. We conclude that chronic calcified trichinosis of the pectoral muscle can be visualised in the OML view of a conventional mammogram. The mammographic appearance of this entity is very characteristic and biopsy would not be required for its diagnosis in the future. (orig.)

  14. Mammographic and sonographic features of tuberculous mastitis

    Energy Technology Data Exchange (ETDEWEB)

    Sakr, Ayman A. E-mail: fahmi.sakr@link.netaymansakr12345@hotmail.com; Fawzy, Rawya K.; Fadaly, Gylan; Baky, Moustafa Abdel

    2004-07-01

    From December 1999 to April 2001, 10 cases of tuberculous mastitis were presented to the Radiology Unit at the Medical Research Institute of Alexandria University for mammographic and sonographic evaluation. Sixty percent presented with masses, 50% mastalgia, 40% discharge, and 10% complained of skin sinus. In 30% of the patients the complaint was bilateral. All cases underwent full mammographic and ultrasonographic (US) studies, and US-guided fine needle aspiration. Also pathological, bacteriological analysis, and polymerase chain reaction (PCR) were done to all patients to prove the tuberculous nature of their lesions. Thirty percent of the cases had surgical excision on their masses. On mammography 30% were found to have mass lesion mimicking malignant tumors, 40% smooth bordered masses, 40% axillary or intramammary adenopathy, 30% asymmetric density, 30% duct ectasia, 20% with skin thickening and nipple retraction, 20% with macrocalcification, and 10% with skin sinus. On US 60% had hypoechoic masses, 40% focal or sectorial duct ectasia, and 50% axillary adenopathy. History of tuberculosis was found in 30% of the cases. Chest X-ray was positive in 20% and breast magnetic resonance imaging was done to one patient who had skin sinus.

  15. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Jørgensen, Karsten Juhl

    2013-01-01

    A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary.......A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary....

  16. Occult intracranial injury in infants.

    Science.gov (United States)

    Greenes, D S; Schutzman, S A

    1998-12-01

    The objectives of this study were as follows: (1) to determine whether clinical symptoms and signs of brain injury are sensitive indicators of intracranial injury (ICI) in infants admitted with head trauma, (2) to describe the clinical characteristics of infants who have ICI in the absence of symptoms and signs of brain injury, and (3) to determine the clinical significance of those ICIs diagnosed in asymptomatic infants. We conducted a retrospective analysis of all infants younger than 2 years of age admitted to a tertiary care pediatric hospital with acute ICI during a 6(1/2)-year period. Infants were considered symptomatic if they had loss of consciousness, history of behavior change, seizures, vomiting, bulging fontanel, retinal hemorrhages, abnormal neurologic examination, depressed mental status, or irritability. All others were considered to have occult ICI. Of 101 infants studied, 19 (19%; 95% confidence interval [CI] 12%, 28%) had occult ICI. Fourteen of 52 (27%) infants younger than 6 months of age had occult ICI, compared with 5 of 34 (15%) infants 6 months to 1 year, and none of 15 (0%) infants older than 1 year. Eighteen (95%) infants with occult ICI had scalp contusion or hematoma, and 18 (95%) had skull fracture. Nine (47%) infants with occult ICI received therapy for the ICI. No infants with occult ICI (0%) (95% CI 0, 14%) required surgery or medical management for increased intracranial pressure. Only 1 subject (5%) with occult ICI had any late symptoms or complications: a brief, self-limited convulsion. We found that 19 of 101 ICIs in infants admitted with head trauma were clinically occult. All 19 occult ICIs occurred in infants younger than 12 months of age, and 18 of 19 had skull fractures. None experienced serious neurologic deterioration or required surgical intervention. Physicians cannot depend on the absence of clinical signs of brain injury to exclude ICI in infants younger than 1 year of age.

  17. Genotypes and haplotypes in the insulin-like growth factors, their receptors and binding proteins in relation to plasma metabolic levels and mammographic density

    Directory of Open Access Journals (Sweden)

    Chanock Stephen J

    2010-03-01

    Full Text Available Abstract Background Increased mammographic density is one of the strongest independent risk factors for breast cancer. It is believed that one third of breast cancers are derived from breasts with more than 50% density. Mammographic density is affected by age, BMI, parity, and genetic predisposition. It is also greatly influenced by hormonal and growth factor changes in a woman's life cycle, spanning from puberty through adult to menopause. Genetic variations in genes coding for hormones and growth factors involved in development of the breast are therefore of great interest. The associations between genetic polymorphisms in genes from the IGF pathway on mammographic density and circulating levels of IGF1, its binding protein IGFBP3, and their ratio in postmenopausal women are reported here. Methods Samples from 964 postmenopausal Norwegian women aged 55-71 years were collected as a part of the Tromsø Mammography and Breast Cancer Study. All samples were genotyped for 25 SNPs in IGF1, IGF2, IGF1R, IGF2R, IGFALS and IGFBP3 using Taqman (ABI. The main statistical analyses were conducted with the PROC HAPLOTYPE procedure within SAS/GENETICS™ (SAS 9.1.3. Results The haplotype analysis revealed six haploblocks within the studied genes. Of those, four had significant associations with circulating levels of IGF1 or IGFBP3 and/or mammographic density. One haplotype variant in the IGF1 gene was found to be associated with mammographic density. Within the IGF2 gene one haplotype variant was associated with levels of both IGF1 and IGFBP3. Two haplotype variants in the IGF2R were associated with the level of IGF1. Both variants of the IGFBP3 haplotype were associated with the IGFBP3 level and indicate regulation in cis. Conclusion Polymorphisms within the IGF1 gene and related genes were associated with plasma levels of IGF1, IGFBP3 and mammographic density in this study of postmenopausal women.

  18. Advances in Fecal Occult Blood Tests: The FIT Revolution

    NARCIS (Netherlands)

    G.P. Young; E.L. Symonds (Erin L.); J.E. Allison (James E.); S.R. Cole (Stephen R.); C.G. Fraser (Callum G.); S. Halloran (S.); E.J. Kuipers (Ernst); H.E. Seaman (Helen E.)

    2015-01-01

    textabstractThere is a wide choice of fecal occult blood tests (FOBTs) for colorectal cancer screening. Goal: To highlight the issues applicable when choosing a FOBT, in particular which FOBT is best suited to the range of screening scenarios. Four scenarios characterize the constraints and expectat

  19. Rastreamento mamográfico do câncer de mama em serviços de saúde públicos e privados Breast cancer mammographic screening in public and private health care systems

    Directory of Open Access Journals (Sweden)

    Ailton Augustinho Marchi

    2006-04-01

    Full Text Available OBJETIVO: avaliar a utilização da mamografia no rastreamento do câncer de mama em serviços de saúde públicos e privados. MÉTODOS: realizou-se estudo seccional entrevistando-se 643 mulheres submetidas à mamografia na cidade de Taubaté, região Sudeste do Brasil: 472 atendidas em serviços de saúde públicos e 171 em serviços privados. Avaliaram-se, por meio dos testes de chi2, exato de Fisher e Wilcoxon, o perfil sociodemográfico e reprodutivo das entrevistadas e características de utilização da mamografia, tais como, a proporção de entrevistadas previamente rastreadas, a idade de início do rastreamento, o intervalo e a freqüência entre as mamografias realizadas. RESULTADOS: as médias de idade das entrevistadas em ambos os grupos foram similares. As proporções de mulheres previamente rastreadas - respectivamente 54,2 e 79,5% em serviços públicos e privados - assim como a idade de início desse rastreamento - 46,8 anos (DP 10,2 nos serviços públicos e 40,2 anos (DP 7,7 nos privados - diferiram significativamente (pPURPOSE: to evaluate the characteristics of mammography use and the social demographic profile of women accessing public and private health care services. METHODS: a cross-sectional study was carried out in the city of Taubaté, southeast Brazil. Six hundred and forty-three women who underwent mammographic examinations in the available health care services were interviewed, 472 of them in public and 171 in private health services. The social demographic and reproductive profiles of the women interviewed and the characteristics of the mammography use, such as the proportion of the women interviewed who had been previously screened, the age when the screening began, the interval between the screenings and their frequency, were evaluated by means of the Fisher exact, Wilcoxon and chi2 tests. RESULTS: the mean age of the interviewed women was similar in both studied groups. The proportion of women previously

  20. Analysis of 193 Mammographic phantom images

    Energy Technology Data Exchange (ETDEWEB)

    Son, Eun Ju; Kim, Eun Kyung; Ko, Kyung Hee; Kim, Young Ah; Oh, Ki Keun [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of); Chung, Sun Yang [College of Medicine, Pochon CHA Univ., Pochon (Korea, Republic of); Kim, Hyuk Joo; Cha, Seung Hwan [Korea Food and Drug Administration, Seoul (Korea, Republic of)

    2003-11-01

    To evaluate the actual state of quality control in Korea through analysis of mammographic phantom images obtained from a multicenter, and to determine the proper exposure conditions required in order to obtain satisfactory phantom images. Between April and June, 2002, 193 phantom images were referred to the Korea Food and Drug Administration for evaluation. Two radiologists recorded the number of fibers, specks and masses they contained, and the 'pass' criteria were as follows: checked number of fibers: four or more; specks, three or more; masses, three or more (a total of ten or more features). Images in which optical density was over 1.2 were classified as satisfactory. In addition, changes in the success ratio, and difference between the two groups (i.e. 'pass' and 'fail', with regard to exposure conditions and optical density) were evaluated. Among the 193 images, 116 (60.1%) passed and 77 (39.9%) failed. Among those which passed, 73/100 (73%) involved to use of a grid, 80/117 (68.3%) were obtained within the optimal kVp range, 50/111 (45.0%) involved the use of optimal mAs, and 79/112 (70.5%) were obtained within the optimal range of optical density. Among those which failed, the corresponding figures were 17/52 (32.6%), 33/66 (50.0%), 31/69 (44.9%), and 35/65 (53.8%), There were statistically significant differences between the pass and fail rates, and with regard to kVp, optical density, and the use of a grid, but with regard to mAs, statistical differences were not significant. If only phantom images with an optical density of over 1.2 [as per the rule of the Mammographic Quality Standard Act (MQSA)] was included, the success rate would fall from 60.1% to 43.0%. The pass rate for mammographic phantom images was 60.1%. If such images are to be satisfactory, they should be obtained within the optimal range of optical density, using optimal kVp and a grid.

  1. The Occult: Diabolica to Alchemists

    Science.gov (United States)

    Delaney, Oliver J.

    1971-01-01

    The 91 items in this bibliography deal with works of occult science. The material is subdivided into biographies, dictionaries, encyclopedias, handbooks, noteworthy histories, indices, annuals, and a few miscellany works with treatises. (95 references) (Author)

  2. Treatment outcomes of occult breast carcinoma and prognostic analyses

    Institute of Scientific and Technical Information of China (English)

    WANG Jing; ZHANG Ye-fan; WANG Xin; WANG Jian; YANG Xue; GAO Yin-qi; FANG Yi

    2013-01-01

    Background The surgical management of occult breast cancer is controversial.We compared the outcomes of different treatments of occult breast cancer and evaluated the potential prognostic factors for overall survival and recurrence.Methods We retrospectively reviewed 77 patients who presented to our hospital from 1968 to 2011 with a diagnosis of occult breast cancer.Patients were divided into three groups:42 patients (63%) were treated with modified radical mastectomy+axillary lymph node dissection (ALND),16 patients (24%) were treated with ALND+postoperative radiotherapy,and 9 patients (13%) with only ALND.Survival analyses were undertaken to compare the efficacy of these three treatments.Results Of the 77 patients with occult breast cancer,2 patients were lost to follow-up and 8 patients refused surgical treatment:67 patients (90.4%) were included in this analysis.The median follow-up was 62.2 (0.6-328.0)months.Kaplan-Meier analyses showed no significant difference in overall survival and recurrence-free survival between the three groups (P=0.494 and 0.397,respectively).The prevalence of local recurrence was 11.9% for the mastectomy+ALND,18.8% for ALND+radiotherapy,and 11.1% for ALND-only groups,and those for distant recurrence were 2.4%,12.5%,and 11.1%,respectively.Compared with progesterone receptor-negative subjects,progesterone receptor-positive patients had better overall survival and lower recurrence rates (P=0.057 and 0.062,respectively).Conclusions There was no significant difference in outcomes between mastectomy and breast-preserving surgery.Expression of the progesterone receptor should be taken into account when evaluating the prognosis of occult breast cancer.

  3. CLASSIFICATION OF MAMMOGRAPHIC MASSES USING FUZZY INFERENCE SYSTEM

    Directory of Open Access Journals (Sweden)

    K. Divyadarshini

    2015-10-01

    Full Text Available Computer aided detection (CAD intends to provide assistance to the mammography detection, reducing breast cancer misdiagnosis, thus allowing better diagnosis and more efficient treatments. In this work the task of automatically classifying the mass tissue into Breast Imaging Reporting and Data System (BI-RADS shape categories: round, oval, lobular, irregular and also as benign or malignant is investigated. Geometrical shape and margin features based on maximum and minimum radius of mass are used in this work to classify the masses. These geometric features are found to be good in discriminating regular shapes from irregular shapes. For the purpose of classification, the masses are segmented from the mammogram using gray level thresholding. Finally, the classification is performed using fuzzy inference system. The fuzzy rules are used to construct the generalized fuzzy membership function for classifying the shape and severity of masses. The images were collected from Mammographic Image Analysis Society (MIAS Database and Digital Database for Screening Mammography (DDSM. The experiments were implemented in MATLAB.

  4. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    Directory of Open Access Journals (Sweden)

    Ana Laura Calderón-Garcidueñas

    2012-01-01

    Full Text Available Breast density (BD is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate ( and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170, fibroglandular 29% (87, heterogeneously dense 5.7% (17, and dense pattern 8.6% (26. Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117 and older than 50 (68.8%, 126/183. Patterns of high breast density (BD (dense + heterogeneously dense were observed in 25.6% (30/117 of women ≤50 years and 7.1% (13/183 of women >50. Asymmetry in BD was observed in 22% (66/300. Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300 of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300 of cases, vascular calcification in 150 cases (78.9%, and fat necrosis in 38 cases (20%. Conclusions. Mexican women have a low percentage of high-density patterns.

  5. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Sanabria-Mondragón, Mónica; Hernández-Beltrán, Lourdes; López-Amador, Noé; Cerda-Flores, Ricardo M.

    2012-01-01

    Breast density (BD) is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate (χ 2) and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170), fibroglandular 29% (87), heterogeneously dense 5.7% (17), and dense pattern 8.6% (26). Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117) and older than 50 (68.8%, 126/183). Patterns of high breast density (BD) (dense + heterogeneously dense) were observed in 25.6% (30/117) of women ≤50 years and 7.1% (13/183) of women >50. Asymmetry in BD was observed in 22% (66/300). Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300) of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300) of cases, vascular calcification in 150 cases (78.9%), and fat necrosis in 38 cases (20%). Conclusions. Mexican women have a low percentage of high-density patterns. PMID:23346398

  6. [Occult hepatitis C virus infection].

    Science.gov (United States)

    Carreño García, Vicente; Nebreda, Javier Bartolomé; Aguilar, Inmaculada Castillo; Quiroga Estévez, Juan Antonio

    2011-03-01

    Occult hepatitis C virus (HCV) infection is characterized by the detection of HCV-RNA in liver in the absence of anti-HCV and serum HCV-RNA determined by conventional techniques. The development of a new enzyme immunoassay for the detection of antibodies against a conserved epitope in the HCV core protein, together with the detection of HCV-RNA in peripheral blood mononuclear cells and in serum after concentrating the viral particles by ultracentrifugation, allow diagnosis of more than 90% of patients with occult HCV without the need to perform a liver biopsy. Histological damage in occult HCV infection ranges from minimal changes to liver cirrhosis and hepatocellular carcinoma, although in general this disease is less severe than classical chronic hepatitis C. A significant prevalence of occult HCV infection has been identified in risk groups such as hemodialysis patients and the family members of patients with occult hepatitis C. This occult HCV infection can also be found in subjects without clinical or biochemical evidence of liver disease. Copyright © 2011 Elsevier España S.L. All rights reserved.

  7. Childhood body size and pubertal timing in relation to adult mammographic density phenotype.

    Science.gov (United States)

    Schoemaker, Minouk J; Jones, Michael E; Allen, Steven; Hoare, Jean; Ashworth, Alan; Dowsett, Mitch; Swerdlow, Anthony J

    2017-02-07

    An earlier age at onset of breast development and longer time between pubertal stages has been implicated in breast cancer risk. It is not clear whether associations of breast cancer risk with puberty or predictors of onset of puberty, such as weight and height, are mediated via mammographic density, an important risk factor for breast cancer. We investigated whether childhood body size and pubertal timing and tempo, collected by questionnaire, are associated with percentage and absolute area mammographic density at ages 47-73 years in 1105 women recruited to a prospective study. After controlling for adult adiposity, weight at ages 7 and 11 years was strongly significantly inversely associated with percentage and absolute dense area (p trend density (p trend = 0.016). Later age at menarche and age at when regular periods were established was associated with increased density, but additional adjustment for childhood weight attenuated the association. A longer interval between thelarche and menarche, and between thelarche and regular periods, was associated with increased dense area, even after adjusting for childhood weight (p trend = 0.013 and 0.028, respectively), and was independent of age at pubertal onset. Greater prepubertal weight and earlier pubertal onset are associated with lower adult breast density, but age at pubertal onset does not appear to have an independent effect on adult density after controlling for childhood adiposity. A possible effect of pubertal tempo on density needs further investigation.

  8. Metabolic syndrome, insulin resistance, and mammographic density in pre- and postmenopausal women.

    Science.gov (United States)

    Kim, Bo-Kyoung; Chang, Yoosoo; Ahn, Jiin; Jung, Hyun-Suk; Kim, Chan-Won; Yun, Kyung Eun; Kwon, Min-Jung; Suh, Byung-Seong; Chung, Eun Chul; Shin, Hocheol; Ryu, Seungho

    2015-09-01

    Little is known about the association of metabolic syndrome (MetS) or insulin resistance (IR) with mammographic density, a strong risk factor for breast cancer. The goal of this study was to evaluate these associations in pre- and postmenopausal women. A cross-sectional study was performed in 73,974 adult women who underwent a comprehensive health screening examination that included a mammogram between 2011 and 2013 (mean age 42.6 years). MetS was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III. IR was assessed with the homeostasis model assessment-insulin resistance (HOMA-IR). Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for dense breast were estimated using logistic regression models after adjustment for potential confounders. In premenopausal women, MetS and all its components except waist circumference were associated with dense breast. After adjustment for potential confounders, the OR (95% CI) for dense breast in women with MetS compared with those without MetS was 1.22 (1.06-1.39). In postmenopausal women, however, there was positive but non-significant association between MetS and dense breast. In both pre- and postmenopausal women, high blood glucose and IR were positively associated with dense breast. The OR (95% CI) for dense breast between the highest and lowest quartiles of HOMA-IR was 1.29 (1.20-1.39) for premenopausal women and 1.44 (1.05-1.97) for postmenopausal women. In a large sample of Korean women, MetS and IR were associated with mammographic dense breast, demonstrating that IR, a potentially modifiable risk factor, may increase breast cancer risk, possibly through high mammographic density.

  9. Occult Invasive Lobular Carcinoma of Breast Detected by Stomach Metastasis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    KIm, So Jung; Jung, Hae Kyoung; Ko, Kyung Hee; Yoon, Jung Hyun [Dept. of Radiology, Bundang CHA general Hospital, CHA University College of Medicine, Seongnam (Korea, Republic of)

    2012-02-15

    Gastric metastasis from primary breast cancer is a rare phenomenon that is more prevalent in the invasive lobular type of breast cancer. We describe a very rare case of occult invasive lobular cancer of the breast detected by the initial presentation of gastric metastasis in a patient without a history of breast cancer. A 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) which showed increased FDG uptake in the stomach, abdominal mesentery and the right breast, and played pivotal roles in the detection of occult primary breast cancer and a diagnosis of gastric metastasis as an ancillary method for obtaining histological results and immunohistochemical stains.

  10. Effects of menopausal hormonal therapy on occult breast tumors.

    Science.gov (United States)

    Santen, Richard J; Song, Yan; Yue, Wei; Wang, Ji-Ping; Heitjan, Daniel F

    2013-09-01

    An estimated 7% of 40-80 year old women dying of unrelated causes harbor occult breast tumors at autopsy. These lesions are too small to be detected by mammography, a method which requires tumors to be approximately 1cm in diameter to be diagnosed. Tumor growth rates, as assessed by "effective doubling times" on serial mammography range from 10 to >700 days with a median of approximately 200 days. We previously reported two models, based on iterative analysis of these parameters, to describe the biologic behavior of undiagnosed, occult breast tumors. One of our models is biologically based and includes parameters of a 200 day effective doubling time, 7% prevalence of occult tumors in the 40-80 aged female population and a detection threshold of 1.16 cm and the other involves computer based projections based on age related breast cancer incidence. Our models facilitate interpretation of the Women's Health Initiative (WHI) and anti-estrogen prevention studies. The biologically based model suggests that menopausal hormone therapy with conjugated equine estrogens plus medroxyprogesterone acetate (MPA) in the WHI trial primarily promoted the growth of pre-existing, occult lesions and minimally initiated de novo tumors. The paradoxical reduction of breast cancer incidence in women receiving estrogen alone is consistent with a model that this hormone causes apoptosis in women deprived of estrogen long term as a result of the cessation of estrogen production after the menopause. Understanding of the kinetics of occult tumors suggests that breast cancer "prevention" with anti-estrogens or aromatase inhibitors represents early treatment rather than a reduction in de novo tumor formation. Our in vivo data suggest that the combination of a SERM, bazedoxifene (BZA), with conjugated equine estrogen (CEE) acts to block maturation of the mammary gland in oophorectomized, immature mice. This hormonal combination is defined by the generic term, tissue selective estrogen complex or

  11. Home Use Tests: Fecal Occult Blood

    Science.gov (United States)

    ... Procedures In Vitro Diagnostics Home Use Tests Fecal Occult Blood Share Tweet Linkedin Pin it More sharing ... test kit to measure the presence of hidden (occult) blood in your stool (feces). What is fecal ...

  12. Malignant Lesions as Mammographically Appearing Intramammary Ganglia; Lesiones malignas con apariencia mamografica de ganglios intramamarios

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Miraveta, P.; Pons, M. J.; Pina, L. J.; Zornoza, G. [Clinica Universitaria de Navarra. Pamplona (Spain)

    2004-07-01

    Intramammary ganglia are frequent mammographic findings of no pathological importance. We present two cases of malignant breast lesions whose mammographic appearance could resemble that of intramammary ganglia. Although the mammographic appearance of a lesion is similar to that of intramammary ganglia, it should be carefully studied, especially if it presents a poorly defined border or is palpable. (Author)

  13. Combined photoacoustic and ultrasound imaging of human breast in vivo in the mammographic geometry

    Science.gov (United States)

    Xie, Zhixing; Lee, Won-Mean; Hooi, Fong Ming; Fowlkes, J. Brian; Pinsky, Renee W.; Mueller, Dean; Wang, Xueding; Carson, Paul L.

    2013-03-01

    This photoacoustic volume imaging (PAVI) system is designed to study breast cancer detection and diagnosis in the mammographic geometry in combination with automated 3D ultrasound (AUS). The good penetration of near-infrared (NIR) light and high receiving sensitivity of a broad bandwidth, 572 element, 2D PVDF array at a low center-frequency of 1MHz were utilized with 20 channel simultaneous acquisition. The feasibility of this system in imaging optically absorbing objects in deep breast tissues was assessed first through experiments on ex vivo whole breasts. The blood filled pseudo lesions were imaged at depths up to 49 mm in the specimens. In vivo imaging of human breasts has been conducted. 3D PAVI image stacks of human breasts were coregistered and compared with 3D ultrasound image stacks of the same breasts. Using the designed system, PAVI shows satisfactory imaging depth and sensitivity for coverage of the entire breast when imaged from both sides with mild compression in the mammographic geometry. With its unique soft tissue contrast and excellent sensitivity to the tissue hemodynamic properties of fractional blood volume and blood oxygenation, PAVI, as a complement to 3D ultrasound and digital tomosynthesis mammography, might well contribute to detection, diagnosis and prognosis for breast cancer.

  14. Reproductive and lifestyle risk factors and mammographic density in Mexican women.

    Science.gov (United States)

    Rice, Megan S; Bertrand, Kimberly A; Lajous, Martin; Tamimi, Rulla M; Torres, Gabriela; López-Ridaura, Ruy; Romieu, Isabelle

    2015-11-01

    Several breast cancer risk factors have been consistently associated with mammographic density (MD); however, data are limited for Hispanic women. We examined data from 1007 premenopausal and 600 postmenopausal women in the Mexican Teachers' Cohort. Multivariable linear regression was used to estimate associations between risk factors and MD. Among premenopausal women, age, current body mass index (BMI), BMI at age 18 years, and weight change since age 18 years were inversely associated with percent MD, whereas benign breast disease, alcohol intake, and breastfeeding 12 months or more were associated with higher percent MD. Among postmenopausal women, age, current BMI, BMI at age 18 years, weight change since age 18 years, and speaking or having parents who speak an indigenous language were inversely associated with percent MD, whereas benign breast disease and greater age at natural menopause were positively associated with percent MD. Other breast cancer risk factors, such as age at menarche, parity, and age at first pregnancy, were not significantly associated with density in either premenopausal or postmenopausal women. Results from the Mexican Teachers' Cohort are generally consistent with predictors of mammographic density observed in primarily non-Hispanic white populations; however, certain risk factors (e.g., parity) were not significantly associated with MD. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Testing for Occult Heartworm Infection

    Science.gov (United States)

    Stogdale, L.

    1984-01-01

    Heartworm infection in dogs is endemic in southern Ontario but occurs only sporadically throughout the remainder of Canada. The disease may either be associated with microfilariae in the patient's blood, a patent infection, or it may be occult. This paper describes a case of occult dirofilariasis in a dog, with emphasis on the diagnosis. A patent infection could be missed if the clinician tests an insufficient amount of blood. He should perform multiple concentration tests using either the modified Knott's technique or a filtration method. Occult infections occur in prepatent or unisexual infections, when the worms become sterile following therapy, or when the host produces antibodies that result in the destruction of the microfilariae. The recent release of a kit which detects the presence of antibodies to the adult heartworms now enables veterinarians to make an accurate diagnosis in the vast majority of dogs. PMID:17422386

  16. Occult Participation: Its Impact on Adolescent Development.

    Science.gov (United States)

    Tennant-Clark, Cynthia M.; And Others

    1989-01-01

    Investigated relationship between occult participation, substance abuse, and level of self-esteem among 25 clinical (alcohol or drug treatment) and 25 nonclinical adolescents. Results indicated that adolescent substance abuse and occult participation were significantly related. Found significant differences between high versus low occult groups…

  17. Locally advanced breast cancers are more likely to present as Interval Cancers: results from the I-SPY 1 TRIAL (CALGB 150007/150012, ACRIN 6657, InterSPORE Trial).

    Science.gov (United States)

    Lin, Cheryl; Buxton, Meredith Becker; Moore, Dan; Krontiras, Helen; Carey, Lisa; DeMichele, Angela; Montgomery, Leslie; Tripathy, Debasish; Lehman, Constance; Liu, Minetta; Olapade, Olufunmilayo; Yau, Christina; Berry, Donald; Esserman, Laura J

    2012-04-01

    Interval cancers (ICs), defined as cancers detected between regular screening mammograms, have been shown to be of higher grade, larger size, and associated with lower survival, compared with screen-detected cancers (SDCs) and comprise 17% of cancers from population-based screening programs. We sought to determine the frequency of ICs in a study of locally advanced breast cancers, the I-SPY 1 TRIAL. Screening was defined as having a mammogram with 2 years, and the proportion of ICs at 1 and 2 years was calculated for screened patients. Differences in clinical characteristics for ICs versus SDCs and screened versus non-screened cancers were assessed. For the 219 evaluable women, mean tumor size was 6.8 cm. Overall, 80% of women were over 40 and eligible for screening; however, only 31% were getting screened. Among women screened, 85% were ICs, with 68% diagnosed within 1 year of a previously normal mammogram. ICs were of higher grade (49% vs. 10%) than SDCs. Among non-screened women, 28% (43/152) were younger than the recommended screening age of 40. Of the entire cohort, 12% of cancers were mammographically occult (MO); the frequency of MO cancers did not differ between screened (11%) and non-screened (15%). ICs were common in the I-SPY 1 TRIAL suggesting the potential need for new approaches beyond traditional screening to reduce mortality in women who present with larger palpable cancers.

  18. Physical activity and mammographic parenchymal patterns among Greek postmenopausal women.

    Science.gov (United States)

    Marmara, Eleni A; Papacharalambous, Xenofon N; Kouloulias, Vassilios E; Maridaki, D Maria; Baltopoulos, J Panayiotis

    2011-05-01

    To examine whether physical activity during the last five years is related to later breast mammographic density in postmenopausal Greek women. We designed a cross-sectional study in 724 women, of ages 45-67 years. An interview-administered questionnaire was used to obtain information on duration and intensity of recreational physical activity during five years preceding study recruitment. Mammograms were evaluated according to BIRADS classification and BIRADS score was also estimated. Multivariate ordinal logistic regression analysis was used to assess associations between physical activity index and breast density according to the BIRADS classification methods. We observed a statistically significant inverse association of mammographic breast density measured by the BIRADS classification method and recreational exercise (OR=-0.10; 95% CI -0.018, -0.001; p=0.022). For one unit increase in physical activity as expressed by the MET-h/week score, the odds of lower versus higher breast density categories are 1.105 greater, given that all of the other variables in the model are held constant. A modifying effect by age at recruitment was evident among participants, with a stronger inverse association between recreational activity and mammographic breast density among older women (OR=-0.036; 95% CI -0.063, -0.009; p=0.009). An inverse association between physical activity and BIRADS score was evident, not reaching statistical significance (OR=0.00; 95% CI -0.009, 0.008; p=0.887). Mammographic breast area was lower in postmenopausal women who participated in sports/recreational physical activity compared to inactive controls. Increasing physical activity levels among postmenopausal women might be a reasonable approach to reduce mammographic density. However, until more physical activity and mammographic breast density studies are conducted that confirm our findings, they have to be interpreted with caution, due to the retrospective nature of our data and the possibility of

  19. Prevalence of the STK15 F31I polymorphism and its relationship with mammographic density

    Directory of Open Access Journals (Sweden)

    J. Giacomazzi

    2011-04-01

    Full Text Available Several studies have identified the single nucleotide polymorphism STK15 F31I as a low-penetrance risk allele for breast cancer, but its prevalence and risk association in the Brazilian population have not been determined. The goal of this study was to identify the frequency of this polymorphism in the Brazilian setting. Considering the high degree of admixture of our population, it is of fundamental importance to validate the results already reported in the literature and also to verify the relationship between this variant and breast cancer risk. A total of 750 women without breast cancer were genotyped using the TaqMan PCR assay for STK15 F31I polymorphism. Clinical information was obtained from review of the medical records and mammographic density from the images obtained using the BI-RADS System. The estimated risk of developing cancer was calculated according to the Gail model. The genotypic frequencies observed in this study were 4.5, 38.7, and 56.6%, respectively, for the STK15 F31I AA, AT and TT genotypes. The AT and AA genotypes were encountered significantly more often in premenopausal women with moderately dense, dense and heterogeneously dense breast tissue (P = 0.023. In addition, the presence of the TT genotype was significantly associated with age at menarche ≥12 years (P = 0.023. High mammographic density, associated with increased breast cancer risk, was encountered more frequently in premenopausal women with the risk genotypes STK15 F31I AA and AT. The genotypic frequencies observed in our Brazilian sample were similar to those described in other predominantly European populations.

  20. Similarity of Fibroglandular Breast Tissue Content Measured from Magnetic Resonance and Mammographic Images and by a Mathematical Algorithm

    Directory of Open Access Journals (Sweden)

    Fatima Nayeem

    2014-01-01

    Full Text Available Women with high breast density (BD have a 4- to 6-fold greater risk for breast cancer than women with low BD. We found that BD can be easily computed from a mathematical algorithm using routine mammographic imaging data or by a curve-fitting algorithm using fat and nonfat suppression magnetic resonance imaging (MRI data. These BD measures in a strictly defined group of premenopausal women providing both mammographic and breast MRI images were predicted as well by the same set of strong predictor variables as were measures from a published laborious histogram segmentation method and a full field digital mammographic unit in multivariate regression models. We also found that the number of completed pregnancies, C-reactive protein, aspartate aminotransferase, and progesterone were more strongly associated with amounts of glandular tissue than adipose tissue, while fat body mass, alanine aminotransferase, and insulin like growth factor-II appear to be more associated with the amount of breast adipose tissue. Our results show that methods of breast imaging and modalities for estimating the amount of glandular tissue have no effects on the strength of these predictors of BD. Thus, the more convenient mathematical algorithm and the safer MRI protocols may facilitate prospective measurements of BD.

  1. Effects of a health education and telephone counseling program on patients with a positive fecal occult blood test result for colorectal cancer screening: A randomized controlled trial.

    Science.gov (United States)

    Chiu, Hui-Chuan; Hung, Hsin-Yuan; Lin, Hsiu-Chen; Chen, Shu-Ching

    2016-11-17

    Our purpose was to evaluate the effects of a health education and telephone counseling program on knowledge and attitudes about colorectal cancer and screening and the psychological impact of positive screening results. A randomized controlled trial was conducted with 2 groups using a pretest and posttest measures design. Patients with positive colorectal cancer screening results were selected and randomly assigned to an experimental (n = 51) or control (n = 51) group. Subjects in the experimental group received a health education and telephone counseling program, while the control group received routine care only. Patients were assessed pretest before intervention (first visit to the outpatient) and posttest at 4 weeks after intervention (4 weeks after first visit to the outpatient). Patients in the experimental group had a significantly better level of knowledge about colorectal cancer and the psychological impact of a positive screening result than did the control group. Analysis of covariance revealed that the health education and telephone counseling program had a significant main effect on colorectal cancer knowledge. A health education and telephone counseling program can improve knowledge about colorectal cancer and about the psychological impact in patients with positive colorectal cancer screening results. The health education and telephone counseling program is an easy, simple, and convenient method of improving knowledge, improving attitudes, and alleviating psychological distress in patients with positive colorectal cancer screening results, and this program can be expanded to other types of cancer screening. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Breast cancer in male-to-female transsexuals: use of breast imaging for detection.

    Science.gov (United States)

    Maglione, Katharine D; Margolies, Laurie; Jaffer, Shabnam; Szabo, Janet; Schmidt, Hank; Weltz, Christina; Sonnenblick, Emily B

    2014-12-01

    The purposes of this article are to describe two cases of breast cancer in male-to-female transsexuals and to review eight cases previously reported in the literature. Breast cancer occurs in male-to-female transsexuals who receive high doses of exogenous estrogen and develop breast tissue histologically identical to that of a biologically female breast. This exposure to estrogen results in increased risk of breast cancer. The first patient described is a male-to-female transsexual with screening-detected ductal carcinoma in situ and a family history of breast cancer. The other patient is a male-to-female transsexual with invasive ductal carcinoma that was occult on diagnostic digital mammographic and ultrasound findings but visualized on digital breast tomosynthesis and breast MR images. The analysis of the eight previously reported cases showed that breast cancer in male-to-female transsexuals occurs at a younger age and is more frequently estrogen receptor negative than breast cancer in others born biologically male. Screening for breast cancer in male-to-female transsexuals should be undertaken for those with additional risk factors (e.g., family history, BRCA2 mutation, Klinefelter syndrome) and should be available to those who desire screening, preferably in a clinical trial.

  3. Stereoscopic representation of the breast from two mammographic view with external markers

    Science.gov (United States)

    Kallergi, Maria; Manohar, Anand

    2003-05-01

    A new breast imaging technique has been develoepd and tested for the stereoscopic representation of the breast. The method uses markers at specific locations on the breast surface and standard mammographic projections and was tested with an anthropomorphic phantom containing five mass-like objects at locations determined by a CT scan. The phantom was imaged with a GE Senographe 2000D digital system with and without the markers. The algorithm's modules included: 1) Breast area segmentation; 2) Pectoral muscle segmentation; 3) Registration and alignment of the mammographic projections based on selected reference points; 4) Breast volume estimation basdd on volume conservation principle during compression and shape definition using surface points; 5) 3D lesion(s) localization and representation. An interactive, ILD-based, graphical interface was also developed for the stereoscopic display of the breast. The reconstruction algorithm assumed that the breast shrinks and stretches uniformly when compression is applied and removed. The relative movement of the markers after compression allowed more accurate estimation of the shrinking and stretching of the surface offering a relatively simple and practical way to improve volume estimation and surface reconstruction. Such stereoscopic representation of the breast and associated findings may improve radiological interpretation and physical examinations for breast cancer diagnosis.

  4. Computer-aided detection of breast carcinoma in standard mammographic projections with digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Destounis, Stamatia [Elizabeth Wende Breast Care, LLC, Rochester, NY (United States); University of Rochester, School of Medicine and Dentistry, Rochester, NY (United States); Hanson, Sarah; Morgan, Renee; Murphy, Philip; Somerville, Patricia; Seifert, Posy; Andolina, Valerie; Arieno, Andrea; Skolny, Melissa; Logan-Young, Wende [Elizabeth Wende Breast Care, LLC, Rochester, NY (United States)

    2009-06-15

    A retrospective evaluation of the ability of computer-aided detection (CAD) ability to identify breast carcinoma in standard mammographic projections. Forty-five biopsy proven lesions in 44 patients imaged digitally with CAD applied at examination were reviewed. Forty-four screening BIRADS {sup registered} category 1 digital mammography examinations were randomly identified to serve as a comparative normal/control population. Data included patient age; BIRADS {sup registered} breast density; lesion type, size, and visibility; number, type, and location of CAD marks per image; CAD ability to mark lesions; needle core and surgical pathologic correlation. The CAD lesion/case sensitivity of 87% (n=39), image sensitivity of 69% (n=31) for mediolateral oblique view and 78% (n=35) for the craniocaudal view was found. The average false positive rate in 44 normal screening cases was 2.0 (range 1-8). The 2.0 figure is based on 88 reported false positive CAD marks in 44 normal screening exams: 98% (n=44) lesions proceeded to excision; initial pathology upgraded at surgical excision from in situ to invasive disease in 24% (n=9) lesions. CAD demonstrated potential to detect mammographically visible cancers in standard projections for all lesion types. (orig.)

  5. Mammographic Breast Density in Chinese Women: Spatial Distribution and Autocorrelation Patterns.

    Directory of Open Access Journals (Sweden)

    Christopher W K Lai

    Full Text Available Mammographic breast density (MBD is a strong risk factor for breast cancer. The spatial distribution of MBD in the breast is variable and dependent on physiological, genetic, environmental and pathological factors. This pilot study aims to define the spatial distribution and autocorrelation patterns of MBD in Chinese women aged 40-60. By analyzing their digital mammographic images using a public domain Java image processing program for segmentation and quantification of MBD, we found their left and right breasts were symmetric to each other in regard to their breast size (Total Breast Area, the amount of BMD (overall PD and Moran's I values. Their MBD was also spatially autocorrelated together in the anterior part of the breast in those with a smaller breast size, while those with a larger breast size tend to have their MBD clustered near the posterior part of the breast. Finally, we observed that the autocorrelation pattern of MBD was dispersed after a 3-year observation period.

  6. Radiologists' preferences for digital mammographic display. The International Digital Mammography Development Group.

    Science.gov (United States)

    Pisano, E D; Cole, E B; Major, S; Zong, S; Hemminger, B M; Muller, K E; Johnston, R E; Walsh, R; Conant, E; Fajardo, L L; Feig, S A; Nishikawa, R M; Yaffe, M J; Williams, M B; Aylward, S R

    2000-09-01

    To determine the preferences of radiologists among eight different image processing algorithms applied to digital mammograms obtained for screening and diagnostic imaging tasks. Twenty-eight images representing histologically proved masses or calcifications were obtained by using three clinically available digital mammographic units. Images were processed and printed on film by using manual intensity windowing, histogram-based intensity windowing, mixture model intensity windowing, peripheral equalization, multiscale image contrast amplification (MUSICA), contrast-limited adaptive histogram equalization, Trex processing, and unsharp masking. Twelve radiologists compared the processed digital images with screen-film mammograms obtained in the same patient for breast cancer screening and breast lesion diagnosis. For the screening task, screen-film mammograms were preferred to all digital presentations, but the acceptability of images processed with Trex and MUSICA algorithms were not significantly different. All printed digital images were preferred to screen-film radiographs in the diagnosis of masses; mammograms processed with unsharp masking were significantly preferred. For the diagnosis of calcifications, no processed digital mammogram was preferred to screen-film mammograms. When digital mammograms were preferred to screen-film mammograms, radiologists selected different digital processing algorithms for each of three mammographic reading tasks and for different lesion types. Soft-copy display will eventually allow radiologists to select among these options more easily.

  7. Identification of a novel percent mammographic density locus at 12q24.

    Science.gov (United States)

    Stevens, Kristen N; Lindstrom, Sara; Scott, Christopher G; Thompson, Deborah; Sellers, Thomas A; Wang, Xianshu; Wang, Alice; Atkinson, Elizabeth; Rider, David N; Eckel-Passow, Jeanette E; Varghese, Jajini S; Audley, Tina; Brown, Judith; Leyland, Jean; Luben, Robert N; Warren, Ruth M L; Loos, Ruth J F; Wareham, Nicholas J; Li, Jingmei; Hall, Per; Liu, Jianjun; Eriksson, Louise; Czene, Kamila; Olson, Janet E; Pankratz, V Shane; Fredericksen, Zachary; Diasio, Robert B; Lee, Adam M; Heit, John A; DeAndrade, Mariza; Goode, Ellen L; Vierkant, Robert A; Cunningham, Julie M; Armasu, Sebastian M; Weinshilboum, Richard; Fridley, Brooke L; Batzler, Anthony; Ingle, James N; Boyd, Norman F; Paterson, Andrew D; Rommens, Johanna; Martin, Lisa J; Hopper, John L; Southey, Melissa C; Stone, Jennifer; Apicella, Carmel; Kraft, Peter; Hankinson, Susan E; Hazra, Aditi; Hunter, David J; Easton, Douglas F; Couch, Fergus J; Tamimi, Rulla M; Vachon, Celine M

    2012-07-15

    Percent mammographic density adjusted for age and body mass index (BMI) is one of the strongest risk factors for breast cancer and has a heritable component that remains largely unidentified. We performed a three-stage genome-wide association study (GWAS) of percent mammographic density to identify novel genetic loci associated with this trait. In stage 1, we combined three GWASs of percent density comprised of 1241 women from studies at the Mayo Clinic and identified the top 48 loci (99 single nucleotide polymorphisms). We attempted replication of these loci in 7018 women from seven additional studies (stage 2). The meta-analysis of stage 1 and 2 data identified a novel locus, rs1265507 on 12q24, associated with percent density, adjusting for age and BMI (P = 4.43 × 10(-8)). We refined the 12q24 locus with 459 additional variants (stage 3) in a combined analysis of all three stages (n = 10 377) and confirmed that rs1265507 has the strongest association in the 12q24 region (P = 1.03 × 10(-8)). Rs1265507 is located between the genes TBX5 and TBX3, which are members of the phylogenetically conserved T-box gene family and encode transcription factors involved in developmental regulation. Understanding the mechanism underlying this association will provide insight into the genetics of breast tissue composition.

  8. Mammographic compression--a need for mechanical standardization

    NARCIS (Netherlands)

    Branderhorst, W.; Groot, J.E. de; Highnam, R.; Chan, A.; Bohm-Velez, M.; Broeders, M.J.; Heeten, GJ. den; Grimbergen, C.A.

    2015-01-01

    BACKGROUND: A lack of consistent guidelines regarding mammographic compression has led to wide variation in its technical execution. Breast compression is accomplished by means of a compression paddle, resulting in a certain contact area between the paddle and the breast. This procedure is associate

  9. Mammographic detection and staging of invasive lobular carcinoma.

    NARCIS (Netherlands)

    Veltman, J.; Boetes, C.; Die, L. van; Bult, P.; Blickman, J.G.; Barentsz, J.O.

    2006-01-01

    The aim of the study was to evaluate mammography in detecting and staging of invasive lobular carcinoma (ILC) in order to assess the performance and impact of observer variability. Forty-two cases of ILC were retrospectively evaluated twice by two breast radiologists. Mammographic performance as wel

  10. Mammographic and sonographic findings of periductal mastitis : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Yang [Pochon CHA Univ. College of Medicine, Sungnam (Korea, Republic of); Oh, Ki Keun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-03-01

    Periductal mastitis arises from major ducts. Radiographic reports describing the phases of duct ectasia and secretory calcifications, have been published, but descriptions of the phases of periductal mastitis are rare. We report the mammographic and ultrasonographic findings of periductal mastitis in a 30-year-old woman who presented with a breast lump.

  11. How mammographic breast density affects radiologists' visual search patterns.

    Science.gov (United States)

    Al Mousa, Dana S; Brennan, Patrick C; Ryan, Elaine A; Lee, Warwick B; Tan, Jennifer; Mello-Thoms, Claudia

    2014-11-01

    To determine the impact of mammographic breast density on the visual search process of radiologists when reading digital mammograms. Institutional review board approval was obtained. A set of 149 craniocaudal digital mammograms were read by seven radiologists, and observer search patterns were recorded. Total time examining each case, time to first hit the lesion, dwell time, and number of hits per area were calculated. The nonparametric Mann-Whitney U test was used for statistical evaluation. In both low- and high-mammographic density cases, significant increases were observed in the time to first hit lesions when they were located outside, compared to overlying fibroglandular dense tissue (P = .001). Significantly longer dwell time (P = .003) and greater number of fixations (P = .0003) were observed when the lesions were situated within--rather than outside--the dense fibroglandular tissue. Increased mammographic breast density changes radiologists' visual search patterns. Dense areas of the parenchyma attracted greater visual attention in both high- and low-mammographic density cases, resulting in faster detection of lesions overlying the fibroglandular dense tissue, along with longer dwell times and greater number of fixations, as compared to lesions located outside the dense fibroglandular regions. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  12. 21 CFR 864.6550 - Occult blood test.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Occult blood test. 864.6550 Section 864.6550 Food... DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6550 Occult blood test. (a) Identification. An occult blood test is a device used to detect occult blood in urine or feces. (Occult blood...

  13. Detection of occult endocervical glandular dysplasia in cervical conization specimens for squamous lesions.

    Science.gov (United States)

    Sopracordevole, F; Clemente, N; Alessandrini, L; Di Giuseppe, J; Cigolot, F; Buttignol, M; Ciavattini, A; Canzonieri, V

    2017-03-01

    The aim of this work was to evaluate the incidence of occult cervical glandular intraepithelial neoplasia (CGIN) and adenocarcinoma of the cervix (AC) in women treated with CO2-laser conization for cervical intraepithelial neoplasia (CIN) or squamocellular cervical cancer (SCC). The medical records of all women with a histological diagnosis of squamous lesions of the uterine cervix (persistent CIN1, CIN2, CIN3 and SCC) who were subsequently treated with CO2-laser conization at our institution, during the period from January 1991 to December 2014, were analyzed in a retrospective case series. Among the 1004 women fulfilling the study inclusion/exclusion criteria, 77 cases (7.7%) of occult glandular lesions (CGIN and AC) were detected on the final cone specimen (48 cases of occult low-grade cervical glandular intraepithelial neoplasia (LCGIN), 25 cases of occult high-grade cervical glandular intraepithelial neoplasia (HCGIN), and four cases of occult "usual-type" AC). No difference in the mean age between women diagnosed with occult glandular lesions and women without occult glandular lesions on the final specimen emerged (39.1±9.3 vs 38.4±9.4, p=0.5). In women with occult LCGIN on cone specimen, mean follow-up of 48 months was reported (range 7-206 months) and no cases of progression to HCGIN or AC were observed. In conclusion, a relatively high rate of occult glandular lesions was found in women treated for squamous lesions. The natural history of CGIN is still uncertain and, in particular, there are some controversies as to whether LCGIN is a precursor lesion of HCGIN or AC. In this context the role of pathologists become very important since the appropriate diagnosis of these lesions could have potential implications in the clinical management of these patients.

  14. Increased COX-2 expression in epithelial and stromal cells of high mammographic density tissues and in a xenograft model of mammographic density.

    Science.gov (United States)

    Chew, G L; Huo, C W; Huang, D; Hill, P; Cawson, J; Frazer, H; Hopper, J L; Haviv, I; Henderson, M A; Britt, K; Thompson, E W

    2015-08-01

    Mammographic density (MD) adjusted for age and body mass index is one of the strongest known risk factors for breast cancer. Given the high attributable risk of MD for breast cancer, chemoprevention with a safe and available agent that reduces MD and breast cancer risk would be beneficial. Cox-2 has been implicated in MD-related breast cancer risk, and was increased in stromal cells in high MD tissues in one study. Our study assessed differential Cox-2 expression in epithelial and stromal cells in paired samples of high and low MD human breast tissue, and in a validated xenograft biochamber model of MD. We also examined the effects of endocrine treatment upon Cox-2 expression in high and low MD tissues in the MD xenograft model. Paired high and low MD human breast tissue samples were immunostained for Cox-2, then assessed for differential expression and staining intensity in epithelial and stromal cells. High and low MD human breast tissues were separately maintained in biochambers in mice treated with Tamoxifen, oestrogen or placebo implants, then assessed for percentage Cox-2 staining in epithelial and stromal cells. Percentage Cox-2 staining was greater for both epithelial (p = 0.01) and stromal cells (p tissues. In high MD biochamber tissues, percentage Cox-2 staining was greater in stromal cells of oestrogen-treated versus placebo-treated tissues (p = 0.05).

  15. The usefulness of additional bilateral whole breast US with negative mammographic results in asymptomatic women

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Jin Young; Jung, Hae Kyoung; Park, Hai Lin; Kwon, Tae Hee [CHA General Hospital, Pochon CHA Univ., Pochon (Korea, Republic of); Kim, Eun Kyung [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2005-12-15

    We wanted to evaluate the clinical utility of performing bilateral whole breast US as a subsequent diagnostic method along with mammography in asymptomatic women. From May 2002 to Dec 2004, we conducted 3998 examinations on 3638 patients with negative findings on the clinical examination and negative mammographic results, and those breast tissues having a BI-RADS category 2, 3, or 4 density were further evaluated by performing bilateral whole breast US. The patients' age distribution ranged from 24 to 66 years (mean age: 43.6 yrs). The abnormalities were compared with core or vacuum assisted core biopsy, operations, and follow up US. For the normal cases, we used the clinical notes and the statistical data from the Korean Central Cancer Registry. For 3998 examinations of 3638 women who were examined with bilateral whole breast US, pathologic confirmations were available for 433 patients and follow-up data were available for 35 patients. The sensitivity, specificity, the positive predictive value and the cancer detection rate of using additional whole breast US were 50, 92.6, 0.6 and 0.5, respectively. The two cancers that were detected only on US were minimal breast cancer. Although all the breast cancers that were detected only on US were minimal breast cancers, performing bilateral whole breast US revealed a low cancer detection rate and a high false positive. Therefore, further studies will be needed to investigate the role of US as a screening tool.

  16. Occult HBV infection and HCC

    Directory of Open Access Journals (Sweden)

    Isabelle Chemin

    2007-02-01

    Full Text Available

    A number of risk factors appear to play a role in Hepatocellularcinoma (HCC, HBV infection being one of the most important. Chronic inflammation and cytokines are key determinants in the development of fibrosis and liver cell proliferation. HBV DNA integration into host cellular DNA, has been extensively studied and may disrupt or promote expression of cellular genes that are important in cell growth and differentiation. Moreover, expression of HBV proteins may have a direct effect on cellular functions, and some of these gene products may lead to malignant transformation. Several HBV genes have been frequently found in infected tissues including truncated pre-S2/S, hepatitis B X gene, and a novel spliced transcript of HBV (hepatitis B spliced protein. The proteins expressed from these integrated genes have been shown to have intracellular activities, including effects on cellular growth and apoptosis. Occult hepatitis B virus (HBV infection is characterized by persistence of HBV DNA into the tissue of hep atitis B surface antigen-negative individuals. The clinical relevance of this peculiar infection, in particular, the impact of occult HBV infection in cases of HCC has been a matter of debate. Prevalence and molecular status of occult HBV in patients with HCC has been investigated in several studies. HCC patients from Italy, France, Japan, Morocco, the United States, Canada etc…..who had no detectable HBsAg in their serum have been studied. In these HBsAg-negative HCC patients, HBV DNA was detected in tumorous and/or in adjacent non tumorous liver tissue using polymerase chain reaction (PCR in almost half of the patients, being anti-HCV positive or not. Some of the patients are positive for anti-HBc antibodies as the only marker of HBV infection, but not all. Covalently closed circular HBV DNA may be detected indicating that at least some of these patients

  17. IUVS/MAVEN Stellar Occultations

    Science.gov (United States)

    Gröller, Hannes; Yelle, Roger; Montmessin, Franck; Lacombe, Gaetan; Schneider, Nicholas M.; Deighan, Justin; Jain, Sonal; Nakagawa, Hiromu; Jakosky, Bruce

    2016-10-01

    We present the latest results from stellar occultations observed with the Imaging Ultraviolet Spectrograph (IUVS) instrument on board of Mars Atmosphere and Volatile EvolutioN (MAVEN) mission. So far 9 campaigns have been executed on average every two months since MAVEN began orbiting Mars. Approximately 50 occultations are recorded in each campaign. The IUVS instrument observes in two spectral regions, the far- and mid-UV. The FUV channel covers wavelengths from 110 to 190 nm and the MUV channel from 170 to 350 nm. By combining those two channels we cover the whole altitude range starting from around 30 km to 150 km. We present the geometric dependent CO2, O2, and O3 number densities from these occultations. The derived O2 mixing ratio varies between 1.5 × 10-3 and 5 × 10-3. In some of the MUV occultations we also can see aerosol extinction. In addition we present temperatures derived from the CO2 densities assuming hydrostatic equilibrium. We retrieved mean temperatures of around 180 K at lower altitudes, which decreasing with altitudes down to a mean of around 130 K at higher altitudes. We see a constantly cold layer with temperatures of 105 – 120 K at a pressure level at roughly 7 × 10-6 Pa, equivalent to an altitude of around 140 km. We also discuss possible wave structures with amplitudes between 5 and 15 K and wavelengths between 10 and 15 km in the obtained temperature profiles. The temperature profiles, retrieved with the IUVS instrument, are mostly in agreement with predicted values from the Mars Climate Database model, except where we see the cold layer around 140 km.

  18. The value of breast MRI in high-risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: Is there a role to choose wisely patients for sentinel node biopsy?

    Science.gov (United States)

    Freitas, Vivianne; Crystal, Pavel; Kulkarni, Supriya R; Ghai, Sandeep; Bukhanov, Karina; Escallon, Jaime; Scaranelo, Anabel M

    2016-06-01

    The aim of this study was to evaluate the presence of clinically and mammographically occult disease using breast MRI in a cohort of cancer patients undergoing contralateral prophylactic mastectomy (CPM) and the utmost indication of axillary assessment (sentinel node biopsy (SLNB)) for this side. A retrospective review of patients with unilateral invasive breast cancer or ductal carcinoma in situ (DCIS) from institutional MRI registry data (2004-2010) was conducted. Characteristics of patients undergoing CPM with breast MRI obtained less than 6 month before surgery were evaluated. A total of 2322 consecutive patients diagnosed with DCIS or stage I to III infiltrating breast cancer underwent preoperative breast MRI. Of these, 1376 patients (59.2%) had contralateral clinical breast exam and mammography without abnormalities; and 116 patients (4.9%) underwent CPM (28 excluded patients had breast MRI more than 6 months before CPM). The mean age of the 88 patients was 49 years (range 28-76 years). Two (2.3%) DCIS identified on surgical pathology specimen were not depicted by MRI and the 5 mm T1N0 invasive cancer (1.1%) was identified on MRI. Preoperative MRI showed 95% accuracy to demonstrate absence of occult disease with negative predicted value (NPV) of 98% (95% CI: 91.64-99.64%). Occult disease was present in 3.4% of CPM. MRI accurately identified the case of invasive cancer in this cohort. The high negative predictive value suggests that MRI can be used to select patients without consideration of SLNB for the contralateral side.

  19. Occult Communications: On Instrumentation, Esotericism, and Epistemology

    Directory of Open Access Journals (Sweden)

    Bernard Dionysius Geoghegan

    2015-09-01

    Full Text Available Viewed from the perspective of the occult, formerly straight and narrow conduits of reason may even begin to resemble irregular relays composed of irregular twists and turns. This essay offers a brief overview of key literature on spiritualism and the occult, some larger reflections on the place of the occult within studies of science and communications, and brief summaries of the essays contained in this volume.

  20. OCCULT POWER AND AFRICA'S SOCIO-ECONOMIC PROBLEMS ...

    African Journals Online (AJOL)

    Dr Ike

    Occult powers are not provable by scientific experiments and experience. ... he possessed. African World View as Background to the Belief in Occult. Powers ..... on witchcraft and how to deal with it. What followed .... real occult power. Often the ...

  1. Scaling Relation for Occulter Manufacturing Errors

    Science.gov (United States)

    Sirbu, Dan; Shaklan, Stuart B.; Kasdin, N. Jeremy; Vanderbei, Robert J.

    2015-01-01

    An external occulter is a spacecraft own along the line-of-sight of a space telescope to suppress starlight and enable high-contrast direct imaging of exoplanets. The shape of an external occulter must be specially designed to optimally suppress starlight and deviations from the ideal shape due to manufacturing errors can result loss of suppression in the shadow. Due to the long separation distances and large dimensions involved for a space occulter, laboratory testing is conducted with scaled versions of occulters etched on silicon wafers. Using numerical simulations for a flight Fresnel occulter design, we show how the suppression performance of an occulter mask scales with the available propagation distance for expected random manufacturing defects along the edge of the occulter petal. We derive an analytical model for predicting performance due to such manufacturing defects across the petal edges of an occulter mask and compare this with the numerical simulations. We discuss the scaling of an extended occulter test-bed.

  2. Diagnosis and surgical treatment of occult cancer of the thyroid: Report of 68 cases%隐匿性甲状腺癌的诊断及手术治疗(附68例报告)

    Institute of Scientific and Technical Information of China (English)

    贺晓斌; 贺宝艳; 陈武科; 周灿

    2012-01-01

    目的 探讨隐匿性甲状腺癌(occult cancer of the thyroid,OCT)的诊断与治疗.方法 回顾性分析1998年-2008年我院收治并经病理证实的68例OCT患者的临床资料.结果 男性11例,女性57例,年龄15-69岁,中位年龄43.5岁.41例(60.2%)患者因发现甲状腺结节就诊,其中16(39.0%)例临床查体未能发现,后经超声、手术探查发现微小结节;17例(25%)以颈淋巴结肿大为首发症状,经超声检查发现同侧甲状腺中微小结节;68例中66例成功得到随访(随访率97.1%),其中甲状腺腺叶切除术患者44例,改良颈淋巴结清除手术患者22例,其中5例(7.6%)患者死亡,2例患者由于地址更换而失访(失访率2.9%).结论 甲状腺乳头状微小癌起病隐患,术前较难诊断.详细的查体和辅助检查是OCT诊断不可缺少的,手术治疗为甲状腺乳头状微小癌的主要手段.%Objective:To investigate the diagnosis and therapy of occult cancer of the thyroid( OCT ). Methods: The clinical data of 68 cases with PTMC treated and confirmed by pathology from 1995 to 2000 were retrospectively analyzed. Results: Eleven patients were male and fifty - seven female, with the media age 43. 5 years( range from 15 to 69 years ). Forty - one( 60. 2% )cases were first treated for thyroid nodules, of which sixteen patients( 39. 0% ) were found with tiny thyroid nodules by ultrasound and surgical exploration but not physical examination. Seventeen cases( 25% )were first treated for deradenoncus. Of the sixty - eight patients sixty - six cases were followed up, of which forty - four patients underwent a lobectomy and twenty - two got modified radical neck dissection, were successfully followed - up, and the follow - up rate was 97. 1% ; five patients( 7. 6% ) dead, two cases were lost for follow up and the lost rate of follow up was 2.9%. Conclusion: The onset of OCT is latent and is hard to diagnose pre-operatively. It is necessary to establish diagnosis by physical examination

  3. Detection of occult tumor cells in regional lymph nodes is associated with poor survival in pN0 non-small cell lung cancer: a meta-analysis

    Science.gov (United States)

    He, Zhicheng; Xia, Yang; Tang, Shaowen; Chen, Yijiang

    2016-01-01

    Background patients of pN0 non-small cell lung cancer (NSCLC) with occult tumor cells (OTCs) in regional lymph nodes (LNs) are reported to have controversial prognostic outcomes. Method We pooled pN0 NSCLC patients with OTCs in LNs and compared with those without OTCs. Patient characteristics, hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and/or disease-free survival (DFS) were analyzed. HR greater than 1 conferred an increased hazard for patients with OTCs. Results Eighteen articles were finally enrolled in the meta-analysis and 15 studies provided sufficient data for extracting HRs for OS, resulting to 5 articles available for DFS analysis. The combined HRs of OS was 2.22 (95% CI, 1.87 to 2.64) and 2.4 (95% CI, 1.71 to 3.36) for analysis of DFS. The similar trend was obtained in the subgroup analyses regarding detection methods and study type. Interestingly, even in the analysis of mean numbers of LNs dissection (MLND) intraoperatively, both subgroups (LNs/Pts. <12 and ≥12) illustrated significant HRs of OS (HR: 3.13, 95% CI, 2.17 to 4.52 in LNs/Pts. <12 subgroup and HR: 2.09, 95% CI, 1.63 to 2.68 in LNs/Pts. ≥12). The combined HR of OS in this section was 2.37 (95% CI, 1.63 to 2.68). No publication bias was detected in all the meta-analysis sections. The prognosis of patients with OTCs is inferior to those without OTCs in the terms of OS and DFS regardless of detection methods, study types and MLND. Conclusions The prognosis of patients with OTCs is inferior to those without OTCs in the terms of OS and DFS regardless of detection methods, study types and MLND. PMID:27076932

  4. Mammographic screening debate on study design: a need to move the field forward.

    Science.gov (United States)

    Ursin, Giske

    2012-12-12

    The mammographic screening debate has been running for decades. The temperature of this debate is unusually high, and all participants, regardless of viewpoint, seem to have a conflict of interest. Another unusual aspect of this debate is the focus on study design, and in particular on designs that some think exceeded their usefulness decades ago. What are the questions that remain to be answered in this debate? Are there methodological issues that have not been adequately addressed? Do we have the right tools to provide up-to-date answers to how women can best protect themselves against dying from breast cancer? This commentary discusses some of the current issues.See related Opinion articles http://www.biomedcentral.com/1741-7015/10/106 and http://www.biomedcentral.com/1741-7015/10/163.

  5. Using Volumetric Breast Density to Quantify the Potential Masking Risk of Mammographic Density.

    Science.gov (United States)

    Destounis, Stamatia; Johnston, Lisa; Highnam, Ralph; Arieno, Andrea; Morgan, Renee; Chan, Ariane

    2017-01-01

    The purposes of this study were to compare BI-RADS density categories with quantitative volumetric breast density (VBD) for the reporting of mammographic sensitivity and to identify which patient factors are most predictive of a diagnosis of interval cancer of the breast versus screen-detected cancer. This retrospective study included screen-detected cancers (n = 652) and interval cancers (n = 119) identified between January 2009 and December 2012. Multivariate logistic regression analysis was used to determine which patient factors are predictive of a diagnosis of interval cancer. Sensitivity (screen-detected cancer / [screen-detected cancer + interval cancer]) was determined with the BI-RADS 4th edition density categories and an automated equivalent density grade obtained with a proprietary tool. Sensitivity changes within automated density grade categories were investigated by use of quantitative thresholds at the midpoints of each category. In univariate analysis, age, menopausal status, and breast density were associated with a diagnosis of interval cancer. Of these risk factors, breast density was the only independent factor whether it was assessed by visual BI-RADS category (odds ratio, 3.54; 95% CI, 1.55-8.10), automated density grade (odds ratio, 4.68; 95% CI, 2.26-9.67), or VBD (odds ratio, 4.51; 95% CI, 1.92-10.61). Sensitivity decreased consistently across increasing automated density grade categories from fatty to extremely dense (95%, 89%, 83%, 65%) and less so for visual BI-RADS (82%, 90%, 84%, 66%). Further dichotomization with VBD cutoffs showed a striking linear relation between VBD and sensitivity (R(2) = 0.959). In this study, breast density was the only risk factor significantly associated with a diagnosis of interval cancer versus screen-detected cancer. Quantitative VBD captures the potential masking risk of breast density more precisely than does the widely used visual BI-RADS density classification system.

  6. Glycemic index, glycemic load and mammographic breast density: the EPIC Florence longitudinal study.

    Directory of Open Access Journals (Sweden)

    Giovanna Masala

    Full Text Available A few studies have evaluated the association between diet and mammographic breast density (MBD and results are inconsistent. MBD, a well-recognized risk factor for breast cancer, has been proposed as a marker of cumulative exposure to hormones and growth factors. Diets with a high glycemic index (GI or glycemic load (GL may increase breast cancer risk, via an effect on the insulin-like growth factor axis. We have investigated the association between carbohydrate intake, GI, GL and MBD in a prospective study. We identified a large series of women, in the frame of the EPIC-Florence cohort, with a mammogram taken five years after enrolment, when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected. Mammograms have been retrieved (1,668, 83% and MBD assessed according to Wolfe's classification. We compared women with high MBD (P2+DY Wolfe's categories with those with low MBD (N1+P1 through logistic models adjusted for age, education, body mass index, menopause, number of children, breast feeding, physical activity, non-alcohol energy, fibers, saturated fat and alcohol. A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile (OR = 1.73, 95%CI 1.13-2.67, p for trend = 0.048 while no association with glycemic index was evident. These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes, and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered. The effect was particularly evident among leaner women, although no interaction was found. A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles. In this Italian population we observed an association between glycemic load, total and rapidly absorbed carbohydrates and high MBD. These novel results warrant further

  7. Glycemic index, glycemic load and mammographic breast density: the EPIC Florence longitudinal study.

    Science.gov (United States)

    Masala, Giovanna; Assedi, Melania; Bendinelli, Benedetta; Ermini, Ilaria; Occhini, Daniela; Sieri, Sabina; Brighenti, Furio; Del Turco, Marco Rosselli; Ambrogetti, Daniela; Palli, Domenico

    2013-01-01

    A few studies have evaluated the association between diet and mammographic breast density (MBD) and results are inconsistent. MBD, a well-recognized risk factor for breast cancer, has been proposed as a marker of cumulative exposure to hormones and growth factors. Diets with a high glycemic index (GI) or glycemic load (GL) may increase breast cancer risk, via an effect on the insulin-like growth factor axis. We have investigated the association between carbohydrate intake, GI, GL and MBD in a prospective study. We identified a large series of women, in the frame of the EPIC-Florence cohort, with a mammogram taken five years after enrolment, when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected. Mammograms have been retrieved (1,668, 83%) and MBD assessed according to Wolfe's classification. We compared women with high MBD (P2+DY Wolfe's categories) with those with low MBD (N1+P1) through logistic models adjusted for age, education, body mass index, menopause, number of children, breast feeding, physical activity, non-alcohol energy, fibers, saturated fat and alcohol. A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile (OR = 1.73, 95%CI 1.13-2.67, p for trend = 0.048) while no association with glycemic index was evident. These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes, and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered. The effect was particularly evident among leaner women, although no interaction was found. A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles. In this Italian population we observed an association between glycemic load, total and rapidly absorbed carbohydrates and high MBD. These novel results warrant further investigations.

  8. Breast Cancer Risk in American Women

    Science.gov (United States)

    ... Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training at ... carry these changes. Mammographic breast density : The glandular (milk-producing) and connective tissue of the breast are ...

  9. A Review of Segmentation of Mammographic Images Based on Breast Density

    Directory of Open Access Journals (Sweden)

    Anusree Mohan

    2015-03-01

    Full Text Available Breast cancer is one of the leading causes of fatality in women. Mammogram is the effectual modality for early detection of breast cancer. Increased mammographic breast density is a moderate independent risk factor for breast cancer, Radiologists have estimated breast density using four broad categories (BI-RADS swearing on visual assessment of mammograms. The aim of this paper is to review approaches for segmentation of breast regions in mammograms according to breast density. Studies based on density have been undertaken because of the relationship between breast cancer and density. Breast cancer usually occurs in the fibroglandular area of breast tissue, which appears bright on mammograms and is described as breast density. Most of the studies are focused on the classification methods for glandular tissue detection. Others highlighted on the segmentation methods for fibroglandular tissue, while few researchers performed segmentation of the breast anatomical regions based on density. There have also been works on the segmentation of other specific parts of breast regions such as either detection of nipple position, skin-air interface or pectoral muscles. The problems on the evaluation performance of the segmentation results in relation to ground truth are also discussed in this paper.

  10. Relationship of Terminal Duct Lobular Unit Involution of the Breast with Area and Volume Mammographic Densities

    Science.gov (United States)

    Gierach, Gretchen L.; Patel, Deesha A.; Pfeiffer, Ruth M.; Figueroa, Jonine D.; Linville, Laura; Papathomas, Daphne; Johnson, Jason M.; Chicoine, Rachael E.; Herschorn, Sally D.; Shepherd, John A.; Wang, Jeff; Malkov, Serghei; Vacek, Pamela M.; Weaver, Donald L.; Fan, Bo; Mahmoudzadeh, Amir Pasha; Palakal, Maya; Xiang, Jackie; Oh, Hannah; Horne, Hisani N.; Sprague, Brian L.; Hewitt, Stephen M.; Brinton, Louise A.; Sherman, Mark E.

    2016-01-01

    Elevated mammographic density (MD) is an established breast cancer risk factor. Reduced involution of terminal duct lobular units (TDLUs), the histologic source of most breast cancers, has been associated with higher MD and breast cancer risk. We investigated relationships of TDLU involution with area and volumetric MD, measured throughout the breast and surrounding biopsy targets (peri-lesional). Three measures inversely related to TDLU involution (TDLU count/mm2, median TDLU span, median acini count/TDLU) assessed in benign diagnostic biopsies from 348 women, ages 40–65, were related to MD area (quantified with thresholding software) and volume (assessed with a density phantom) by analysis of covariance, stratified by menopausal status and adjusted for confounders. Among premenopausal women, TDLU count was directly associated with percent peri-lesional MD (P-trend=0.03), but not with absolute dense area/volume. Greater TDLU span was associated with elevated percent dense area/volume (P-trendbreast cancer risk suggest that associations of MD with breast cancer may partly reflect amounts of at-risk epithelium. If confirmed, these results could suggest a prevention paradigm based on enhancing TDLU involution and monitoring efficacy by assessing MD reduction. PMID:26645278

  11. The recurrence pattern following delayed breast reconstruction after mastectomy for breast cancer suggests a systemic effect of surgery on occult dormant micrometastases.

    Science.gov (United States)

    Dillekås, Hanna; Demicheli, Romano; Ardoino, Ilaria; Jensen, Svein A H; Biganzoli, Elia; Straume, Oddbjørn

    2016-07-01

    The purpose of this study was to characterize the recurrence dynamics in breast cancer patients after delayed reconstruction. We hypothesized that surgical reconstruction might stimulate dormant micrometastases and reduce time to recurrence. All mastectomy breast cancer patients with delayed surgical reconstruction at Haukeland University Hospital, between 1977 and 2007, n = 312, were studied. Our control group consisted of 1341 breast cancer patients without reconstruction. For each case, all patients in the control group with identical T and N stages and age ±2 years were considered. A paired control was randomly selected from this group. 10 years after primary surgery, 39 of the cases had relapsed, compared to 52 of the matched controls. The reconstructed group was analyzed for relapse dynamics after mastectomy; the first peak in relapses was similarly timed, but smaller than for the controls, while the second peak was similar in time and size. Second, the relapse pattern was analyzed with reconstruction as the starting point. A peak in recurrences was found after 18 months, and a lower peak at the 5th-6th year. The height of the peak correlated with the extent of surgery and initial T and N stages. Timing of the peak was not affected, neither was the cumulative effect. The relapse pattern, when time origin is placed both at mastectomy and at reconstruction, is bimodal with a peak position at the same time points, at 2 years and at 5-6 years. The timing of the transition from dormant micrometastases into clinically detectable macrometastases might be explained by an enhancing effect of surgery.

  12. MRI surveillance for women with dense breasts and a previous breast cancer and/or high risk lesion.

    Science.gov (United States)

    Nadler, Michelle; Al-Attar, Hyder; Warner, Ellen; Martel, Anne L; Balasingham, Sharmila; Zhang, Liying; Lipton, Joseph H; Curpen, Belinda

    2017-08-01

    The role of surveillance breast MRI for women with mammographically dense breasts, a personal history of breast cancer (BC), atypical hyperplasia (AH), or lobular carcinoma in situ (LCIS) is unclear. We estimated the performance of annual surveillance MRI in women with a combination of these risk factors. We performed a retrospective review of the clinical, radiological, and pathological parameters of women who received annual concurrent surveillance breast MRI and mammography between 04/2013 and 12/2015 and fulfilled all of the following criteria: 1) age <70; 2) prior diagnosis of AH, LCIS or BC; 3) heterogeneously or extremely dense breast(s); and 4) did not qualify for our provincial breast MRI high risk screening program. This study included 198 patients (266 MRI exams). MRI detected 15 cancers: 11 invasive stage I and 4 in-situ. All but 1 were mammographically occult and there were no interval cancers. The cancer detection rate (CDR) and false positive (FP) rate were 6.1% and 21% for round one and 4.7% and 12.5% for round two, respectively. Not being on anti-estrogen therapy and having a 1st degree relative with BC significantly increased the likelihood of tumor detection. The CDR and FP rate of surveillance MRI in this study were comparable to those reported for women with BRCA mutations. The addition of annual MRI to mammography should be considered for surveillance of women with a combination of these risk factors, particularly if they have a family history of BC and are not on anti-estrogen therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Occult hemorrhage in children with severe ITP.

    Science.gov (United States)

    Flores, Adolfo; Buchanan, George R

    2016-03-01

    Little is known about the frequency and significance of clinically unapparent or occult hemorrhage in ITP. Therefore, we prospectively explored the sites and frequency of occult bleeding in children with severe ITP at diagnosis or upon symptomatic relapse in a prospective, single-institution cohort study of patients ≤ 18 years of age and a platelet count ≤ 10,000/mm(3) . Data collected included bleeding severity assessment, urinalysis, fecal occult blood testing, and non-contrast brain MRI. Stool and urine samples were tested within 7 days of diagnosis or symptomatic relapse. Three months after diagnosis or relapse a noncontrast brain MRI evaluated hemosiderin deposits resulting from prior localized hemorrhage. Fifty-two ITP patients were enrolled with a mean platelet count of 4,000/mm(3) . A significant occurrence of occult hemorrhage was identified in the urine (27%) compared with clinically overt hematuria (0.91%, P occult bleeding in the urinary tract. There was no relationship between occult hemorrhage and bleeding manifestations on physical examination. Occult hemorrhage was not a harbinger of subsequent bleeding. Our findings suggest that occult hemorrhage occurs with greater frequency than overt bleeding in children with severe ITP. CNS microbleeding is a potential risk in this patient population. Assessment of brain microbleeds and microscopic hematuria in this patient population require additional study.

  14. Solitary brain metastasis of an occult and stable small-cell lung cancer in a schizophrenic patient: a 3-year control.

    Science.gov (United States)

    Jesien-Lewandowicz, Emilia; Spych, Michal; Fijuth, Jacek; Kordek, Radzislaw

    2010-08-01

    Small-cell lung cancer is a highly aggressive carcinoma, with poorer prognosis in patients with brain metastases. We present the case of a 49-year-old woman diagnosed with a cerebellar tumour which, following surgery, was revealed to be a metastatic small-cell lung carcinoma. Subsequent CT and PET scanning showed a small, isolated 8 mm nodule in the upper lobe of the right lung. The patient was suffering from schizophrenia and has been treated with clozapine for 17 years. Because of the unusual presentation, there was no therapy given for the primary tumour at the time, and systemic therapy or surgery was discussed. However, 18 months later, the nodule was slightly larger (14 mm), and surgery was performed. On pathology examination, the tumour was presented as a typical small-cell carcinoma. Standard chest irradiation with systemic chemotherapy was given. At the time of writing, 39 months after diagnosis of metastatic small-cell carcinoma, the patient is disease free. However, this case is unusual in that a long-term observation of a small stable primary tumour in the lung took place without any therapy being given. This case strongly supports the thesis that small-cell lung cancer may comprise a heterogeneous group of tumours with different biological properties. The proapoptotic effect of clozapine may be also taken into account.

  15. Mammographic Artifacts on Full-Field Digital Mammography

    OpenAIRE

    Choi, Jae Jeong; Kim, Sung Hun; Kang, Bong Joo; Choi, Byung Gil; Song, ByungJoo; Jung, Haijo

    2013-01-01

    This study investigates the incidence of full-field digital mammographic (FFDM) artifacts with three systems at two institutions and compares the artifacts between two detector types and two grid types. A total of 4,440 direct and 4,142 indirect FFDM images were reviewed by two radiologists, and artifacts were classified as patient related, hardware related, and software processing. The overall incidence of FFDM artifacts was 3.4 % (292/8,582). Patient related artifacts (motion artifacts and ...

  16. Sonographic and Mammographic Features of Breast Apocrine Metaplasia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Do Youn; Kang, Seok Seon; Ji, Eun Kyung; Kwon, Tae Hee; Park, Hae Lin; Shim, Jeong Yun [CHA Hospital, Pochon CHA University College of Medicine, Pocheon (Korea, Republic of)

    2008-03-15

    To evaluate the sonographic and mammographic features of apocrine metaplasia of the breast. We retrospectively evaluated the sonographic and mammographic findings of 16 lesions that were diagnosed with only apocrine metaplasia after mammotome excision. The age ranged from 27 years old to 57 years old (mean age: 40 years old). The sonographic features were interpreted by the ACR BI-RADS(American College of Radiology Breast Imaging Reporting and Data System) for shape, orientation, margin, boundary, echo pattern, posterior acoustic feature, calcification and special cases. The mammographic features were interpreted by the ACR BI-RADS (American College of Radiology Breast Imaging Reporting and Data System) for breast composition, shape, margin, density and calcification. Sonographic features were that the shapes were oval (n = 16) in 100%. The orientation was parallel (n =15) in 94%. The margins were circumscribed (n = 8) in 50% and microlobulated (n = 8) in 50%. The echo patterns were hypoechoic (n = 8) in 50%, complex (n = 5) in 31% and anechoic (n = 3) in 19%. Posterior acoustic enhancement was seen in 69% (n = 11). There was internal microcyst (n = 4) in 25%. There was no calcification. Mammography performed for 12 cases demonstrated negative findings (n = 10) for 83%, obscured hypodense mass (n = 1) for 8% in 11 cases of breast composition 3 and 4, and circumscribed isodense mass (n = 1)for 8% in one case of breast composition 2. There was no calcification. The final assessment was category 4a (n= 7) in 44%, category 3 (n = 6) in 38% and category 2 (n = 3) in 19%. Although sonographic and mammographic features of apocrine metaplasia are occasionally suspicious malignancy such as microlobulation and complex echo. We consider the possibility of apocrine metaplasia if masses show internal microcyst and abrupt boundary

  17. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet

    DEFF Research Database (Denmark)

    Paci, Eugenio; Lynge, Elsebeth

    2012-01-01

    To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women.......To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women....

  18. Occultations for probing atmosphere and climate

    CERN Document Server

    Foelsche, Ulrich; Steiner, Andrea

    2004-01-01

    Use of occultation methodology for observing the Earth's atmosphere and climate has become so broad as to comprise solar, lunar, stellar, navigation and satellite­ crosslink occultation methods. The atmospheric parameters obtained extend from the fundamental variables temperature, density, pressure, water vapor, and ozone via a multitude of trace gas species to particulate species such as aerosols and cloud liquid water. Ionospheric electron density is sensed as well. The methods all share the key properties of self-calibration, high accuracy and vertical resolution, global coverage, and (if using radio signals) all-weather capability. Occultation data are thus of high value in a wide range of fields including climate monitoring and research, atmospheric physics and chemistry, operational meteorology, and other fields such as space weather and planetary science. This wide area of variants and uses of the occultation method has led to a diversi­ fication of the occultation-related scientific community into a...

  19. Computing mammographic density from a multiple regression model constructed with image-acquisition parameters from a full-field digital mammographic unit

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Lee-Jane W [Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555-1109 (United States); Nishino, Thomas K [Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555-0709 (United States); Khamapirad, Tuenchit [Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555-0709 (United States); Grady, James J [Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555-1109 (United States); Jr, Morton H Leonard [Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555-0709 (United States); Brunder, Donald G [Department of Academic Computing/Academic Resources, University of Texas Medical Branch, Galveston, TX 77555-1035 (United States)

    2007-08-21

    Breast density (the percentage of fibroglandular tissue in the breast) has been suggested to be a useful surrogate marker for breast cancer risk. It is conventionally measured using screen-film mammographic images by a labor-intensive histogram segmentation method (HSM). We have adapted and modified the HSM for measuring breast density from raw digital mammograms acquired by full-field digital mammography. Multiple regression model analyses showed that many of the instrument parameters for acquiring the screening mammograms (e.g. breast compression thickness, radiological thickness, radiation dose, compression force, etc) and image pixel intensity statistics of the imaged breasts were strong predictors of the observed threshold values (model R{sup 2} = 0.93) and %-density (R{sup 2} = 0.84). The intra-class correlation coefficient of the %-density for duplicate images was estimated to be 0.80, using the regression model-derived threshold values, and 0.94 if estimated directly from the parameter estimates of the %-density prediction regression model. Therefore, with additional research, these mathematical models could be used to compute breast density objectively, automatically bypassing the HSM step, and could greatly facilitate breast cancer research studies.

  20. Computing mammographic density from a multiple regression model constructed with image-acquisition parameters from a full-field digital mammographic unit

    Science.gov (United States)

    Lu, Lee-Jane W.; Nishino, Thomas K.; Khamapirad, Tuenchit; Grady, James J.; Leonard, Morton H., Jr.; Brunder, Donald G.

    2007-08-01

    Breast density (the percentage of fibroglandular tissue in the breast) has been suggested to be a useful surrogate marker for breast cancer risk. It is conventionally measured using screen-film mammographic images by a labor-intensive histogram segmentation method (HSM). We have adapted and modified the HSM for measuring breast density from raw digital mammograms acquired by full-field digital mammography. Multiple regression model analyses showed that many of the instrument parameters for acquiring the screening mammograms (e.g. breast compression thickness, radiological thickness, radiation dose, compression force, etc) and image pixel intensity statistics of the imaged breasts were strong predictors of the observed threshold values (model R2 = 0.93) and %-density (R2 = 0.84). The intra-class correlation coefficient of the %-density for duplicate images was estimated to be 0.80, using the regression model-derived threshold values, and 0.94 if estimated directly from the parameter estimates of the %-density prediction regression model. Therefore, with additional research, these mathematical models could be used to compute breast density objectively, automatically bypassing the HSM step, and could greatly facilitate breast cancer research studies.

  1. Gram-negative bacteremia as a clinical marker of occult malignancy

    DEFF Research Database (Denmark)

    Søgaard, Kirstine K; Farkas, Dóra K; Søgaard, Mette;

    2017-01-01

    OBJECTIVES: Gram-negative bacteremia may be a harbinger of occult cancer. We examined the risk of cancer following hospitalization with bacteremia. METHODS: Using medical databases, we conducted a nationwide population-based cohort study of all Danes with a discharge diagnosis of Gram-negative ba...... of follow-up, the SIR declined to 1.13 (95% CI: 1.05-1.20). CONCLUSIONS: Gram-negative bacteremia is a clinical marker of occult cancer.......OBJECTIVES: Gram-negative bacteremia may be a harbinger of occult cancer. We examined the risk of cancer following hospitalization with bacteremia. METHODS: Using medical databases, we conducted a nationwide population-based cohort study of all Danes with a discharge diagnosis of Gram...... of gastrointestinal cancer (3- to 13-fold higher), genitourinary cancer (4- to 10-fold higher), non-Hodgkin lymphoma (5-fold higher), non-specified metastatic cancer (5-fold higher), and breast and lung cancer (2-fold higher). The 6-12 months SIR for any cancer was 1.46 (95% CI: 1.22-1.72), and beyond 1 year...

  2. MRI对X线上致密型乳腺中乳腺癌的诊断价值%The Value of MRI in Diagnosing Breast Cancer in Mammographic Dense Breasts

    Institute of Scientific and Technical Information of China (English)

    姜婷婷; 李志; 汪登斌; 柴维敏

    2012-01-01

    Purpose: To explore the MRI characteristics of breast cancers with histopathological correlation in dense breasts on mammography compared with those in nondense. Methods: From March, 2009 to March, 2010, there were 180 women who were diagnosed with breast cancer, and 77 of them were regarded as having dense breasts on mammography. All patients were performed with breast MRI by using GE 1.5 T Signa Excite MR imager. The MRI manifestations were analyzed to define the characteristics of the breast cancers in dense breast compared with those in non-dense breast. Results: The dense breast group had 66 infiltrating ductal carcinoma (85.7%), 8 ductal carcinoma in situ(DCIS)( 10.4%), 3 other types(3.9%);while the non-dense breast group included 85 infiltrating ductal carcinoma (82.5%),7 DCIS(6.8%),11 other types(10.7%). The size of the lesion in dense breast was bigger than that in non-dense breast (2.3cm vs 1.9cm, P<0.05). The breast cancers in dense breast were vulnerable to have a spiculated or obscured margin (43 of 60 in the dense breast group vs 47 of 87 in the non-dense breast group, P<0.05). The grading of the invasive ductal carcinoma (IDC) was higher than that in non-dense breasts(P<0.05). The patients in dense breast group were younger than the other group (47.2 yrs vs 60.1 yrs, P<0.05) Conclusion: The breast cancer in the dense breast has different MRI findings with histopathological correlation compared with those in non-dense breast.%目的:探讨致密型乳腺中乳腺癌MRI表现,以组织病理学为标准,与非致密型乳腺中乳腺癌作对照分析.方法:2009年3月至2010年3月来我院完成乳腺MRI及X线摄影检、病理组织学诊断为乳腺癌的连续180例病人纳入研究,年龄28~85岁,平均54.4岁;按X线摄影上纤维腺体组织密度分型标准将入组病例分为致密型和非致密型,并对两组的乳腺癌MRI表现进行对比分析,进一步归纳出致密型中乳腺癌的MRI特点.结果:致密型乳腺77

  3. Breast nodules detection in images of ultrasonographic and mammographic simulators; Deteccao de nodulos mamarios em imagens de simuladores ultrassonografico e mamografico

    Energy Technology Data Exchange (ETDEWEB)

    Marcomini, Karem D.; Schiabel, Homero, E-mail: karem.dm@usp.br [Universidade de Sao Paulo (USP), Sao Carlos, SP (Brazil). Escola de Engenharia. Dept. de Engenharia Eletrica; Carneiro, Antonio Adilton O. [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras. Dept. de Fisica

    2013-08-15

    Due to the high incidence rate of breast cancer in women, many procedures have been developed to assist in the diagnosis and early detection. Mammography and ultrasonography stand out as the main breast imaging techniques. In this context, the schemes of computer-aided diagnosis have provided to the specialist a more accurate and reliable second opinion by minimizing the visual subjectivity inter-observer. Thus, we propose the application of an automated method of segmentation, through the neural network SOM, to provide accurate information regarding the border of the lesion. The tests were employed in 100 mammographic images and 70 sonographic, both cases obtained by simulation. In order to verify the accuracy of the boundaries demarcated by the automatic detector, quantitative measurements were extracted to compare these images with the manually delineated by an experienced radiologist. The proposed technique presented high accuracy and sensitivity, and low error rate in correctly representing the mammographic and sonographic findings. (author)

  4. Clinicopathologic correlations and significance of clinically occult mammary lesions.

    Science.gov (United States)

    Schwartz, G F; Feig, S A; Patchefsky, A S

    1978-03-01

    Experience with 189 clinically occult, i.e., nonpalpable breast lesions is presented. The described technique of localization and excision all but guarantees removal of even the smallest radiographically suspicious findings with an inconspicuous incision and minimal breast deformity. The incidence of carcinoma encountered in these 189 biopsies is 27.5%. Axillary node metastases were present in less than 25% of the invasive nonpalpable cancers, approximately half of what might have been expected if the lesions had been discovered in the usual manner. There were no patients with axillary node metastases among those with in situ ductal or microinvasive ductal carcinomas. This implies a better prognosis and lower death rate from breast cancer in these patients. Screening programs employing mammography, designed to detect breast cancers in this pre-palpable stage, are encountered as a means of uncovering a higher proportion of such cancers at an earlier stage in their natural histories.

  5. Clinicopathological features and prognosis analysis of 72 patients with occult breast cancer%隐匿性乳腺癌72例临床病理特征和预后分析

    Institute of Scientific and Technical Information of China (English)

    黄清丰; 吕晶; 霍彦平; 杨迎旭; 付倩; 张兰; 邱新光

    2014-01-01

    目的:分析隐匿性乳腺癌( occult breast cancer ,OBC)的临床病理特征及预后情况,了解患者生存状态并探讨其最佳诊疗方案。方法回顾性分析72例经手术和病理证实的OBC的临床资料,并将同期320例非OBC作为对照组探讨其预后情况。结果72例均以腋窝肿物为首要症状。 MRI乳腺内可疑病灶检出率为71.4%,高于钼靶 X 线摄影的53.5%,2者差异有统计学意义(χ2=11.876, P =0.001)。腋下淋巴结转移灶癌细胞多为中-低分化,表现为淋巴结弥漫浸润的成片的大Apocrine样细胞;免疫组化CK7、CK20和TTF-1的阳性率分别为96.7%、6.7%和3.3%,与对照组相比差异无统计学意义(χ2=0.058,P=0.810);ER、PR的阳性率分别为46.7%和36.7%,显著低于对照组,差异有统计学意义(χ2=4.535,P=0.033)。临床分期、术式、淋巴结转移数目是影响其预后的独立因素。结论 OBC以腋窝肿物为首要症状,MRI联合免疫组化更有利于OBC的诊断与鉴别诊断;OBC的ER、PR阳性率低,改良根治术联合辅助治疗可能是更好的治疗选择。%Objective To analyze the clinicopathological features and prognosis of patients with occult breast cancer ( OBC) , as well as to explore the best treatment .Methods The clinical data of 72 patients with OBC confirmed by pathology were retrospectively analyzed , while 320 cases with other kind of breast cancer were the control group .Results Axillary mass was the first sign of the 72 patients with OBC.The diagnosis rate of MRI was higher than mammary graphy ( 71.4% vs 53.5%) .The difference had statistical significance (χ2 =11.876, P=0.001) .The characteristics of OBC with axillary lymph node metastasis was mainly moderately or low differenti -ated, usually with diffuse infiltrative cancer cells , flaky, like large Apocrine cells.Compared with the control group, the positive rate of CK7, CK20 and TTF-1 had no

  6. Influence of sample return time and ambient temperature on the performance of an immunochemical faecal occult blood test with a new buffer for colorectal cancer screening.

    Science.gov (United States)

    Dancourt, Vincent; Hamza, Samia; Manfredi, Sylvain; Drouillard, Antoine; Bidan, Jeanne-Marie; Faivre, Jean; Lepage, Come

    2016-03-01

    The haemoglobin concentration measured by faecal immunochemical tests (FIT) may be decreased in cases of delayed sample return or high temperature. It is an issue of great importance. The aim of this study was to investigate the effects of sample return time and of season on the performance of an FIT (FOB-Gold) with a new buffer. The study included 20 371 participants involved in the French organized colorectal cancer (CRC) screening programme. The probability of a positive screening test, detection rates and positive predictive values for CRC and advanced adenoma were analysed according to sample return time and season of screening. A sample of positive FIT was stored for 7 days in an incubator at 20°C or 30°C. The positivity rate was 4.1% for a sample return time of up to 3 days, 4.1% for 4-5 days and 4.6% for 6-7 days (P=0.25). In multivariate analysis, there was no association between positivity rates, detection rates and positive predictive values for CRC and advanced adenoma and the sample return time or the season of screening. At a constant temperature of 20°C, there was a decrease in the haemoglobin concentration of 5.1% after 7 days. The decrease reached 20.5% at a temperature of 30°C. It was only 4.5% during the first 4 days of storage in the incubator. With the new buffer, delay in sample return or season did not affect the clinical outcome. When temperatures reach 30°C, the faecal sample must be returned promptly.

  7. Key Issues of Clinical Management for Occult Breast Cancer%隐匿型乳腺癌的临床诊治要点

    Institute of Scientific and Technical Information of China (English)

    张斌; 孟然; 赵洪猛; 曹旭晨

    2010-01-01

    隐匿型乳腺癌(Occull breast cancer,OBC)是以腋窝淋巴结转移癌为主要表现的一种少见的乳腺癌表现.对于这类患者应当进行完善的术前检查,不仅需要包括标准的双侧乳腺摄影片,还要通过超声和核磁共振评估双侧乳腺和腋窝淋巴结,以寻找原发病灶.由于此类患者具有较高的局部复发风险,因此不推荐单纯对乳腺进行观察,乳房局部治疗应包括全乳切除,也可以考虑保留乳房联合全乳放疗.同时也应进行腋窝淋巴结清扫以提高局部控制并且完善分期.此外,患者还可以接受新辅助或辅助全身治疗.虽然隐匿性乳腺癌伴腋窝转移患者的疾病分期为T0N1-2M0期,但比同期别原发性乳腺癌预后更好,腋窝淋巴结转移数目,尤其是小于4枚转移与4枚或以上转移相比仍然是最为可靠的预测结局的因素.

  8. Early detection of occult atrial fibrillation and stroke prevention.

    Science.gov (United States)

    Keach, Joseph Walker; Bradley, Steven M; Turakhia, Mintu P; Maddox, Thomas M

    2015-07-01

    Atrial fibrillation (AF) is a very common arrhythmia and significantly increases stroke risk. This risk can be mitigated with oral anticoagulation, but AF is often asymptomatic, or occult, preventing timely detection and treatment. Accordingly, occult AF may cause stroke before it is clinically diagnosed. Currently, guidelines for the early detection and treatment of occult AF are limited. This review addresses recent advancements in occult AF detection methods, identification of populations at high risk for occult AF, the treatment of occult AF with oral anticoagulation, as well as ongoing trials that may answer critically important questions regarding occult AF screening.

  9. Sociology of religion and the occult revival

    Directory of Open Access Journals (Sweden)

    Lennart Ejerfeldt

    1975-01-01

    Full Text Available The "new" that makes the cults of the occult revival to "new religions" of the Western world, is their recently increased social significance. Historically most of modern occultism is anything but new. From the research and theorizing about the occult revival we have picked up some main themes. The first is the social diffusion of the new occultism. In this field, we find some studies of superstition, especially astrology. These illuminate the differences in social connotation between the consumers of superstition and the followers of institutional religion. Secondly the study of the occult revival has made valuable contributions to the conceptualizing of "cult" and the cultic phenomenon. Thirdly, we will look upon the connection between the occult revival and the counter-culture. The problem of the rise of cults as a symptom of socio-cultural change will be briefly discussed with reference to Bell's thesis of "the disjuntion of culture and social structure". Lastly, we proffer some reflections on the occult revival and the new spiritual trends in the churches, which so sharply contrast with the theology and churchmanship of the sixties.

  10. Effect of a low-fat, high-carbohydrate dietary intervention on change in mammographic density over menopause.

    Science.gov (United States)

    Martin, Lisa J; Greenberg, Carolyn V; Kriukov, Valentina; Minkin, Salomon; Jenkins, David J A; Yaffe, Martin; Hislop, Gregory; Boyd, Norman F

    2009-01-01

    We have previously shown that a low-fat dietary intervention for 2 years in women with extensive mammographic density decreased mammographic density to a greater extent than in the control group. Post-hoc analysis indicated that this effect was strongest in women who became postmenopausal during the follow-up period. The purpose of the present study was to determine if this potentially important finding could be confirmed in a new and larger group of subjects with a longer follow-up time. Participants in a low-fat dietary intervention trial who were premenopausal at entry and became postmenopausal during follow-up were examined. Total breast, dense, and non-dense area and percent density were measured in baseline and postmenopause mammograms using a computer-assisted method. Total breast and non dense area increased more in the control group compared to the intervention group (for breast area 2.6 and 0.2 cm(2), respectively; P=0.05, and for non-dense area 10.9 and 8.1 cm(2), respectively; P=0.06). Dense area decreased to a similar degree in both groups (-8.2 and -8.0 cm(2), respectively; P=0.84). Percent density decreased to a slightly greater degree in the control compared to intervention group (-9.4 and -7.8%, respectively, P=0.11). There were no significant differences between study groups after adjustment for weight change. Menopause reduced density to a similar extent in the low-fat diet and control groups. If a low-fat diet reduces breast cancer risk, the effect is unlikely to be through changes in mammographic density at menopause.

  11. Future Nanosatellite Constellation for Radio Occultation Measurements

    Science.gov (United States)

    Fallet, C.; Mahfouf, J. F.; Hauchechrne, A.; Mathieu, R.; Martin, T.; Capet, N.; Mandea, M.

    2016-08-01

    The future nanosatellite constellation for radio occultation measurements aims to provide 10000 occultations per day (horizon 2020). The radio occultation technique based on the refraction of an electromagnetic signal between a GNSS satellite (Global Navigation Satellite System) and a receiver satellite located o a low orbit provides a way to observe the Earth's atmosphere, especially its temperature, pressure and water vapor, but also the ionosphere. This technique is now considered a mature concept, the benefits clearly recognized by the communities of weather prediction, climatology and space weather. Activities are underway at CNES to define a low cost system and instrumental concept to satisfy the specifications of the different communities.

  12. The Approach to Occult Gastrointestinal Bleed.

    Science.gov (United States)

    Naut, Edgar R

    2016-09-01

    Occult gastrointestinal bleeding is not visible and may present with a positive fecal occult blood test or iron deficiency anemia. Obscure bleeding can be overt or occult, with no source identified despite an appropriate diagnostic workup. A stepwise approach to this evaluation after negative upper and lower endoscopy has been shown to be cost effective. This includes repeat endoscopies if warranted, followed by video capsule endoscopy (VCE) if no obstruction is present. If the VCE is positive then specific endoscopic intervention may be possible. If negative, patients may undergo either repeat testing or watchful waiting with iron supplements. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The Lunar Occultation Observer (LOCO) mission concept

    Science.gov (United States)

    Miller, Richard S.

    2007-09-01

    The hard X-ray sky has tremendous potential for future discoveries and is one of the last electromagnetic regimes without a sensitive all-sky survey. A new approach to such a survey is to utilize the Moon as an occulting disk. The Lunar Occultation Observer (LOCO) mission concept, based on this Lunar Occultation Technique (LOT) and incorporating advanced inorganic scintillators as a detection medium, represents a sensitive and cost effective option for NASA's Beyond Einstein Black Hole Finder Probe or a future Explorer-class mission. We present the motivating factors for the LOT, outline developmental details and simulation results, as well as give preliminary estimates for source detection sensitivity.

  14. The occultation of Arcturus in the Vatican

    CERN Document Server

    Sigismondi, Costantino

    2013-01-01

    The dome of Saint Peter's Basilica plays the role of the Moon during a stellar occultation and Arcturus is the target star. This occultation-like phenomenon is useful for introducing to occultation astronomy a class of student up to university level. It can be organized very easily at the convenience of the audience. Techical and didactical aspects are discussed; the video is available at http://www.youtube.com/watch?v=hIfsj7t-u-c and has been realized with an ordinary camcorder.

  15. 隐匿性乳腺癌的治疗选择及预后因素分析%Analyses of treatment outcomes and prognostic factors for occult breast cancer

    Institute of Scientific and Technical Information of China (English)

    杨雪; 王靖; 张业繁; 王翔宇; 方仪

    2015-01-01

    Objective:Occult breast cancer (OBC) accounts for 0.3%-1.0%of all breast cancers. Because of the rarity of this dis-ease, its treatment and prognosis remain unclear. Our study evaluated the treatment outcomes and prognostic factors associated with OBC. Methods:A total of 82 patients diagnosed with OBC based on available criteria were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China, between January 1968 and June 2014. Except for 16 patients who were treated by needle biopsy or excisional biopsy only and were subsequently excluded, all of the cases reported were included in the study. Of the remaining 66 patients, one was male. Patient data, tumor characteristics, and treatment and outcome variables were evaluated. Overall survival (OS) and disease-free survival (DFS) were analyzed. A unicentric retrospective review of 66 patients with OBC was performed. Re-sults:The median follow-up was 75.5 months (7.0-328.0). No significant differences in OS and DFS were observed between patients who underwent mastectomy plus axillary lymph node dissection (Mast+ALND) and those who underwent breast conservation surgery (P>0.05). Univariate analysis revealed that nodal status is a significant prognosis factor of DFS (P=0.031). Conclusion:No significant difference in treatment outcomes between mastectomy+ALND and breast conservation surgery was observed. Nodal status may be an independent predictor of poor outcomes in OBC patients.%目的:探讨隐匿性乳腺癌的治疗方法和预后。方法:回顾性分析中国医学科学院肿瘤医院1968年1月至2014年6月收治的66例隐匿性乳腺癌患者的临床病理及治疗转归资料。结果:患者中位生存期为75.5(7.0~328.0)个月,仅行腋窝淋巴结清扫的保乳手术与改良根治术者的总生存和无病生存差异无统计学意义(P>0.05)。单因素分析提示腋窝淋巴结分期是唯一可能与无病生存(P=0.035)相关的因素。结论

  16. Endoscopic Follow-Up of Positive Fecal Occult Blood Testing in the Ontario FOBT Project

    Directory of Open Access Journals (Sweden)

    Lawrence Paszat

    2007-01-01

    Full Text Available BACKGROUND: The Ontario FOBT Project is a pilot study of fecal occult blood testing (FOBT for colorectal cancer screening conducted among age-eligible volunteers (50 to 75 years in 12 of 37 public health regions in Ontario.

  17. Automated analysis of multiple sections for the detection of occult cells in lymph nodes

    NARCIS (Netherlands)

    Mesker, WE; Doekhie, FS; Vrolijk, H; Keyzer, R; Sloos, WCR; Morreau, H; O'Kelly, PS; de Bock, GH; Tollenaar, RAEM; Tanke, HJ

    2003-01-01

    Purpose: At present, reverse transcription (RT)-PCR against carcino-embryonic antigen mRNA is one of the few research tools for the detection of occult cells in histopathologically assessed negative lymph nodes from patients with colorectal cancer. The aim of this study was to investigate the suitab

  18. Phase-Occultation Nulling Coronagraphy

    CERN Document Server

    Lyon, Richard G; Clampin, Mark; Petrone, Peter

    2015-01-01

    The search for life via characterization of earth-like planets in the habitable zone is one of the key scientific objectives in Astronomy. We describe a new phase-occulting (PO) interferometric nulling coronagraphy (NC) approach. The PO-NC approach employs beamwalk and freeform optical surfaces internal to the interferometer cavity to introduce a radially dependent plate scale difference between each interferometer arm (optical path) that nulls the central star at high contrast while transmitting the off-axis field. The design is readily implemented on segmented-mirror telescope architectures, utilizing a single nulling interferometer to achieve high throughput, a small inner working angle (IWA), sixth-order or higher starlight suppression, and full off-axis discovery space, a combination of features that other coronagraph designs generally must trade. Unlike previous NC approaches, the PO-NC approach does not require pupil shearing; this increases throughput and renders it less sensitive to on-axis common-mo...

  19. Optimal Breast Biopsy Decision-Making Based on Mammographic Features and Demographic Factors.

    Science.gov (United States)

    Chhatwal, Jagpreet; Alagoz, Oguzhan; Burnside, Elizabeth S

    2010-11-01

    Breast cancer is the most common non-skin cancer affecting women in the United States, where every year more than 20 million mammograms are performed. Breast biopsy is commonly performed on the suspicious findings on mammograms to confirm the presence of cancer. Currently, 700,000 biopsies are performed annually in the U.S.; 55%-85% of these biopsies ultimately are found to be benign breast lesions, resulting in unnecessary treatments, patient anxiety, and expenditures. This paper addresses the decision problem faced by radiologists: When should a woman be sent for biopsy based on her mammographic features and demographic factors? This problem is formulated as a finite-horizon discrete-time Markov decision process. The optimal policy of our model shows that the decision to biopsy should take the age of patient into account; particularly, an older patient's risk threshold for biopsy should be higher than that of a younger patient. When applied to the clinical data, our model outperforms radiologists in the biopsy decision-making problem. This study also derives structural properties of the model, including sufficiency conditions that ensure the existence of a control-limit type policy and nondecreasing control-limits with age.

  20. Mammographic images segmentation using texture descriptors.

    Science.gov (United States)

    Mascaro, Angelica A; Mello, Carlos A B; Santos, Wellington P; Cavalcanti, George D C

    2009-01-01

    Tissue classification in mammography can help the diagnosis of breast cancer by separating healthy tissue from lesions. We present herein the use of three texture descriptors for breast tissue segmentation purposes: the Sum Histogram, the Gray Level Co-Occurrence Matrix (GLCM) and the Local Binary Pattern (LBP). A modification of the LBP is also proposed for a better distinction of the tissues. In order to segment the image into its tissues, these descriptors are compared using a fidelity index and two clustering algorithms: k-Means and SOM (Self-Organizing Maps).

  1. Study of a Positron Emission Mammograph

    CERN Document Server

    Trummer, J; Lecoq, P

    2007-01-01

    Today breast cancer is among the most common causes of death for women. One in eight women will develop a tumour in her breast at least once in her lifetime. An early detection of the cancer is crucial to the patient's survival and recovery. For early detec- tion it is necessary to have an instrument with high spatial resolution and efficiency. The scope of this thesis is two aspects of a dedicated PET scanner for mammography developed by the Crystal Clear Collaboration, the ClearPEM. The first half of the thesis deals with the experimental work on scintillation crystals which constitute the main part of the detector. The second part looks into the design of the whole system and the possibility of future enhancements by adding an ultrasound probe and /or a veto-counter. The effects of these changes are studied by employing simulation tools. The key to excellent detector performance is to use scintillation crystals with properties best matched to the requirements of a given application. To better understand th...

  2. McDonald's and the Occult.

    Science.gov (United States)

    Singer, Barry

    1979-01-01

    Discusses "occult" and "paranormal" literature which is often mistaken for nonfiction. Suggests that most publishers are unwilling to publish scientific perspectives on the paranormal because such writings would be unmarketable. Journal availability: see SO 507 190. (KC)

  3. Patient factors associated with non-attendance at colonoscopy after a positive screening faecal occult blood test.

    Science.gov (United States)

    Plumb, Andrew A; Ghanouni, Alex; Rainbow, Sandra; Djedovic, Natasha; Marshall, Sarah; Stein, Judith; Taylor, Stuart A; Halligan, Steve; Lyratzopoulos, Georgios; von Wagner, Christian

    2017-03-01

    Background Screening participants with abnormal faecal occult blood test results who do not attend further testing are at high risk of colorectal cancer, yet little is known about their reasons for non-attendance. Methods We conducted a medical record review of 170 patients from two English Bowel Cancer Screening Programme centres who had abnormal guaiac faecal occult blood test screening tests between November 2011 and April 2013 but did not undergo colonoscopy. Using information from patient records, we coded and categorized reasons for non-attendance. Results Of the 170 patients, 82 were eligible for review, of whom 66 had at least one recorded reason for lack of colonoscopy follow-up. Reasons fell into seven main categories: (i) other commitments, (ii) unwillingness to have the test, (iii) a feeling that the faecal occult blood test result was a false positive, (iv) another health issue taking priority, (v) failing to complete bowel preparation, (vi) practical barriers (e.g. lack of transport), and (vii) having had or planning colonoscopy elsewhere. The most common single reasons were unwillingness to have a colonoscopy and being away. Conclusions We identify a range of apparent reasons for colonoscopy non-attendance after a positive faecal occult blood test screening. Education regarding the interpretation of guaiac faecal occult blood test findings, offer of alternative confirmatory test options, and flexibility in the timing or location of subsequent testing might decrease non-attendance of diagnostic testing following positive faecal occult blood test.

  4. Improved mammographic interpretation of masses using computer-aided diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Leichter, I. [Dept. of Electro-Optics, Jerusalem College of Technology (Israel); Fields, S.; Novak, B. [Dept. of Radiology, Hadassah University Hospital, Mt. Scopus Jerusalem (Israel); Nirel, R. [Dept. of Statistics, Hebrew University of Jerusalem, Mt. Scopus, Jerusalem (Israel); Bamberger, P. [Dept. of Electronics, Jerusalem College of Technology, Jerusalem (Israel); Lederman, R. [Department of Radiology, Hadassah University Hospital, Ein Kerem, Jerusalem (Israel); Buchbinder, S. [Department of Radiology, Montefiore Medical Center, University Hospital for the Albert Einstein College of Medicine, Bronx, New York (United States)

    2000-02-01

    The aim of this study was to evaluate the effectiveness of computerized image enhancement, to investigate criteria for discriminating benign from malignant mammographic findings by computer-aided diagnosis (CAD), and to test the role of quantitative analysis in improving the accuracy of interpretation of mass lesions. Forty sequential mammographically detected mass lesions referred for biopsy were digitized at high resolution for computerized evaluation. A prototype CAD system which included image enhancement algorithms was used for a better visualization of the lesions. Quantitative features which characterize the spiculation were automatically extracted by the CAD system for a user-defined region of interest (ROI). Reference ranges for malignant and benign cases were acquired from data generated by 214 known retrospective cases. The extracted parameters together with the reference ranges were presented to the radiologist for the analysis of 40 prospective cases. A pattern recognition scheme based on discriminant analysis was trained on the 214 retrospective cases, and applied to the prospective cases. Accuracy of interpretation with and without the CAD system, as well as the performance of the pattern recognition scheme, were analyzed using receiver operating characteristics (ROC) curves. A significant difference (p < 0.005) was found between features extracted by the CAD system for benign and malignant cases. Specificity of the CAD-assisted diagnosis improved significantly (p < 0.02) from 14 % for the conventional assessment to 50 %, and the positive predictive value increased from 0.47 to 0.62 (p < 0.04). The area under the ROC curve (A{sub z}) increased significantly (p < 0.001) from 0.66 for the conventional assessment to 0.81 for the CAD-assisted analysis. The A{sub z} for the results of the pattern recognition scheme was higher (0.95). The results indicate that there is an improved accuracy of diagnosis with the use of the mammographic CAD system above that

  5. Accuracy of the mammographic report category according to BIRADS.

    Science.gov (United States)

    Hirunpat, Siriporn; Tanomkiat, Wiwatana; Khojarern, Rungrat; Arpakupakul, Nualta

    2005-01-01

    To determine the accuracy and predictive value of the mammographic report according to the BIRADS categories in Songklanagarind University Hospital. Mammograms of 1000 women who came to Songklanagarind University Hospital from June 1998 to September 1999 were reported and placed in category 1 for negative results, category 2 for benign lesions, category 3 for probably benign lesions, category 4 for suspicious lesions and category 5 for highly suspicious lesions. Accuracy was determined by either histology or by unchanged follow-up mammography within 24 months. The total accuracy was 97.8%, sensitivity 62.5% and specificity 98.1%.

  6. Analysis On Classification Techniques In Mammographic Mass Data Set

    Directory of Open Access Journals (Sweden)

    Mrs. K. K. Kavitha

    2015-07-01

    Full Text Available Data mining, the extraction of hidden information from large databases, is to predict future trends and behaviors, allowing businesses to make proactive, knowledge-driven decisions. Data-Mining classification techniques deals with determining to which group each data instances are associated with. It can deal with a wide variety of data so that large amount of data can be involved in processing. This paper deals with analysis on various data mining classification techniques such as Decision Tree Induction, Naïve Bayes , k-Nearest Neighbour (KNN classifiers in mammographic mass dataset.

  7. Metástase oculta em linfonodo sentinela no câncer de mama em estádios iniciais Occult metastasis in sentinel lymph node in early-stage breast cancer

    Directory of Open Access Journals (Sweden)

    José Roberto Morales Piato

    2008-09-01

    Full Text Available OBJETIVO: a identificação e biópsia do linfonodo sentinela (LS no câncer de mama em estádio inicial vêm substituindo a dissecção axilar total. Neste estudo, será apresentada a técnica de processamento do LS, visando o diagnóstico de metástase oculta com base no exame histológico e imuno-histoquímico. MÉTODOS: entre os anos de 2002 e 2005, 266 linfonodos sentinelas foram dissecados em 170 pacientes com câncer de mama em estádio inicial. Foram incluídos apenas os linfonodos considerados negativos durante análise intra-operatória por citologia. Os linfonodos foram seccionados tranversalmente em quatro ou cinco fatias e incluídos em parafina. Em cada bloco de parafina, dois cortes histológicos com 4 µm de espessura foram montados em lâminas para microscopia de luz e corados pela técnica da hematoxilina-eosina e imunoperoxidase (citoqueratina AE1/AE3. RESULTADOS: a avaliação histológica convencional identificou metástase no LS de 22 pacientes (12,9%. Em seis destas (3,5%, o acometimento foi do tipo micrometástase. Já a metástase oculta diagnosticada exclusivamente pela imuno-histoquímica ocorreu em 16 pacientes (9,4%. Em 11 destas (6,5% foram detectadas células tumorais isoladas e em cinco (2,9%, micrometástases. CONCLUSÕES: a associação do exame histológico de parafina e imuno-histoquímica aumenta a capacidade de identificar metástase oculta no LS de pacientes com câncer de mama em estádios iniciais.PURPOSE: sentinel lymph node biopsy in early-stage breast cancer patients has been substituting the total axillary lymph node is presented dissection. The technique of processing the sentinel lymph node and the aim of this study was to investigate the efficacy of occult metastasis identification based on the standard histological and immunohistochemical examination. METHODS: between 2002 and 2005, 266 sentinel lymph nodes were harvested from axillary biopsy of 170 patients with early stage breast cancer. All

  8. Radio-guided localization of clinically occult breast lesions: current modalities and future directions.

    Science.gov (United States)

    Aydogan, Fatih; Velidedeoglu, Mehmet; Kilic, Fahrettin; Yilmaz, Halit

    2014-01-01

    The extensive availability of breast cancer screening programs and improvement in diagnostic imaging have led to more frequent detection of suspicious and clinically occult breast lesions. Early detection of tumor is important for breast-conserving treatment. Incomplete excision is a major risk factor for local recurrence. Following precise localization and removing the entire lesion while achieving adequate clear margins is the key factor for successful management of non-palpable breast lesions. For this purpose, several techniques such as wire-guided localization, intra-operative ultrasound guided resection, radio-guided occult lesion localization and radioactive seed localization have been described and applied. In this article, we overview the two commonly used localization techniques, radio-guided occult lesion localization and wire-guided localization, particularly describing their advantages and drawbacks.

  9. The diagnostic value of xero-mammography in clinically occult breast carcinoma.

    Science.gov (United States)

    Kambouris, T; Kotoulas, K; Pontifex, G

    1984-05-01

    Seventy-four clinically occult breast carcinomas were detected in 7535 patients who were examined clinically and by xeromammography. The criteria by which a diagnosis of clinically occult breast carcinoma was established are described in detail. The most frequent finding of a clinically occult breast carcinoma in the xeromammogram was an irregular mass density 1 cm in diameter or less with microcalcifications. Axillary lymph node metastases were present in 29.7% of the total group of patients, which is much fewer than what might have been expected if the carcinomas had been discovered by palpation during the clinical examination or by the patient herself. This means a better prognosis and a lower death rate from breast carcinoma. Screening xeromammography is encouraged for all women after the age of 40, especially for those who belong to the high-risk group, even though they are quite asymptomatic, as there is hope of detecting cancers before they become palpable.

  10. 不典型乳腺癌钼靶X线特征分析%Mammographic Features of Non-typical Breast Carcinoma

    Institute of Scientific and Technical Information of China (English)

    秦燕; 赵年; 彭丽蓉; 张勇; 雷果维; 赵艳玲

    2011-01-01

    Objective To investigate the clinical and mammographic features of non-typical breast carcinoma so as to improve the diagnostic level of non-typical breast carcinoma. Methods The mammographic features of 35 patients with non-typical breast carcinoma confirmed by surgery and pathology were analyzed retrospectively. Results The mammographic features of berast carcinoma were non-typical masses in 10 cases .cluster calcification in 22 cases,focal of difuse increased density in 13 cases,structural disorder in 4 cases,dilated ducts in 3 cases. Conclusion Non-typical masses and cluster calcification may be the main feature of non-typical breast cancer in mammography.%目的:探讨不典型乳腺癌钼靶X线片特征.方法:对35例经手术病理证实的不典型乳腺癌钼靶X线片进行回顾性分析.结果:不典型肿块10例,簇状细小钙化22例,局灶性致密影13例,结构紊乱4例,血管影增粗3例.结论:不典型肿块和簇样钙化是不典型乳腺癌的最主要钼靶X线片特点.

  11. GPCALMA: a Grid Approach to Mammographic Screening

    CERN Document Server

    Bagnasco, S; Cerello, P G; Delogu, P; Fantacci, M E; Torres, E L; Masala, G L; Oliva, P R; Retico, A; Stumbo, S

    2004-01-01

    The next generation of High Energy Physics experiments requires a GRID approach to a distributed computing system and the associated data management: the key concept is the "Virtual Organisation" (VO), a group of geographycally distributed users with a common goal and the will to share their resources. A similar approach is being applied to a group of Hospitals which joined the GPCALMA project (Grid Platform for Computer Assisted Library for MAmmography), which will allow common screening programs for early diagnosis of breast and, in the future, lung cancer. HEP techniques come into play in writing the application code, which makes use of neural networks for the image analysis and shows performances similar to radiologists in the diagnosis. GRID technologies will allow remote image analysis and interactive online diagnosis, with a relevant reduction of the delays presently associated to screening programs.

  12. Radio occultation measurements of the lunar ionosphere.

    Science.gov (United States)

    Pluchino, S.; Schillirò, F.; Salerno, E.; Pupillo, G.; Maccaferri, G.; Cassaro, P.

    Radio occultation measurements by using interplanetary probes is a well known technique to obtain information on planetary atmospheres. To further understand the morphology of the lunar ionosphere we performed radio occultation experiments by using the radio sounding technique. This method mainly consists in the analisys of the effects produced on the radio wave transmitted from the spacecraft to the Earth when it crosses the atmosphere. The wave amplitude and phase undergo modifications that are correlated to the physical parameters - i.e. electron density - of the crossed medium. The first data set was obtained during the lunar occultations of the European probe SMART-1 shortly before impacting the lunar soil on September 3rd, 2006. During this experiment several radio occultation measurements of the signal transmitted by the spacecraft were performed in S and X band by using the 32 meters radiotelescopes (at Medicina and Noto) of the Istituto di Radioastronomia - Istituto Nazionale di Astrofisica. Further experiments were performed during lunar occultations of Saturn and Venus. On May 22nd and June 18th 2007 the Cassini spacecraft, orbiting Saturn, and the Venus Express spacecraft, orbiting Venus, respectively were occulted by the Moon. The variation of the Total Electron Content (TEC) measured by our instruments (˜ 1013 el/m2) on this occasion is in agreement with values of the electron number density acquired by in situ measuments of the US Apollo missions and the USSR Luna 19 and 22 probes.

  13. Method of Modeling and Simulation of Shaped External Occulters

    Science.gov (United States)

    Lyon, Richard G. (Inventor); Clampin, Mark (Inventor); Petrone, Peter, III (Inventor)

    2016-01-01

    The present invention relates to modeling an external occulter including: providing at least one processor executing program code to implement a simulation system, the program code including: providing an external occulter having a plurality of petals, the occulter being coupled to a telescope; and propagating light from the occulter to a telescope aperture of the telescope by scalar Fresnel propagation, by: obtaining an incident field strength at a predetermined wavelength at an occulter surface; obtaining a field propagation from the occulter to the telescope aperture using a Fresnel integral; modeling a celestial object at differing field angles by shifting a location of a shadow cast by the occulter on the telescope aperture; calculating an intensity of the occulter shadow on the telescope aperture; and applying a telescope aperture mask to a field of the occulter shadow, and propagating the light to a focal plane of the telescope via FFT techniques.

  14. Background {sup 18}F-FDG uptake in positron emission mammography (PEM): Correlation with mammographic density and background parenchymal enhancement in breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Hye Ryoung, E-mail: huilings@hanmail.net [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chun, In Kook, E-mail: inkook.chun@gmail.com [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Eo, Jae Seon, E-mail: jaeseon76@gmail.com [Department of Nuclear Medicine, Korea University Guro Hospital, 148 Gurodongro, Guro-gu, Seoul 152-703 (Korea, Republic of); Jeyanth, Joseph Xavier, E-mail: jeyanth7@snu.ac.kr [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chang, Jung Min, E-mail: imchangjm@gmail.com [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Cho, Nariya, E-mail: river7774@gmail.com [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Keon Wook, E-mail: kangkw@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of)

    2013-10-01

    We aimed to determine whether background {sup 18}F-FDG uptake in positron emission mammography (PEM) was related to mammographic density or background parenchymal enhancement in breast MRI. Methods: We studied a total of 52 patients (mean age, 50.9 years, 26 premenopausal, 26 postmenopausal) with newly diagnosed breast cancer who underwent {sup 18}F-FDG PEM (positron emission mammography), conventional mammography and breast MRI. The background mean {sup 18}F-FDG uptake value on PEM was obtained by drawing a user-defined region of interest (ROI) in a normal area of the contralateral breast. We reviewed the mammography retrospectively for overall breast density of contralateral breast according to the four-point scale (grade 1–4) of the Breast Imaging Reporting and Data System (BI-RADS) classification. The background parenchymal enhancement of breast MRI was classified as minimal, mild, moderate, or marked. All imaging findings were interpreted by two readers in consensus without knowledge of image findings of other modalities. Results: Multiple linear regression analysis revealed a significant correlation between background {sup 18}F-FDG uptake on PEM and mammographic density after adjustment for age and menopausal status (P < 0.01), but not between background {sup 18}F-FDG uptake on PEM and background parenchymal enhancement on MRI. Conclusion: Background {sup 18}F-FDG uptake on PEM significantly increases as mammographic density increases. Background parenchymal enhancement in breast MRI was not an independent predictor of the background {sup 18}F-FDG uptake on PEM unlike mammographic density.

  15. Pixelated CdTe detectors to overcome intrinsic limitations of crystal based positron emission mammographs

    Science.gov (United States)

    De Lorenzo, G.; Chmeissani, M.; Uzun, D.; Kolstein, M.; Ozsahin, I.; Mikhaylova, E.; Arce, P.; Cañadas, M.; Ariño, G.; Calderón, Y.

    2013-01-01

    A positron emission mammograph (PEM) is an organ dedicated positron emission tomography (PET) scanner for breast cancer detection. State-of-the-art PEMs employing scintillating crystals as detection medium can provide metabolic images of the breast with significantly higher sensitivity and specificity with respect to standard whole body PET scanners. Over the past few years, crystal PEMs have dramatically increased their importance in the diagnosis and treatment of early stage breast cancer. Nevertheless, designs based on scintillators are characterized by an intrinsic deficiency of the depth of interaction (DOI) information from relatively thick crystals constraining the size of the smallest detectable tumor. This work shows how to overcome such intrinsic limitation by substituting scintillating crystals with pixelated CdTe detectors. The proposed novel design is developed within the Voxel Imaging PET (VIP) Pathfinder project and evaluated via Monte Carlo simulation. The volumetric spatial resolution of the VIP-PEM is expected to be up to 6 times better than standard commercial devices with a point spread function of 1 mm full width at half maximum (FWHM) in all directions. Pixelated CdTe detectors can also provide an energy resolution as low as 1.5% FWHM at 511 keV for a virtually pure signal with negligible contribution from scattered events.

  16. Mammographic density is the main correlate of tumors detected on ultrasound but not on mammography.

    Science.gov (United States)

    Häberle, Lothar; Fasching, Peter A; Brehm, Barbara; Heusinger, Katharina; Jud, Sebastian M; Loehberg, Christian R; Hack, Carolin C; Preuss, Caroline; Lux, Michael P; Hartmann, Arndt; Vachon, Celine M; Meier-Meitinger, Martina; Uder, Michael; Beckmann, Matthias W; Schulz-Wendtland, Rüdiger

    2016-11-01

    Although mammography screening programs do not include ultrasound examinations, some diagnostic units do provide women with both mammography and ultrasonography. This article is concerned with estimating the risk of a breast cancer patient diagnosed in a hospital-based mammography unit having a tumor that is visible on ultrasound but not on mammography. A total of 1,399 women with invasive breast cancer from a hospital-based diagnostic mammography unit were included in this retrospective study. For inclusion, mammograms from the time of the primary diagnosis had to be available for computer-assisted assessment of percentage mammographic density (PMD), as well as Breast Imaging Reporting and Data System (BIRADS) assessment of mammography. In addition, ultrasound findings were available for the complete cohort as part of routine diagnostic procedures, regardless of any patient or imaging characteristics. Logistic regression analyses were conducted to identify predictors of mammography failure, defined as BIRADS assessment 1 or 2. The probability that the visibility of a tumor might be masked at diagnosis was estimated using a regression model with the identified predictors. Tumors were only visible on ultrasound in 107 cases (7.6%). PMD was the strongest predictor for mammography failure, but age, body mass index and previous breast surgery also influenced the risk, independently of the PMD. Risk probabilities ranged from 1% for a defined low-risk group up to 40% for a high-risk group. These findings might help identify women who should be offered ultrasound examinations in addition to mammography.

  17. Mammographic density and factors determining it from the point of view of high oncological risks

    Directory of Open Access Journals (Sweden)

    D. A. Vasilyev

    2011-01-01

    Full Text Available There is now extensive proof that high percentage of mammographic density (MD is an independent risk factor for breast cance.r Taking this into account, the research data are summarized with regard to relation of MD to anthropometric, as well as hormonal, genetic and genotoxic factors. There is a negative correlation between MD and such risk factors as age, number of deliveries, BMI and waist-hip ratio. Most inves- tigations show a direct connection between MD and prolactin level or insulin-like growth factor in blood, mostly in premenopaus al women. Relations of MD with blood estrogens, testosterone, sex hormone binding globulin prove to be too diverse to be taken in account of. It is pos- sible that the action of hormones, especially estrogens, is mediated through their metabolites catecholestrogens and / or reactive oxygen spe- cies. There is certain evidence that a genetic component plays a role in MD. It refers to COMT Val158Met, IGF-I rs6220 A> G and UGT1A1 in premenopausal women, and to ESR1 (XbaI и PvuII in menopausal cases.Although it is obvious that the risk of breast cancer related to MD is brought about by many factors, there is a necessity for studying addi- tional criteria modifying the process, as well as for searching means for preventing it.

  18. Reliance on double pedicle TRAM flap technique in breast reconstruction based on mammographic evidence

    Directory of Open Access Journals (Sweden)

    Yüksel Fuat

    2004-01-01

    Full Text Available Breast reconstruction is now a part of the overall treatment of breast cancer. Its main drawback is rather the suspicion to conceal any probable recurrence. Fat necrosis is a particularly important finding because it can be mistaken for a local recurrence. Alternatively, local recurrences may be dismissed as areas of fat necrosis. Fat necrosis is a relatively minor complication of TRAM flap breast reconstruction but one that can induce anxiety, expense, and inconvenience for patients and concerns about tumor recurrence. The techniques selected for reconstruction must carry the least risks for these awful complications. 15 breast cancer cases were treated in our center by using Bostwick′s principles. These include double-pedicle technique in cases with one or two risk factors and added vascular delay two weeks prior to this procedure in cases with more risk factors. During the follow up period, neither the patients nor her physicians experienced any nodules in their treatment sites clinically. One case is the only exception that she felt hardness but it softened. Mammographically, no images of fat necrosis were observed in any of the cases. In contrary to other studies reporting no advantages of double pedicle technique to lessen the risk for fat necrosis, we observed fat necrosis only in one of 15 cases. This may be because both sides of the flap are supplied axially and delay procedures are added in high risk patients.

  19. Clinical analysis of female occult breast cancer with axillary neck node metastasis and literature reviews%女性隐性乳腺癌临床分析及文献复习

    Institute of Scientific and Technical Information of China (English)

    张梅; 徐忠法; 陶阳; 宁连胜; 于洋; 赵文川

    2008-01-01

    Objective To investigate the characteristic,diagnosis,clinical staging, treatment and clinical prognosis of occult breast carcinoma (OBC). Method Forty-six cases of OBC were analyzed retrospectively with the clinical and follow-up information that were confirmed by postoperative pathologic diagnosis from November 1981 to November 2005. Results All patients showed axillary node enlargement as the first sign and were operated.The operation included axillary node excision in 2 patients,radical mastec-tomy or modified radical mastectomy in 44 patients. Forty-five cases got follow-up for 1-22 years,33 cases had existed 3 years,18 cases had existed 5 years,8 cases had existed 10 years. Conclusions For axillary mass which causes are uncertain ,the possibility of OBC should be considered .Meanwhile excision and pathological examination is necessary.The metastatic histological structure and immunohistochemical index of the axillary nodes usually provide important clue for the source of this tumor.Radical or modified mastectomy is the best method, and pest-operative chemotherapy and/or radiotherapy should be done. It has been showed that targeted therapy is very important to breast cancer with C-erbB-2 positive recently.To the cases that neck lymphatic metastasis is M4G3 positive by immunohistochemical examination and no primary focus clinically, the diagnosis of OBC should be considered. The cases without primary focus have better prognosis than those with primary focus.%目的 探讨女性隐性乳腺癌的发病特点、诊断、分期、治疗方法及临床预后.方法 对46例女性隐性乳腺癌患者的临床、病理及随访资料进行回顾性分析.结果 46例患者均以腋窝肿块为首发症状且均予手术治疗.手术方式为单纯腋窝肿块切除术2例,明确病理诊断后,联合化疗无效,分别于术后5个月和1年出现远处转移,失去手术机会,1例仍在化疗中,另1例失访;行乳腺癌根治术或改良根治术44例.45

  20. The Big Occulting Steerable Satellite (BOSS)

    CERN Document Server

    Copi, C J; Copi, Craig J.; Starkman, Glenn D.

    1999-01-01

    Natural (such as lunar) occultations have long been used to study sources on small angular scales, while coronographs have been used to study high contrast sources. We propose launching the Big Occulting Steerable Satellite (BOSS), a large steerable occulting satellite to combine both of these techniques. BOSS will have several advantages over standard occulting bodies. BOSS would block all but about 4e-5 of the light at 1 micron in the region of interest around the star for planet detections. Because the occultation occurs outside the telescope, scattering inside the telescope does not degrade this performance. BOSS could be combined with a space telescope at the Earth-Sun L2 point to yield very long integration times, in excess of 3000 seconds. If placed in Earth orbit, integration times of 160--1600 seconds can be achieved from most major telescope sites for objects in over 90% of the sky. Applications for BOSS include direct imaging of planets around nearby stars. Planets separated by as little as 0.1--0....

  1. [Progress in research of occult hepatitis B virus infection].

    Science.gov (United States)

    Huang, X Y; Shi, Q F; Huang, T

    2017-05-10

    Occult hepatitis B virus infection is a worldwide public health problem, which seriously affects the clinical diagnosis of hepatitis B and threatens the safety of blood transfusion. The concept of occult hepatitis B virus infection, the pathogenesis of occult hepatitis B virus infection, the prevalence of occult hepatitis B virus infection in different groups, including healthy population and different patients, and the possibility of transmission were summarized. The prevalence of occult hepatitis B virus infection was found in healthy population and different patients, and there is possibility of occult hepatitis B virus infection to be transmitted through blood transfusion. The paper provides a comprehensive introduction of the pathogenesis and prevalence of occult hepatitis B virus infection. More attention should be paid to occult hepatitis B virus infection.

  2. [Occult hepatitis B virus infection and hepatocellular carcinoma].

    Science.gov (United States)

    Lee, Jong Joon; Kwon, Oh Sang

    2013-09-01

    Many studies have suggested that occult HBV infection has a substantial clinical relevance to hepatocellular carcinoma (HCC). Occult HBV infection is an important risk factor for the development of cirrhosis and HCC in patients without HBsAg. As a matter of fact, occult HBV infection is one of the most common causes of crytogenic HCC in endemic areas of HBV. However, there still are controversial issues about the association between occult HBV infection and HCC according to the underlying liver disease. In alcoholic cirrhosis, occult HBV infection may exert synergistic effect on the development of HCC. However, there is insufficient evidence to relate occult HBV infection to hepatocarcinogenesis in non-alcoholic fatty liver disease. In cryptogenic HCC, occult HBV infection may play a direct role in the development of HCC. In order to elucidate the assocciation between occult HBV infection and HCC, underlying liver disease must be specified and larger number of cases must be included in future studies.

  3. Investigation of Combined Detection of Fecal Occult Blood Test and Fecal DNA Test in the Opportunity Screening for Colorectal Cancer%联合检测粪隐血试验与粪便 DNA 在大肠癌机会性筛查中的探讨

    Institute of Scientific and Technical Information of China (English)

    钟选芳; 甘爱华; 张晓慧; 许岸高; 肖丹

    2015-01-01

    Objective To investigate the application and significance of opportunistic screening for colorectal cancer using combined detection of fecal occult blood test and fecal DNA test. Methods Forty-six patients with colorectal cancer and 30 normal volunteers were given with opportunistic screening,and were tested using immuno-chemical fecal occult blood tests(IFOBT),as well as the APC,P53 and K-ras mutations in the feces were detected by using polymerase chain reaction single strand conformation polymorphism(PCR-SSCP). Results The positive rate of IFOBT was 45. 7%(21 / 46)and 13. 3%(4 / 30)in the colorectal cancer group and the normal group,respec-tively. Meanwhile,the mutation rate of APC,P53,K-ras genes in the colorectal cancer group were 58. 7%(27 / 46), 65. 2%(30 / 46)and 60. 9%(28 / 46);and were 3. 3%(1 / 30),0. 0%(0 / 30)and 0. 0%(0 / 30)in the normal group. There was no significant difference in the sensitivity and specificity between IFOBT and fecal DNA screening of colorectal cancer,and the sensitivity of joint detection was higher than any single detection method. Conclusion The combined detection of fecal occult blood test and fecal DNA can raise the efficacy of the colorectal cancer screening,it can be used to become an effective noninvasive method of colorectal cancer in the opportunistic screen-ing of early diagnosis and screening.%目的:探讨联合检测粪隐血试验与粪便 DNA 用于大肠癌机会性筛查的应用和意义。方法入组行机会性筛查的46例大肠癌患者和30例正常者的粪便,分别应用免疫法粪便隐血试验(IFOBT)2次,应用PCR-SSCP 方法检测粪便中 APC、P53和 K-ras 基因突变情况。结果大肠癌组和正常组粪便 IFOBT 的阳性率分别为45.7%(21/46)和13.3%(4/30),APC、P53、K-ras 的突变率分别为58.7%(27/46)、65.2%(30/46)、60.9%(28/46)和3.3%(1/30)、0.0%(0/30)、0.0%(0/30),IFOBT 和粪便 DNA 筛查大肠癌的敏感性和特异性差

  4. Pathologic findings in nonpalpable invasive breast cancer.

    Science.gov (United States)

    McKinney, C D; Frierson, H F; Fechner, R E; Wilhelm, M C; Edge, S B

    1992-01-01

    Previous studies have shown that patients with nonpalpable invasive breast cancer have a favorable prognosis. These studies, however, have not analyzed pathologic features of mammographically detected tumors according to tumor size. We describe the histopathologic features of 77 nonpalpable invasive breast cancers, comparing neoplasms less than or equal to 1 cm with larger clinically occult tumors. Forty-seven lesions (61%) were less than or equal to 1 cm (group A) and 30 (39%) were greater than 1 cm (group B). In group A, there were 30 infiltrating ductal carcinomas (IDC); seven infiltrating lobular carcinomas (ILC); and two cases each of mixed ILC and IDC, mixed tubular carcinoma and ILC, and infiltrating cribriform carcinoma. There was one case each of mucinous carcinoma, apocrine carcinoma, tubular carcinoma, and mixed mucinous and IDC. In group B, there were 23 (77%) IDC, five (17%) ILC, and two mixed IDC and ILC. Tumors in group B were more frequently grade 3 (22% versus 7%), but this was not statistically significant (p = 0.21). There were no important differences in the frequency, subtypes and location of carcinoma in situ, or other histopathologic parameters evaluated in the biopsy specimens. Mastectomy specimens with axillary lymph node dissections were available for review in 64 cases (83%). Group B patients had a higher rate of residual invasive carcinoma (31% versus 13%) and lymph node metastases (31% versus 16%), but these differences were not statistically significant. Residual carcinoma in situ was more frequent in group B (54%) compared with group A (26%) (p = .036). Of seven group B cases with negative biopsy margins, residual invasive carcinoma was present in five (71%). We conclude that small nonpalpable invasive breast cancers differ from larger nonpalpable tumors primarily in size. The finding of negative biopsy margins should not be construed as conclusive evidence for the absence of residual infiltrating disease.

  5. Evaluation of expert criteria for preoperative magnetic resonance imaging of newly diagnosed breast cancer.

    Science.gov (United States)

    Behrendt, Carolyn E; Tumyan, Lusine; Gonser, Laura; Shaw, Sara L; Vora, Lalit; Paz, I Benjamin; Ellenhorn, Joshua D I; Yim, John H

    2014-08-01

    Despite 2 randomized trials reporting no reduction in operations or local recurrence at 1 year, preoperative magnetic resonance imaging (MRI) is increasingly used in diagnostic workup of breast cancer. We evaluated 5 utilization criteria recently proposed by experts. Of women (n = 340) newly diagnosed with unilateral breast cancer who underwent bilateral MRI, most (69.4%) met at least 1 criterion before MRI: mammographic density (44.4%), under consideration for partial breast irradiation (PBI) (19.7%), genetic-familial risk (12.9%), invasive lobular carcinoma (11.8%), and multifocal/multicentric disease (10.6%). MRI detected occult malignant lesion or extension of index lesion in 21.2% of index, 3.3% of contralateral, breasts. No expert criterion was associated with MRI-detected malignant lesion, which associated instead with pre-MRI plan of lumpectomy without PBI (48.2% of subjects): Odds Ratio 3.05, 95% CI 1.57-5.91 (p adjusted for multiple hypothesis testing = 0.007, adjusted for index-vs-contralateral breast and covariates). The expert guidelines were not confirmed by clinical evidence.

  6. Polymorphisms in genes involved in the estrogen pathway and mammographic density

    Directory of Open Access Journals (Sweden)

    Dumas Isabelle

    2010-11-01

    Full Text Available Abstract Background Single nucleotide polymorphisms (SNPs in genes involved in the estrogen pathway appear to be associated with breast cancer risk and possibly with mammographic density (MD, but little is known of these associations among premenopausal women. This study examines the association of 11 polymorphisms in five estrogen-related genes (estrogen receptors alpha and beta (ERα, ERβ, 17β-hydroxysteroid dehydrogenase 1 (HSD17B1, catechol-O-methyltransferase (COMT, cytochrome P450 1B1 (CYP1B1 with premenopausal MD. Effect modification of four estrogen-related factors (parity, age at menarche, hormonal derivatives use and body mass index (BMI on this relation is also assessed. Methods Polymorphisms were genotyped in 741 premenopausal Caucasian women whose MD was measured in absolute density (AD, cm2 and percent density using a computer-assisted method. Multivariate linear models were used to examine the associations (Ptrend and interactions (Pi. Results None of the SNPs showed a statistically significant association with AD. However, each additional rare allele of rs1056836 CYP1B1 was associated with a reduction in AD among nulliparous women (Ptrend = 0.004, while no association was observed among parous women (Ptrend = 0.62; Pi = 0.02. An increase in the number of rare alleles of the HSD17B1 SNP (rs598126 and rs2010750 was associated with an increase in AD among women who never used hormonal derivatives (Ptrend = 0.06 and Ptrend = 0.04, respectively, but with a decrease in AD among past hormonal derivatives users (Ptrend = 0.04; Pi = 0.02 and Ptrend = 0.08; Pi = 0.01, respectively. Moreover, a negative association of rs598126 HSD17B1 SNP with AD was observed among women with higher BMI (>median (Ptrend = 0.01; Pi = 0.02. A negative association between an increased number of rare alleles of COMT rs4680 SNP and AD was limited to women who never used hormonal derivatives (Ptrend = 0.02; Pi = 0.03 or with late age at menarche (>median

  7. The Radio Occultation Processing Package ROPP

    Directory of Open Access Journals (Sweden)

    I. D. Culverwell

    2015-01-01

    Full Text Available This paper describes the Radio Occultation Processing Package, ROPP, a product of the EUMETSAT Radio Occultation Meteorology Satellite Application Facility (ROM SAF developed by a large number of scientists over many years. A brief review of the concepts, functionality and structure of ROPP is followed by more detailed descriptions of its key capabilities. Example results from a full chain of processing using some of the ROPP tools are presented. Some current and prospective uses of ROPP are given. Instructions on how to access the code and its supporting documentation are provided.

  8. Sleep patterns, sleep disorders and mammographic density in spanish women: The DDM-Spain/Var-DDM study.

    Science.gov (United States)

    Pedraza-Flechas, Ana María; Lope, Virginia; Moreo, Pilar; Ascunce, Nieves; Miranda-García, Josefa; Vidal, Carmen; Sánchez-Contador, Carmen; Santamariña, Carmen; Pedraz-Pingarrón, Carmen; Llobet, Rafael; Aragonés, Nuria; Salas-Trejo, Dolores; Pollán, Marina; Pérez-Gómez, Beatriz

    2017-05-01

    We explored the relationship between sleep patterns and sleep disorders and mammographic density (MD), a marker of breast cancer risk. Participants in the DDM-Spain/var-DDM study, which included 2878 middle-aged Spanish women, were interviewed via telephone and asked questions on sleep characteristics. Two radiologists assessed MD in their left craneo-caudal mammogram, assisted by a validated semiautomatic-computer tool (DM-scan). We used log-transformed percentage MD as the dependent variable and fitted mixed linear regression models, including known confounding variables. Our results showed that neither sleeping patterns nor sleep disorders were associated with MD. However, women with frequent changes in their bedtime due to anxiety or depression had higher MD (e(β):1.53;95%CI:1.04-2.26). Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Quality assurance applied to mammographic equipments using phantoms and software for its evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Mayo, Patricia, E-mail: p.mayo@titaniast.co [Titania Servicios Tecnologicos S.L., Grupo Dominguis, Apartado 46015, Valencia (Spain); Rodenas, Francisco [Departamento de Matematica Aplicada, Universidad Politecnica de Valencia, Apartado 46022, Valencia (Spain); Manuel Campayo, Juan [Hospital Clinico Universitario de Valencia, Avda. Blasco Ibanez, Apartado 46017, Valencia (Spain); Verdu, Gumersido [Departamento de Ingenieria Quimica y Nuclear, Universidad Politecnica de Valencia, Apartado 46022, Valencia (Spain)

    2010-07-21

    The image quality assessment in radiographic equipments is a very important item for a complete quality control of the radiographic image chain. The periodic evaluation of the radiographic image quality must guarantee the constancy of this quality to carry out a suitable diagnosis. Mammographic phantom images are usually used to study the quality of images obtained by determined mammographic equipment. The digital image treatment techniques allow to carry out an automatic analysis of the phantom image. In this work we apply some techniques of digital image processing to analyze in an automatic way the image quality of mammographic phantoms, namely CIRS SP01 and RACON for different varying conditions of the mammographic equipment. The CIRS SP01 phantom is usually used in analogic mammographic equipments and the RACON phantom has been specifically developed by authors to be applied to acceptance and constancy tests of the image quality in digital radiographic equipments following recommendations of international associations. The purpose of this work consists in analyzing the image quality for both phantoms by means of an automatic software utility. This analysis allows us to study the functioning of the image chain of the mammographic system in an objective way, so an abnormal functioning of the radiographic equipment might be detected.

  10. Quality assurance applied to mammographic equipments using phantoms and software for its evaluation

    Science.gov (United States)

    Mayo, Patricia; Rodenas, Francisco; Manuel Campayo, Juan; Verdú, Gumersido

    2010-07-01

    The image quality assessment in radiographic equipments is a very important item for a complete quality control of the radiographic image chain. The periodic evaluation of the radiographic image quality must guarantee the constancy of this quality to carry out a suitable diagnosis. Mammographic phantom images are usually used to study the quality of images obtained by determined mammographic equipment. The digital image treatment techniques allow to carry out an automatic analysis of the phantom image. In this work we apply some techniques of digital image processing to analyze in an automatic way the image quality of mammographic phantoms, namely CIRS SP01 and RACON for different varying conditions of the mammographic equipment. The CIRS SP01 phantom is usually used in analogic mammographic equipments and the RACON phantom has been specifically developed by authors to be applied to acceptance and constancy tests of the image quality in digital radiographic equipments following recommendations of international associations. The purpose of this work consists in analyzing the image quality for both phantoms by means of an automatic software utility. This analysis allows us to study the functioning of the image chain of the mammographic system in an objective way, so an abnormal functioning of the radiographic equipment might be detected.

  11. Fibrocystic disease of breast: variable mammographic and sonography appearance

    Energy Technology Data Exchange (ETDEWEB)

    Han, Heon; Cha, Yoo Mi; Yang, Joo Hyun; Song, Ek Hyun; Hwang, Hee Yong; Chung, Hyo Sun; Park, Sung Hye [Chung Ang Gil Hospital, Incheon (Korea, Republic of)

    1993-12-15

    Fibrocystic disease of the breast is a frequent cause of abnormal mammogram and ultrasonogram in patients with breast pain. The differentiation of fibrocystic disease form fibroadenoma or carcinoma is often difficult. The present study was performed to evaluate the mammographic and sonographic features of fibrocystic disease of the breast Mammograms and sonogram s of 45 patients with pathologically proven fibrocystic disease of breast were analyzed and correlated retrospectively with the pathologic specimens. Clinically the patients had palpable breast lumps or focal skin thickening. The patients were aged 19 to 64 years(average, 37 years) Histologic examination of 29 patients with abnormal findings in mammograms and/or sonograms revealed stromal fibrosis in 28(97%), cyst formation in 24(83%), epithelial hyperplasia in 29(90%), apocrine metaplasia in 7 (24%), chronic inflammation in 15 (52%), fibroadenomatous change in 2 (7%), large pseudocyst formation in 2 (7%), calcification in 1 (3%), and/or chondroid maseptol in 1 (3%). Of 43 patients with mammograms, 23 showed no detectable lesion, even in retrospect, because of dense mammograms there were well marginated mass in 7, poorly marginated mass in 4, multiple small nodules in 2, mixed density radio opaque mass in 3, radiolucent mass in one, and asymmetrical dense breast in 3. One case had calcification within the mass, and another one had very high density nodules that showed chondroid metaplasia. In 14 patients with sonograms, the echogenicity was variable; anechoic in 2, hypoechoic in 8, isoechoic in 3, or mixed echoic in one. The shape of the lesion was round in 2, ovoid in 8, tubular in 2, and irregular in 2. The margin was well marginated in 11 and poorly marginated in 3. Fibrocystic breast disease, which is a frequent cause of breast lumps, has variable findings in mammograms and sonograms. Therefore, fibrocystic disease should be included in the differential diagnosis of breast mass when the typical

  12. BI-RADS CATEGORIZATION AND POSITIVE PREDICTIVE VALUE OF MAMMOGRAPHIC FEATURES

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To determine whether the categories defined in the Breast Imaging Reporting and Data System (BI-RADS) are useful predictors of malignancy. Methods: A total of 348 cases with benign and malignant breast diseases were collected. Mammographic and pathologic findings were reviewed. Mammograms of 348 cases were characterized according to BI-RADS descriptors and were categorized by the final assessment categories. Results: Of the all 348 patients, 232 (67%) were carcinomas. Significantly more masses with calcification and speculation were found in breast cancers than in benign breast diseases. BI-RADS final assessment categories were category 2 and 3 in 106 cases, in which 75% (79/106) were benign; category 4 and 5 in 242 cases, in which 85% (205/242) were carcinomas. BI-RADS categories 4 and 5 are useful predictors of relative likelihood of malignancy. The features with higher positive predictive values for carcinomas were irregular shape, indistinct or speculated margins, fine or linear calcification morphology, and regional calcification distribution. Conclusion: BI-RADS lexicon is successful in providing a standardized language for physicians to describe lesion morphology. BI-RADS category is useful for predicting the presence of malignancy.

  13. High and low mammographic density human breast tissues maintain histological differential in murine tissue engineering chambers.

    Science.gov (United States)

    Chew, G L; Huang, D; Lin, S J; Huo, C; Blick, T; Henderson, M A; Hill, P; Cawson, J; Morrison, W A; Campbell, I G; Hopper, J L; Southey, M C; Haviv, I; Thompson, E W

    2012-08-01

    Mammographic density (MD) is the area of breast tissue that appears radiologically white on mammography. Although high MD is a strong risk factor for breast cancer, independent of BRCA1/2 mutation status, the molecular basis of high MD and its associated breast cancer risk is poorly understood. MD studies will benefit from an animal model, where hormonal, gene and drug perturbations on MD can be measured in a preclinical context. High and low MD tissues were selectively sampled by stereotactic biopsy from operative specimens of high-risk women undergoing prophylactic mastectomy. The high and low MD tissues were transferred into separate vascularised biochambers in the groins of SCID mice. Chamber material was harvested after 6 weeks for histological analyses and immunohistochemistry for cytokeratins, vimentin and a human-specific mitochondrial antigen. Within-individual analysis was performed in replicate mice, eliminating confounding by age, body mass index and process-related factors, and comparisons were made to the parental human tissue. Maintenance of differential MD post-propagation was assessed radiographically. Immunohistochemical staining confirmed the preservation of human glandular and stromal components in the murine biochambers, with maintenance of radiographic MD differential. Propagated high MD regions had higher stromal (p = 0.0002) and lower adipose (p = 0.0006) composition, reflecting the findings in the original human breast tissue, although glands appeared small and non-complex in both high and low MD groups. No significant differences were observed in glandular area (p = 0.4) or count (p = 0.4) between high and low MD biochamber tissues. Human mammary glandular and stromal tissues were viably maintained in murine biochambers, with preservation of differential radiographic density and histological features. Our study provides a murine model for future studies into the biomolecular basis of MD as a risk factor for breast cancer.

  14. Vision 20/20: Mammographic breast density and its clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Kwan-Hoong, E-mail: ngkh@ummc.edu.my; Lau, Susie [Department of Biomedical Imaging and University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2015-12-15

    Breast density is a strong predictor of the failure of mammography screening to detect breast cancer and is a strong predictor of the risk of developing breast cancer. The many imaging options that are now available for imaging dense breasts show great promise, but there is still the question of determining which women are “dense” and what imaging modality is suitable for individual women. To date, mammographic breast density has been classified according to the Breast Imaging-Reporting and Data System (BI-RADS) categories from visual assessment, but this is known to be very subjective. Despite many research reports, the authors believe there has been a lack of physics-led and evidence-based arguments about what breast density actually is, how it should be measured, and how it should be used. In this paper, the authors attempt to start correcting this situation by reviewing the history of breast density research and the debates generated by the advocacy movement. The authors review the development of breast density estimation from pattern analysis to area-based analysis, and the current automated volumetric breast density (VBD) analysis. This is followed by a discussion on seeking the ground truth of VBD and mapping volumetric methods to BI-RADS density categories. The authors expect great improvement in VBD measurements that will satisfy the needs of radiologists, epidemiologists, surgeons, and physicists. The authors believe that they are now witnessing a paradigm shift toward personalized breast screening, which is going to see many more cancers being detected early, with the use of automated density measurement tools as an important component.

  15. Exploring a new bilateral focal density asymmetry based image marker to predict breast cancer risk

    Science.gov (United States)

    Aghaei, Faranak; Mirniaharikandehei, Seyedehnafiseh; Hollingsworth, Alan B.; Wang, Yunzhi; Qiu, Yuchen; Liu, Hong; Zheng, Bin

    2017-03-01

    Although breast density has been widely considered an important breast cancer risk factor, it is not very effective to predict risk of developing breast cancer in a short-term or harboring cancer in mammograms. Based on our recent studies to build short-term breast cancer risk stratification models based on bilateral mammographic density asymmetry, we in this study explored a new quantitative image marker based on bilateral focal density asymmetry to predict the risk of harboring cancers in mammograms. For this purpose, we assembled a testing dataset involving 100 positive and 100 negative cases. In each of positive case, no any solid masses are visible on mammograms. We developed a computer-aided detection (CAD) scheme to automatically detect focal dense regions depicting on two bilateral mammograms of left and right breasts. CAD selects one focal dense region with the maximum size on each image and computes its asymmetrical ratio. We used this focal density asymmetry as a new imaging marker to divide testing cases into two groups of higher and lower focal density asymmetry. The first group included 70 cases in which 62.9% are positive, while the second group included 130 cases in which 43.1% are positive. The odds ratio is 2.24. As a result, this preliminary study supported the feasibility of applying a new focal density asymmetry based imaging marker to predict the risk of having mammography-occult cancers. The goal is to assist radiologists more effectively and accurately detect early subtle cancers using mammography and/or other adjunctive imaging modalities in the future.

  16. Statistical Methods for Detecting Stellar Occultations by Kuiper Belt Objects the Taiwanese-American Occultation Survey

    CERN Document Server

    Liang, C L; De Pater, I; Alcock, C B; Axelrod, T; Wang, A; Liang, Chyng-Lan; Rice, John A.; Pater, Imke de; Alcock, Charles; Axelrod, Tim; Wang, Andrew

    2002-01-01

    The Taiwanese-American Occultation Survey (TAOS) will detect objects in the Kuiper Belt, by measuring the rate of occultations of stars by these objects, using an array of three to four 50cm wide-field robotic telescopes. Thousands of stars will be monitored, resulting in hundreds of millions of photometric measurements per night. To optimize the success of TAOS, we have investigated various methods of gathering and processing the data and developed statistical methods for detecting occultations. In this paper we discuss these methods. The resulting estimated detection efficiencies will be used to guide the choice of various operational parameters determining the mode of actual observation when the telescopes come on line and begin routine observations. In particular we show how real-time detection algorithms may be constructed, taking advantage of having multiple telescopes. We also discuss a retrospective method for estimating the rate at which occultations occur.

  17. Factors Predicting Fecal Occult Blood Testing among Residents of Bushehr, Iran, Based on the Health Belief Model.

    Science.gov (United States)

    Ghobadi Dashdebi, Kamel; Noroozi, Azita; Tahmasebi, Rahim

    2016-01-01

    Colorectal cancer is a major cause of mortality worldwide. Fecal occult blood testing has proven a very effective screening tool for early detection and mortality reduction. The aim of this study was to determine predictors factors related to fecal occult blood testing using the Health Belief Model method among residents of Bushehr, Iran. A cross sectional study was performed on a sample of 600 men and women more than 50 years of age. The sample was selected by a convenience method from patients referred to public and private laboratories throughout the city. Each subject filled out a questionnaire which was designed and developed based on Health Belief Model constructs. Statistical analysis was conducted using ANOVA, T-test, chi-square test, and logistic regression. Fecal occult blood tests were performed on 179 (29.8%) out of 600 subjects, of which 95 patients (58.1%) did a periodic examination test and 84 patients (46.9%) had a doctor's advice for testing. According to the logistic regression model, the perceived barriers (P=0.0, Exp(B)= 0.3), perceived benefits (P occult blood testing among subjects.The results showed that reducing people's perception of barriers to testing, increasing perceived benefits of screening, and reinforcing self efficacy can have major effect in increasing the rate of fecal occult blood screening for colorectal cancer prevention.

  18. Controversies about occult hepatitis B virus infection

    Institute of Scientific and Technical Information of China (English)

    Ersan Ozaslan; Tugrul Purnak

    2009-01-01

    We read with great interest the paper written by Shi et al, reviewing the molecular characteristics and stages of chronic hepatitis B virus (HBV) infection. We think that some points in the definition of occult HBV infection (OBI) and their conclusion about the management of OBI may need further considerations.

  19. Occult spondyloarthritis in inflammatory bowel disease.

    Science.gov (United States)

    Bandinelli, Francesca; Manetti, Mirko; Ibba-Manneschi, Lidia

    2016-02-01

    Spondyloarthritis (SpA) is a frequent extra-intestinal manifestation in patients with inflammatory bowel disease (IBD), although its real diffusion is commonly considered underestimated. Abnormalities in the microbioma and genetic predisposition have been implicated in the link between bowel and joint inflammation. Otherwise, up to date, pathogenetic mechanisms are still largely unknown and the exact influence of the bowel activity on rheumatic manifestations is not clearly explained. Due to evidence-based results of clinical studies, the interest on clinically asymptomatic SpA in IBD patients increased in the last few years. Actually, occult enthesitis and sacroiliitis are discovered in high percentages of IBD patients by different imaging techniques, mainly enthesis ultrasound (US) and sacroiliac joint X-ray examinations. Several diagnostic approaches and biomarkers have been proposed in an attempt to correctly classify and diagnose clinically occult joint manifestations and to define clusters of risk for patient screening, although definitive results are still lacking. The correct recognition of occult SpA in IBD requires an integrated multidisciplinary approach in order to identify common diagnostic and therapeutic strategies. The use of inexpensive and rapid imaging techniques, such as US and X-ray, should be routinely included in daily clinical practice and trials to correctly evaluate occult SpA, thus preventing future disability and worsening of quality of life in IBD patients.

  20. Occult hepatitis B infection: an evolutionary scenario

    Directory of Open Access Journals (Sweden)

    Lukashov Vladimir V

    2008-12-01

    Full Text Available Abstract Background Occult or latent hepatitis B virus (HBV infection is defined as infection with detectable HBV DNA and undetectable surface antigen (HBsAg in patients' blood. The cause of an overt HBV infection becoming an occult one is unknown. To gain insight into the mechanism of the development of occult infection, we compared the full-length HBV genome from a blood donor carrying an occult infection (d4 with global genotype D genomes. Results The phylogenetic analysis of polymerase, core and X protein sequences did not distinguish d4 from other genotype D strains. Yet, d4 surface protein formed the evolutionary outgroup relative to all other genotype D strains. Its evolutionary branch was the only one where accumulation of substitutions suggests positive selection (dN/dS = 1.3787. Many of these substitutiions accumulated specifically in regions encoding the core/surface protein interface, as revealed in a 3D-modeled protein complex. We identified a novel RNA splicing event (deleting nucleotides 2986-202 that abolishes surface protein gene expression without affecting polymerase, core and X-protein related functions. Genotype D strains differ in their ability to perform this 2986-202 splicing. Strains prone to 2986-202 splicing constitute a separate clade in a phylogenetic tree of genotype D HBVs. A single substitution (G173T that is associated with clade membership alters the local RNA secondary structure and is proposed to affect splicing efficiency at the 202 acceptor site. Conclusion We propose an evolutionary scenario for occult HBV infection, in which 2986-202 splicing generates intracellular virus particles devoid of surface protein, which subsequently accumulates mutations due to relaxation of coding constraints. Such viruses are deficient of autonomous propagation and cannot leave the host cell until it is lysed.

  1. The Big Occulting Steerable Satellite (BOSS)

    Energy Technology Data Exchange (ETDEWEB)

    Copi, Craig J.; Starkman, Glenn D.

    2000-03-20

    Natural (such as lunar) occultations have long been used to study sources on small angular scales, while coronographs have been used to study high-contrast sources. We describe here the properties of the Big Occulting Steerable Satellite (BOSS), a large steerable occulting satellite to combine both of these techniques. BOSS will have several advantages over standard occulting bodies. BOSS would block all but about 4x10{sup -5} of the light at 1 {mu}m in the region of interest around the star for planet detections (with even better blocking possible using new film surface etching techniques). Because the occultation occurs outside the telescope, scattering inside the telescope does not degrade this performance. BOSS could be combined with a space telescope at the Earth-Sun L2 point to yield very long integration times, in excess of 3000 s. If placed in Earth orbit, integration times of 160-1600 s can be achieved from most major telescope sites for objects in over 90% of the sky. Applications for BOSS include direct imaging of planets around nearby stars. Planets separated by as little as 0.1''-0.25'' from the star they orbit could be seen down to a relative intensity as little as 1x10{sup -9} around a magnitude 8 (or brighter) star. Other applications include ultra-high-resolution imaging of compound sources, such as microlensed stars and quasars, down to a resolution as little as 0.1 mas. (c) 2000 The American Astronomical Society.

  2. Cassini Radio Occultation by Enceladus Plume

    Science.gov (United States)

    Kliore, A.; Armstrong, J.; Flasar, F.; French, R.; Marouf, E.; Nagy, A.; Rappaport, N.; McGhee, C.; Schinder, P.; Anabtawi, A.; Asmar, S.; Barbinis, E.; Fleischman, D.; Goltz, G.; Aguilar, R.; Rochblatt, D.

    2006-12-01

    A fortuitous Cassini radio occultation by Enceladus plume occurs on September 15, 2006. The occultation track (the spacecraft trajectory in the plane of the sky as viewed from the Earth) has been designed to pass behind the plume (to pass above the south polar region of Enceladus) in a roughly symmetrical geometry centered on a minimum altitude above the surface of about 20 km. The minimum altitude was selected primarily to ensure probing much of the plume with good confidence given the uncertainty in the spacecraft trajectory. Three nearly-pure sinusoidal signals of 0.94, 3.6, and 13 cm-wavelength (Ka-, X-, and S-band, respectively) are simultaneously transmitted from Cassini and are monitored at two 34-m Earth receiving stations of the Deep Space Network (DSN) in Madrid, Spain (DSS-55 and DSS-65). The occultation of the visible plume is extremely fast, lasting less than about two minutes. The actual observation time extends over a much longer time interval, however, to provide a good reference baseline for potential detection of signal perturbations introduced by the tenuous neutral and ionized plume environment. Given the likely very small fraction of optical depth due to neutral particles of sizes larger than about 1 mm, detectable changes in signal intensity is perhaps unlikely. Detection of plume plasma along the radio path as perturbations in the signals frequency/phase is more likely and the magnitude will depend on the electron columnar density probed. The occultation time occurs not far from solar conjunction time (Sun-Earth-probe angle of about 33 degrees), causing phase scintillations due to the solar wind to be the primary limiting noise source. We estimate a delectability limit of about 1 to 3E16 electrons per square meter columnar density assuming about 100 seconds integration time. Potential measurement of the profile of electron columnar density along the occultation track is an exciting prospect at this time.

  3. MR imaging-guided sonography followed by fine-needle aspiration cytology in occult carcinoma of the breast

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie); Brouwers-Kuyper, E.M.; M.M.A. Tilanus-Linthorst (Madeleine); T. Wiggers (Theo); M. Oudkerk (Matthijs)

    2000-01-01

    markdownabstractOBJECTIVE. In patients with axillary metastases as clinical evidence of possible occult breast cancer, a combined approach of MR imaging, sonography, and aspiration biopsy cytology was evaluated. SUBJECTS AND METHODS. Thirty-one women with metastatic adenocarcinoma in their axillar

  4. Preoperative breast magnetic resonance imaging and contralateral breast cancer occurrence among older women with ductal carcinoma in situ.

    Science.gov (United States)

    Wang, Shi-Yi; Long, Jessica B; Killelea, Brigid K; Evans, Suzanne B; Roberts, Kenneth B; Silber, Andrea; Gross, Cary P

    2016-07-01

    Although preoperative magnetic resonance imaging (MRI) can detect mammographically occult contralateral breast cancers (CBCs) among women with ductal carcinoma in situ (DCIS), the impact of MRI on the incidence of subsequent CBC events is unclear. We examined whether MRI use decreases CBC occurrences and detection of invasive disease among women who develop a CBC. Utilizing the Surveillance, Epidemiology, and End Results-Medicare dataset, we assessed overall, synchronous (cancer diagnosis), and subsequent (≥6 months after diagnosis, i.e., metachronous) CBC occurrence in women aged 67-94 years diagnosed with DCIS during 2004-2009, with follow-up through 2011. We applied a matched propensity score approach to compare the stage-specific incidence rate of CBC according to MRI use. Our sample consisted of 9166 beneficiaries, 1258 (13.7 %) of whom received preoperative MRI. After propensity score matching, preoperative MRI use was significantly associated with a higher synchronous CBC detection rate (108.6 vs. 29.7 per 1000 person-years; hazard ratio [HR] = 3.65; p clinically evident.

  5. Feature extraction using convolutional neural network for classifying breast density in mammographic images

    Science.gov (United States)

    Thomaz, Ricardo L.; Carneiro, Pedro C.; Patrocinio, Ana C.

    2017-03-01

    Breast cancer is the leading cause of death for women in most countries. The high levels of mortality relate mostly to late diagnosis and to the direct proportionally relationship between breast density and breast cancer development. Therefore, the correct assessment of breast density is important to provide better screening for higher risk patients. However, in modern digital mammography the discrimination among breast densities is highly complex due to increased contrast and visual information for all densities. Thus, a computational system for classifying breast density might be a useful tool for aiding medical staff. Several machine-learning algorithms are already capable of classifying small number of classes with good accuracy. However, machinelearning algorithms main constraint relates to the set of features extracted and used for classification. Although well-known feature extraction techniques might provide a good set of features, it is a complex task to select an initial set during design of a classifier. Thus, we propose feature extraction using a Convolutional Neural Network (CNN) for classifying breast density by a usual machine-learning classifier. We used 307 mammographic images downsampled to 260x200 pixels to train a CNN and extract features from a deep layer. After training, the activation of 8 neurons from a deep fully connected layer are extracted and used as features. Then, these features are feedforward to a single hidden layer neural network that is cross-validated using 10-folds to classify among four classes of breast density. The global accuracy of this method is 98.4%, presenting only 1.6% of misclassification. However, the small set of samples and memory constraints required the reuse of data in both CNN and MLP-NN, therefore overfitting might have influenced the results even though we cross-validated the network. Thus, although we presented a promising method for extracting features and classifying breast density, a greater database is

  6. Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide.

    Directory of Open Access Journals (Sweden)

    Anya Burton

    2017-06-01

    Full Text Available Mammographic density (MD is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known.We examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35-85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD. MD was read centrally using a quantitative method (Cumulus and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of pooled data, adjusted for body mass index, reproductive factors, mammogram view, image type, and reader. In all, 4,534 women were premenopausal, and 6,481 postmenopausal, at the time of mammography. A large age-adjusted difference in percent MD (PD between post- and premenopausal women was apparent (-0.46 cm [95% CI: -0.53, -0.39] and appeared greater in women with lower breast cancer risk profiles; variation across population groups due to heterogeneity (I2 was 16.5%. Among premenopausal women, the √PD difference per 10-year increase in age was -0.24 cm (95% CI: -0.34, -0.14; I2 = 30%, reflecting a compositional change (lower dense area and higher non-dense area, with no difference in breast area. In postmenopausal women, the corresponding difference in √PD (-0.38 cm [95% CI: -0.44, -0.33]; I2 = 30% was additionally driven by increasing breast area. The study is limited by different mammography systems and its cross-sectional rather than longitudinal nature.Declines in MD with increasing age are present premenopausally, continue postmenopausally, and are most pronounced over the menopausal transition. These effects were highly consistent across diverse groups of women worldwide, suggesting that they result from an intrinsic biological, likely hormonal, mechanism common to

  7. Mammographic Density and Vitamin D Levels - A Cross-sectional Study.

    Science.gov (United States)

    Straub, Loreen; Riedel, Johanna; Luppa, Peter B; Wissing, Johanna; Artmann, Almut; Kiechle, Marion; Seifert-Klauss, Vanadin Regina

    2017-03-01

    Background Some studies have already proposed an inverse association between vitamin D levels and breast density. As breast density is already considered an established risk factor for breast cancer, such a connection could offer a new starting point for the prevention of breast cancer. Material and Methods To investigate this suggested connection, a total of 412 pre- and 572 post-menopausal women for whom mammography was indicated were recruited into this cross-sectional study. In addition to a questionnaire-based interview on the patient's general and gynecological medical history, her eating habits and lifestyle, serum levels of 25-hydroxyvitamin D [25(OH)D], calcium, phosphate and creatinine were determined. Breast density was determined by mammography and categorized as 1 to 4 according to the ACR classification. In addition to performing descriptive analysis to get a better overview of the data, a number of multivariate regression models were developed to determine the impact of confounders and the connection between vitamin D and mammographic density. Results More than half of all participants had low levels of 25(OH)D (density (n = 463 had ACR 2; n = 343 had ACR 3). Logistic regression analysis showed that lower 25(OH)D serum levels were associated significantly more often with high rather than medium breast density. This association remained, even after adjusting for other factors which influence breast density such as age, BMI and menopausal status (p = 0.032 for ACR 4 vs. ACR 2; p = 0.028 for ACR 4 vs. ACR 3). When the same analysis was done separately for pre-menopausal and post-menopausal women, BMI in both groups was found to be inversely correlated with breast density and this inverse correlation was highly significant. In post-menopausal women, age was found to be similarly correlated while 25(OH)D did not appear to be associated with ACR. In pre-menopausal women the opposite was the case: although there was no correlation between

  8. Developing a new case based computer-aided detection scheme and an adaptive cueing method to improve performance in detecting mammographic lesions

    Science.gov (United States)

    Tan, Maxine; Aghaei, Faranak; Wang, Yunzhi; Zheng, Bin

    2017-01-01

    The purpose of this study is to evaluate a new method to improve performance of computer-aided detection (CAD) schemes of screening mammograms with two approaches. In the first approach, we developed a new case based CAD scheme using a set of optimally selected global mammographic density, texture, spiculation, and structural similarity features computed from all four full-field digital mammography images of the craniocaudal (CC) and mediolateral oblique (MLO) views by using a modified fast and accurate sequential floating forward selection feature selection algorithm. Selected features were then applied to a ‘scoring fusion’ artificial neural network classification scheme to produce a final case based risk score. In the second approach, we combined the case based risk score with the conventional lesion based scores of a conventional lesion based CAD scheme using a new adaptive cueing method that is integrated with the case based risk scores. We evaluated our methods using a ten-fold cross-validation scheme on 924 cases (476 cancer and 448 recalled or negative), whereby each case had all four images from the CC and MLO views. The area under the receiver operating characteristic curve was AUC  =  0.793  ±  0.015 and the odds ratio monotonically increased from 1 to 37.21 as CAD-generated case based detection scores increased. Using the new adaptive cueing method, the region based and case based sensitivities of the conventional CAD scheme at a false positive rate of 0.71 per image increased by 2.4% and 0.8%, respectively. The study demonstrated that supplementary information can be derived by computing global mammographic density image features to improve CAD-cueing performance on the suspicious mammographic lesions.

  9. Mammographic artifacts on full-field digital mammography.

    Science.gov (United States)

    Choi, Jae Jeong; Kim, Sung Hun; Kang, Bong Joo; Choi, Byung Gil; Song, ByungJoo; Jung, Haijo

    2014-04-01

    This study investigates the incidence of full-field digital mammographic (FFDM) artifacts with three systems at two institutions and compares the artifacts between two detector types and two grid types. A total of 4,440 direct and 4,142 indirect FFDM images were reviewed by two radiologists, and artifacts were classified as patient related, hardware related, and software processing. The overall incidence of FFDM artifacts was 3.4% (292/8,582). Patient related artifacts (motion artifacts and skin line artifacts) were the most commonly detected types (1.7%). Underexposure among hardware related artifacts and high-density artifacts among software processing artifacts also were common (0.7 and 0.5%, respectively). These artifacts, specific to digital mammography, were more common with the direct detector type and the crossed air grid type than with the indirect type and linear grid type (p artifacts on FFDM were patient related, which might be controlled by the instruction of a patient and technologist. Underexposure and high-density artifacts were more common with direct detector and crossed air type of grid.

  10. [Chronic hepatitis and occult HCV infection].

    Science.gov (United States)

    Kowala-Piaskowska, Arleta; Mozer-Lisewska, Iwona; Pham, Tram N Q; Michalak, Tomasz I

    2010-01-01

    Hepatitis C virus (HCV) was discovered in 1989. HCV is a positive single-strand RNA. We all have thought, that HCV can replicate only in liver tissue, but now we know, that HCV can replicate in extrahepatic tissue as well. In about 48-86% of HCV infected patients, chronic hepatitis C (CHC) has been noticed and eventually, after tens of years, liver insufficiency, cirrhosis or hepatocellular carcinoma. The current recommended treatment for CHC is a combination of pegylated-interferon alpha and Ribavirin. Presently it is known, that HCV infection can persist as an occult infection. RNA HCV can be detected in patients after successful treatment for CHC or spontaneous elimination. Persistent HCV replication in hepatocytes or lymphoid cells would likely lead to continuous antigenic stimulation of the immune system. This prolonged replication may contribute to the immune tolerance of HCV, impairment of immune response and even further virus persistence. This occult infection grows more important in transplantation.

  11. Ionospheric Signatures in Radio Occultation Data

    Science.gov (United States)

    Mannucci, Anthony J.; Ao, Chi; Iijima, Byron A.; Kursinkski, E. Robert

    2012-01-01

    We can extend robustly the radio occultation data record by 6 years (+60%) by developing a singlefrequency processing method for GPS/MET data. We will produce a calibrated data set with profile-byprofile data characterization to determine robust upper bounds on ionospheric bias. Part of an effort to produce a calibrated RO data set addressing other key error sources such as upper boundary initialization. Planned: AIRS-GPS water vapor cross validation (water vapor climatology and trends).

  12. Method for combined FDG-PET and radiographic imaging of primary breast cancers.

    Science.gov (United States)

    Adler, Lee P; Weinberg, Irving N; Bradbury, Michelle S; Levine, Edward A; Lesko, Nadine M; Geisinger, Kim R; Berg, Wendie A; Freimanis, Rita I

    2003-01-01

    The purpose of the study was to demonstrate the feasibility of a hybrid functional/anatomic breast imaging platform with biopsy capability for facilitating lesion detection and diagnosis. This platform consists of an investigative dedicated positron emission mammography (PEM) device mounted on a stereotactic X-ray mammography system, permitting sequential acquisition of mammographic and emission images during a single breast compression. There is automatic coregistration of images from both modalities, and these results can be successfully correlated with histopathologic findings. The potential utility of functional images correlated to anatomic images would include noninvasively detecting clinically and radiographically occult cancers, assessing response to therapy, discriminating between benign and malignant breast masses, and ultimately reducing the number of invasive and costly surgical interventions. A spot-digital mammogram and subsequent PEM image, collected over a 4-minute period, were obtained in a single patient with the breast in compression after intravenous injection of (F-18)-2-deoxy-2-fluoro-D-glucose (FDG) at the time of stereotactic biopsy. The authors conclude that FDG-based lesion localization information may be combined with the lesion X-ray attenuation characteristics using this common imaging platform.

  13. OCCULTISM AND MEDIUMSHIP IN FERNANDO PESSOA

    Directory of Open Access Journals (Sweden)

    Alisson Diêgo Dias de Medeiros

    2016-03-01

    Full Text Available This work is the result of a research on the influence that the occultism had on the work of the Portuguese poet Fernando Pessoa. To delimitate the study, we selected papers of Fernando Pessoa, which  suggested that the poet considered himself medium, and hence influenced his work, building his depersonalization. This work presents, thus, as main objectiveto analyze personal papers of Fernando Pessoa, whose outstanding characteristic is the presence of occultism and the supposed mediumship defended by him in response to non-literary and heteronymic manifestations. To this end, I focused on specific objectives, which are: a to study the speech of Fernando Pessoa on his supposed mediumship / occultism b to analyze specific texts that are, for the poet, mediumistic manifestations c to study excerpts from a set of personal letters in which Fernando Pessoa suggested being a medium. It is true that this dissertation will address many discussions already made by scholars and specialists in Fernando Pessoa, but we consider the possibility to deepen issues and contribute to the critical fortune of the poet.

  14. Comparison of Danish dichotomous and BI-RADS classifications of mammographic density

    DEFF Research Database (Denmark)

    Hodge, Rebecca; Hellmann, Sophie Sell; von Euler-Chelpin, My

    2014-01-01

    dichotomous mammographic density classification system from 1991 to 2001 with the density BI-RADS classifications, in an attempt to validate the Danish classification system. MATERIAL AND METHODS: The study sample consisted of 120 mammograms taken in Copenhagen in 1991-2001, which tested false positive......, and which were in 2012 re-assessed and classified according to the BI-RADS classification system. We calculated inter-rater agreement between the Danish dichotomous mammographic classification as fatty or mixed/dense and the four-level BI-RADS classification by the linear weighted Kappa statistic. RESULTS......: Of the 120 women, 32 (26.7%) were classified as having fatty and 88 (73.3%) as mixed/dense mammographic density, according to Danish dichotomous classification. According to BI-RADS density classification, 12 (10.0%) women were classified as having predominantly fatty (BI-RADS code 1), 46 (38.3%) as having...

  15. [Occult hepatitis B virus infection in chronic hepatitis C].

    Science.gov (United States)

    Jang, Jae Young; Park, Eui Ju

    2013-09-01

    Occult HBV infection is defined as the presence of HBV DNA in the liver (with or without detectable or undetectable HBV DNA in the serum) of individuals testing negative for HBsAg. Studies on occult HBV infection in hepatitis C patients have reported highly variable prevalence, because the prevalence of occult HBV infection varies depending on the hepatitis B risk factors and methodological approaches. The most reliable diagnostic approach for detecting occult HBV detection is through examination of liver DNA extracts. HCV has been suspected to strongly suppress HBV replication up to the point where it may be directly responsible for occult HBV infection development. However, more data are needed to arrive at a definitive conclusion regarding the role of HCV in inducing occult HBV infection. Occult HBV infection in chronic hepatitis C patients is a complex biological entity with possible relevant clinical implications. Influence of occult HBV infection on the clinical outcomes of chronic hepatitis C may be considered negative. However, recent studies have shown that occult HBV infection could be associated with the development of hepatocellular carcinoma and contribute to the worsening of the course of chronic liver disease over time in chronic hepatitis C patients. Nevertheless, the possible role of occult HBV infection in chronic hepatitis C is still unresolved and no firm conclusion has been made up until now. It still remains unclear how occult HBV infection affects the treatment of chronic hepatitis C. Therefore, in order to resolve current controversies and understand the pathogenic role and clinical impacts of occult HBV infection in chronic hepatitis C patients, well-designed clinical studies are needed.

  16. OCCULT-ORSER complete conversational user-language translator

    Science.gov (United States)

    Ramapriyan, H. K.; Young, K.

    1981-01-01

    Translator program (OCCULT) assists non-computer-oriented users in setting up and submitting jobs for complex ORSER system. ORSER is collection of image processing programs for analyzing remotely sensed data. OCCULT is designed for those who would like to use ORSER but cannot justify acquiring and maintaining necessary proficiency in Remote Job Entry Language, Job Control Language, and control-card formats. OCCULT is written in FORTRAN IV and OS Assembler for interactive execution.

  17. What can the Occult do for you? STarlight Attenuation & Reddening Survey of Multiple Occulting Galaxies (STARSMOG)

    CERN Document Server

    Holwerda, B W

    2015-01-01

    Interstellar dust is still the dominant uncertainty in Astronomy, limiting precision in e.g., cosmological distance estimates and models of how light is re-processed within a galaxy. When a foreground galaxy serendipitously overlaps a more distant one, the latter backlights the dusty structures in the nearer foreground galaxy. Such an overlapping or occulting galaxy pair can be used to measure the distribution of dust in the closest galaxy with great accuracy. The STARSMOG program uses HST observation of occulting galaxy pairs to accurately map the distribution of dust in foreground galaxies in fine ($<$100 pc) detail. Furthermore, Integral Field Unit observations of such pairs will map the effective extinction curve in these occulting galaxies, disentangling the role of fine-scale geometry and grain composition on the path of light through a galaxy. The overlapping galaxy technique promises to deliver a clear understanding of the dust in galaxies: the dust geometry, a probability function of the amount of...

  18. 3.0 Tesla vs 1.5 Tesla breast magnetic resonance imaging in newly diagnosed breast cancer patients.

    Science.gov (United States)

    Butler, Reni S; Chen, Christine; Vashi, Reena; Hooley, Regina J; Philpotts, Liane E

    2013-08-28

    To compare 3.0 Tesla (T) vs 1.5T magnetic resonance (MR) imaging systems in newly diagnosed breast cancer patients. Upon Institutional Review Board approval, a Health Insurance Portability and Accountability Act-compliant retrospective review of 147 consecutive 3.0T MR examinations and 98 consecutive 1.5T MR examinations in patients with newly diagnosed breast cancer between 7/2009 and 5/2010 was performed. Eleven patients who underwent neoadjuvant chemotherapy in the 3.0T group were excluded. Mammographically occult suspicious lesions (BIRADS Code 4 and 5) additional to the index cancer in the ipsilateral and contralateral breast were identified. Lesion characteristics and pathologic diagnoses were recorded, and results achieved with both systems compared. Statistical significance was analyzed using Fisher's exact test. In the 3.0T group, 206 suspicious lesions were identified in 55% (75/136) of patients and 96% (198/206) of these lesions were biopsied. In the 1.5T group, 98 suspicious lesions were identified in 53% (52/98) of patients and 90% (88/98) of these lesions were biopsied. Biopsy results yielded additional malignancies in 24% of patients in the 3.0T group vs 14% of patients in the 1.5T group (33/136 vs 14/98, P = 0.07). Average size and histology of the additional cancers was comparable. Of patients who had a suspicious MR imaging study, additional cancers were found in 44% of patients in the 3.0T group vs 27% in the 1.5T group (33/75 vs 14/52, P = 0.06), yielding a higher positive predictive value (PPV) for biopsies performed with the 3.0T system. 3.0T MR imaging detected more additional malignancies in patients with newly diagnosed breast cancer and yielded a higher PPV for biopsies performed with the 3.0T system.

  19. Usefullness of routine use of fecal occult blood test in a hospital setting

    Directory of Open Access Journals (Sweden)

    Simona Ravnik

    2006-12-01

    Full Text Available Background: Fecal occult blood test, hematest, is a well excepted non-invasive method used for detecting different diseases of the gastrointestinal tract. It was proven in different randomized studies that usage of this simple method may facilitate further diagnostic and therapeutic treatment.Patients and methods: The retrospective analysis includes patients, which were admitted to the gastroenterological and endoscopy department of the General hospital Maribor in the last quarter of the year 2005. In all patients fecal occult blood test was performed.Results: We examined 200 patients, 104 women and 96 men, average age 63.9 years, SD±16.9, ranging from 21 to 97 years. Positive hematest was discovered in 76 patients (38 %. The source of hemorrhage from the upper digestive tract was confirmed in 37 patients (48.6 % of all positive tests and from the lower digestive tract in 34 patients (46 % of all positive tests. The most frequent causes of hemorrhage from the lower digestive tract were chronic inflammatory bowel disease (13.1 % of all positive tests, colorectal cancer (10.5 % and polyps (6.6 %. The source of hemorrhage was not located in five patients (6.6 % of all positive tests despite the accurate diagnostic procedure.Conclusions: By performing a fecal occult blood screening in non-symptomatic patients, we can make an essential step towards discovering different gastrointestinal diseases, even colorectal cancer in its early, limited form, when the effect of treatment is greatest.

  20. Comparison of subjective and fully automated methods for measuring mammographic density.

    Science.gov (United States)

    Moshina, Nataliia; Roman, Marta; Sebuødegård, Sofie; Waade, Gunvor G; Ursin, Giske; Hofvind, Solveig

    2017-01-01

    Background Breast radiologists of the Norwegian Breast Cancer Screening Program subjectively classified mammographic density using a three-point scale between 1996 and 2012 and changed into the fourth edition of the BI-RADS classification since 2013. In 2015, an automated volumetric breast density assessment software was installed at two screening units. Purpose To compare volumetric breast density measurements from the automated method with two subjective methods: the three-point scale and the BI-RADS density classification. Material and Methods Information on subjective and automated density assessment was obtained from screening examinations of 3635 women recalled for further assessment due to positive screening mammography between 2007 and 2015. The score of the three-point scale (I = fatty; II = medium dense; III = dense) was available for 2310 women. The BI-RADS density score was provided for 1325 women. Mean volumetric breast density was estimated for each category of the subjective classifications. The automated software assigned volumetric breast density to four categories. The agreement between BI-RADS and volumetric breast density categories was assessed using weighted kappa (kw). Results Mean volumetric breast density was 4.5%, 7.5%, and 13.4% for categories I, II, and III of the three-point scale, respectively, and 4.4%, 7.5%, 9.9%, and 13.9% for the BI-RADS density categories, respectively ( P for trend density categories was kw = 0.5 (95% CI = 0.47-0.53; P density increased with increasing density category of the subjective classifications. The agreement between BI-RADS and volumetric breast density categories was moderate.

  1. Impact of Breast Reader Assessment Strategy on mammographic radiologists' test reading performance.

    Science.gov (United States)

    Suleiman, Wasfi I; Rawashdeh, Mohammad A; Lewis, Sarah J; McEntee, Mark F; Lee, Warwick; Tapia, Kriscia; Brennan, Patrick C

    2016-06-01

    The detection of breast cancer is somewhat limited by human factors, and thus there is a need to improve reader performance. This study assesses whether radiologists who regularly undertake the education in the form of the Breast Reader Assessment Strategy (BREAST) demonstrate any changes in mammography interpretation performance over time. In 2011, 2012 and 2013, 14 radiologists independently assessed a year-specific BREAST mammographic test-set. Radiologists read a different single test-set once each year, with each comprising 60 digital mammogram cases. Radiologists marked the location of suspected lesions without computer-aided diagnosis (CAD) and assigned a confidence rating of 2 for benign and 3-5 for malignant lesions. The mean sensitivity, specificity, location sensitivity, JAFROC FOM and ROC AUC were calculated. A Kruskal-Wallis test was used to compare the readings for the 14 radiologists across the 3 years. Wilcoxon signed rank test was used to assess comparison between pairs of years. Relationships between changes in performance and radiologist characteristics were examined using a Spearman's test. Significant increases were noted in mean sensitivity (P = 0.01), specificity (P = 0.01), location sensitivity (P = 0.001) and JAFROC FOM (P = 0.001) between 2011 and 2012. Between 2012 and 2013, significant improvements were noted in mean sensitivity (P = 0.003), specificity (P = 0.002), location sensitivity (P = 0.02), JAFROC FOM (P = 0.005) and ROC AUC (P = 0.008). No statistically significant correlations were shown between the levels of improvement and radiologists' characteristics. Radiologists' who undertake the BREAST programme demonstrate significant improvements in test-set performance during a 3-year period, highlighting the value of ongoing education through the use of test-set. © 2016 The Royal Australian and New Zealand College of Radiologists.

  2. Ipsilateral occult hernias during endoscopic groin hernia repair

    Directory of Open Access Journals (Sweden)

    Jain Mayank

    2008-01-01

    Full Text Available Endoscopic repair of groin hernias allows the surgeon to have a complete view of the groin and pelvis to diagnose occult hernias both ipsilaterally and contralaterally. These occult hernias can then be treated simultaneously and may reduce the incidence of recurrence and persistent symptoms. The authors present four unusual cases where occult hernias were found ipsilaterally during an endoscopic repair. All these occult hernias were treated along with the clinically diagnosed hernia at the same surgery with excellent results and no post-operative morbidity.

  3. 连续切片联合免疫组化染色在临床Ⅰ、Ⅱ期乳腺癌前哨淋巴结隐性转移检测中的应用%Application of serial sections and immunohistochemical staining in detection of occult metastases in sentinel lymph node of stage Ⅰ,Ⅱ breast cancer

    Institute of Scientific and Technical Information of China (English)

    张春丽; 刘珺; 杨敏; 张根花

    2012-01-01

    Objective To evaluate the application of serial sections and immunohistochemical staining for breast sentinel lymph node (SLN) biopsy in detection of occult metastases of breast cancer. Methods Forty three patients with stage I, II breast cancer underwent SLN methylene blue tracer biopsy, outpost of the lymph node biopsy (of SLNB) and axillary lymph node dissection (of ALND). Negative SLN diagnosed by conventional HE staining were sliced with 100μm space for serial sections, then HE(SS HE) and CK19, small breast epithelial mucin(SBEM), EpCAM immune labeling staining (SS+IHC) were applied to determine the optimal spacing for detecting occult metastases and the best immune markers. Results Thirty nine SLN cases were successfully detected in 43 patients with a success rate of 90.7%; among them 12 cases were positive in the largest section of HE staining of 72 SLN, including 2 cases of micro metastasis with a positive rate of 27.9%; the rates of 17 CK19, SBEM, EpCAM positive cases increased to 39.5%; 5 cases were detected to have occult metastases in the negative largest section of HE by the SS HE, including 3 cases of micrometastasis. The spacing were 100, 200, 300,400 and 500 μm in 55 negative conventional HE staining SLN, the rates of occult metastases detected by SS HE and IHC were 9.0%, 7.3%, 7.3%, 3.6% and 3.6%. There was no significant difference in the rates of occult metastases detection when comparing the spacing of 200, 300 μm with the spacing of 100μm (P >0.05), and when comparing to the spacing of 400μm, 500 μm there was significant difference (P<0.05). Conclusion The application of serial section and IHC can increase the rate of 0.2-2mm micrometastasis detection and improve the accuracy of clinical staging and the guidance for post-treatment.%目的 探讨连续切片联合免疫组化染色在临床Ⅰ、Ⅱ期乳腺癌前哨淋巴结(SLN)隐性转移检测中的应用.方法 对43例临床Ⅰ、Ⅱ期乳腺癌患者行SLN亚甲蓝示踪法活检,

  4. Mammographically detected breast arterial calcifications: Indicators for arteriosclerotic diseases?

    Energy Technology Data Exchange (ETDEWEB)

    Taskin, Fuesun [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey)]. E-mail: fusuntaskin@yahoo.com; Akdilli, Alev [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Karaman, Can [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Unsal, Alparslan [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Koeseoglu, Kutsi [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Ergin, Filiz [Adnan Menderes University, Faculty of Medicine, Department of Public Health, Aydin (Turkey)

    2006-11-15

    Purpose: To determine the prevalence of breast arterial calcifications (BAC) detected on mammography and search for conditions that may influence their existence. Materials and methods: The mammograms of 6156 consecutive patients were reevaluated for the presence of BAC. Four hundred eighty-five women having BAC were enrolled in the patient group. Additionally, randomly selected 500 women, without BAC constituted the control group. Hospital records of the participants were reviewed for parity, menopausal status, oral contraceptive agent (OCA) usage, hormone replacement therapy (HRT) usage, presence of diabetes, hypertension, hyperlipidemia, albuminuria and history of myocardial infarction (MI). Results: Prevalence of BAC was 7.9% on mammograms. Ninety-four women were aged between 40 and 49 years, 165 were aged between 50 and 59 years and 226 were over 60 years among BAC positive 485 women. A significant relationship was found for the frequency of BAC versus age and HRT usage in all age groups (p < 0.05). Similarly, significant relationships were also found for the frequency of BAC versus OCA usage, HRT usage, hyperlipidemia and diabetes in age group of 40-49 and in age group of 50-59, and for the frequency of BAC versus albuminuria in age group of 40-49, BAC versus history of myocardial infarction in age group of 59-59 and over 60 years (p < 0.05). The correlations were not significant for the relationships of BAC with OCA usage, hyperlipidemia, diabetes and albuminuria in women over 60 years (p > 0.05). Conclusion: Most benign findings like BAC are not routinely reported during mammographic evaluation. Our study showed that, presence of BAC on mammography was strongly related to advancing age. However, these findings may signify a systemic risk and can be used as precautious indicators for undocumented systemic diseases, especially in premenopausal women.

  5. New perspectives in occult hepatitis C virus infection.

    Science.gov (United States)

    Carreño, Vicente; Bartolomé, Javier; Castillo, Inmaculada; Quiroga, Juan Antonio

    2012-06-21

    Occult hepatitis C virus (HCV) infection, defined as the presence of HCV RNA in liver and in peripheral blood mononuclear cells (PBMCs) in the absence of detectable viral RNA in serum by standard assays, can be found in anti-HCV positive patients with normal serum levels of liver enzymes and in anti-HCV negative patients with persistently elevated liver enzymes of unknown etiology. Occult HCV infection is distributed worldwide and all HCV genotypes seem to be involved in this infection. Occult hepatitis C has been found not only in anti-HCV positive subjects with normal values of liver enzymes or in chronic hepatitis of unknown origin but also in several groups at risk for HCV infection such as hemodialysis patients or family members of patients with occult HCV. This occult infection has been reported also in healthy populations without evidence of liver disease. Occult HCV infection seems to be less aggressive than chronic hepatitis C although patients affected by occult HCV may develop liver cirrhosis and even hepatocellular carcinoma. Thus, anti-HCV negative patients with occult HCV may benefit from antiviral therapy with pegylated-interferon plus ribavirin. The persistence of very low levels of HCV RNA in serum and in PBMCs, along with the maintenance of specific T-cell responses against HCV-antigens observed during a long-term follow-up of patients with occult hepatitis C, indicate that occult HCV is a persistent infection that is not spontaneously eradicated. This is an updated report on diagnosis, epidemiology and clinical implications of occult HCV with special emphasis on anti-HCV negative cases.

  6. New perspectives in occult hepatitis C virus infection

    Institute of Scientific and Technical Information of China (English)

    Vicente Carre(n)o; Javier Bartolomé; Inmaculada Castillo; Juan Antonio Quiroga

    2012-01-01

    Occult hepatitis C virus (HCV) infection,defined as the presence of HCV RNA in liver and in peripheral blood mononuclear cells (PBMCs) in the absence of detectable viral RNA in serum by standard assays,can be found in anti-HCV positive patients with normal serum levels of liver enzymes and in anti-HCV negative patients with persistently elevated liver enzymes of unknown etiology.Occult HCV infection is distributed worldwide and all HCV genotypes seem to be involved in this infection.Occult hepatitis C has been found not only in anti-HCV positive subjects with normal values of liver enzymes or in chronic hepatitis of unknown origin but also in several groups at risk for HCV infection such as hemodialysis patients or family members of patients with occult HCV.This occult infection has been reported also in healthy populations without evidence of liver disease.Occult HCV infection seems to be less aggressive than chronic hepatitis C although patients affected by occult HCV may develop liver cirrhosis and even hepatocellular carcinoma.Thus,anti-HCV negative patients with occult HCV may benefit from antiviral therapy with pegylatedinterferon plus ribavirin.The persistence of very low levels of HCV RNA in serum and in PBMCs,along with the maintenance of specific T-cell responses against HCV-antigens observed during a long-term follow-up of patients with occult hepatitis C,indicate that occult HCV is a persistent infection that is not spontaneously eradicated.This is an updated report on diagnosis,epidemiology and clinical implications of occult HCV with special emphasis on anti-HCV negative cases.

  7. An automatic framework for assessing breast cancer risk due to various hormone replacement therapies (HRT)

    DEFF Research Database (Denmark)

    Karemore, Gopal; Brandt, Sami; Nielsen, Mads

    It is well known that menopausal hormone therapy increases mammographic density. Increase in breast density may relate to breast cancer risk. Several computer assisted automatic methods for assessing mammographic density have been suggested by J.W. Byng (1996), N. Karssemeijer (1998), J.M. Boone(...... features describing the local elongatedness or stripiness, especially trained to see the effect of HRT (Hormone Replacement Therapy ) thereby providing a non-subjective and reproducible measure and compare it to the BIRADS and percentage density measure....

  8. Acurácia dos achados mamográficos do câncer de mama: correlação da classificação BI-RADS e achados histológicos Accuracy of mammographic findings in breast cancer: correlation between BI-RADS classification and histological findings

    Directory of Open Access Journals (Sweden)

    José Hermes Ribas do Nascimento

    2010-04-01

    Full Text Available OBJETIVO: A proposta deste estudo foi avaliar a acurácia da classificação BI-RADS® na mamografia. Os pontos secundários foram descrever a frequência de apresentação dos diferentes achados mamográficos e avaliar a concordância entre observadores. MATERIAIS E MÉTODOS: Os exames de 115 pacientes, encaminhados para core biopsy, foram reavaliados independentemente por dois médicos especialistas, cegados, utilizando a recomendação do BI-RADS. Posteriormente, os exames foram comparados com a histologia. A acurácia da classificação BI-RADS na mamografia foi avaliada. A concordância entre os médicos foi calculada pela estatística kappa (κ de Cohen e as diferenças nos grupos de comparação foram analisadas com teste qui-quadrado. RESULTADOS: Esta pesquisa demonstrou que a acurácia mamográfica oscilou de 75% a 62% na diferenciação entre lesões benignas de malignas com o uso do BI-RADS. Houve importante concordância na descrição das margens dos nódulos (κ= 0,66. Baixa concordância foi identificada na descrição dos contornos (formas dos nódulos (κ= 0,40 e na descrição das calcificações, tanto em relação à sua distribuição (κ= 0,24 como também em relação à morfologia (κ= 0,36. CONCLUSÃO: O presente estudo demonstrou que o método é acurado na diferenciação de lesões benignas de malignas. A concordância foi fraca na análise das calcificações quanto a morfologia e distribuição, no entanto, identificou-se elevação progressiva dos valores preditivos positivos nas subcategorias 4.OBJECTIVE: The present study was aimed at evaluating the BI-RADS® classification accuracy in mammography. Additionally, the frequency of different findings was described and the interobserver agreement was evaluated. MATERIALS AND METHODS: Mammographic images of 115 patients were independently and blindly reviewed by two specialists in compliance with BI-RADS recommendations, and later compared with histological data. The

  9. Data analysis of 2005 Regulus occultation and simulation of the 2014 occultation

    CERN Document Server

    Sigismondi, Costantino; Flatrès, Thomas

    2014-01-01

    On March 20, 2014 at 6:06 UT (2:06 New York time) Regulus, the 1.3 magnitude brighter star of Leo constellation, is going to be occulted by the asteroid 163 Erigone. The unusual event, visible to the naked eye over NYC, can allow to measure the shape of the asteroid, with reaching a space resolution below the diffraction limit of the eye, and of all instruments not based on interferometry. Ultimately the aperture of the instrument is related to the amount of scintillation affecting the light curve of the occultation, limitating the accuracy of video recorded data. The asteroid profile scans the surface of the star at a velocity of 6 mas/s; the diameter of the star is about 1.3 mas and the detection of the stellar limb darkening signature is discussed, taking into consideration also the Fresnel fringes. New data reduction with R-OTE software of the 2005 Regulus occultation and simulations of the 2014 occultation with Fren_difl software are presented.

  10. Prevalence of colorectal diseases in immunological fecal occult blood test (I-FOBT) positive patients in a tertiary care hospital in Bangladesh.

    Science.gov (United States)

    Mollick, S H; Roy, P K; Bhuiyan, M R; Mia, A R; Alam, M S; Mollick, K A; Pervin, S; Hassan, M Q

    2014-10-01

    Bleeding lesion anywhere in the GI tract can cause positive reaction to Immunological Fecal Occult Blood Test (FOBT). Although any colonic lesion can cause occult lower GI bleeding, relative frequency of this lesion not known. Guaic based tests require prior preparation and dietary restriction and less sensitive and specific than IFOBT for detection of occult bleeding .IFOBT is specific for human hemoglobin and is more sensitive and specific for detection of occult bleeding from any colonic lesion. Aim of this study was to diagnose occult gastrointestinal bleeding with positive IFOBT and the prevalence of colorectal disease in IFOBT positive patients in a tertiary care hospital in Bangladesh. This was a prospective cross sectional study conducted in Department of gastroenterology in collaboration with clinical pathology, BSMMU, Dhaka during the period of January 2009 to December 2009. In this study 200 patients meeting the inclusion criteria were included. Detailed clinical history and physical findings were recorded; FOBT was done on single stool specimen. Positive occult bleeding was confirmed in 90 patients of whom 80 patients underwent colonoscopy. The mean age of study population was 36.73±13.64 (range 16 to 72) years. At colonoscopy lesion were identified in 46(57.50%) patients, of which colonic polyp in12 (15%), colorectal cancer in 11(13.7%), inflammatory bowel disease in 3(3.75%), hemorrhoids and anal fissure in 7(8.75%), tuberculosis in 5(6.25%), and proctitis in 1(1.25%) cases. A positive IFOBT is more sensitive and specific test than other FOBT for detection of occult lower GI bleeding of colonic origin. In this study colorectal diseases were detected in 57.50% of the IFOBT positive patients, so IOBT can be used as an important diagnostic tool for detection of occult lower GI bleeding.

  11. Categorizing the Occult: Vodun, Sorcery and Religious Beliefs In Benin

    DEFF Research Database (Denmark)

    Strandsbjerg, Camilla

    2011-01-01

    characterized as witchcraft or occult. Reflecting upon earlier research and particularly on the choice of terminology of the occult in writing on religion and political change in Benin (PhD thesis 2008), this paper seeks to clarify some of the epistemological, academic and historical reasons that have formed...

  12. The Treatment of the Occult in General Encyclopedias.

    Science.gov (United States)

    Sonnenfeld, Gary F.

    This paper is a content analysis of three general encyclopedias, "Encyclopedia Americana" (EA), "Encyclopaedia Brittanica" (EB), and "World Book Encyclopedia" (WBC), which quantifies the treatment of the occult. Entries are selected from each by starting with the article "Occultism" and tracing all…

  13. Prevalence of occult hepatitis B virus infection

    Institute of Scientific and Technical Information of China (English)

    Maria Luisa Gutiérrez-García; Conrado M Fernandez-Rodriguez; Jose Luis Lledo-Navarro; Ingrid Buhigas-Garcia

    2011-01-01

    Occult hepatitis B virus (HBV) infection (OBI) is characterized by the persistence of HBV DNA in the liver tissue in individuals negative for the HBV surface antigen. The prevalence of OBI is quite variable depending on the level of endemic disease in different parts of the world,the different assays utilized in the studies, and the different populations studied. Many studies have been carried out on OBI prevalence in different areas of the world and categories of individuals. The studies show that OBI prevalence seems to be higher among subjects at high risk for HBV infection and with liver disease than among individuals at low risk of infection and without liver disease.

  14. Less mammographic density after nasal versus oral administration of postmenopausal hormone therapy

    NARCIS (Netherlands)

    Dijck, J.A. van; Otten, J.D.M.; Karssemeijer, N.; Kenemans, P.; Verbeek, A.L.M.; Mooren, M.J. van der

    2011-01-01

    ABSTRACT Objective Nasal administration gives a more acute but shorter rise in serum hormone levels than oral administration and may therefore have less effect on the fibroglandular tissue in the breasts. We studied the change in mammographic breast density after nasal vs. oral administration of pos

  15. Screening for occult malignancy with FDG-PET/CT in patients with unprovoked venous thromboembolism.

    Science.gov (United States)

    Alfonso, Ana; Redondo, Margarita; Rubio, Tomás; Del Olmo, Beatriz; Rodríguez-Wilhelmi, Pablo; García-Velloso, María J; Richter, José A; Páramo, José A; Lecumberri, Ramón

    2013-11-01

    Extensive screening strategies to detect occult cancer in patients with unprovoked venous thromboembolism (VTE) are complex and no benefit in terms of survival has been reported. FDG-PET/CT (2-[F-18] fluoro-2-deoxy-D-glucose positron emission tomography combined with computed tomography), a noninvasive technique for the diagnosis and staging of malignancies, could be useful in this setting. Consecutive patients ≥ 50 years with a first unprovoked VTE episode were prospectively included. Screening with FDG-PET/CT was performed 3-4 weeks after the index event. If positive, appropriate diagnostic work-up was programmed. Clinical follow-up continued for 2 years. Blood samples were collected to assess coagulation biomarkers. FDG-PET/CT was negative in 68/99 patients (68.7%), while suspicious FDG uptake was detected in 31/99 patients (31.3%). Additional diagnostic work-up confirmed a malignancy in 7/31 patients (22.6%), with six of them at early stage. During follow-up, two patients with negative FDG-PET/CT were diagnosed with cancer. Sensitivity (S), positive (PPV) and negative predictive values (NPV) of FDG-PET/CT as single tool for the detection of occult malignancy were 77.8% (95% CI: 0.51-1), 22.6% (95% CI: 0.08-0.37) and 97.1% (95% CI: 0.93-1), respectively. Median tissue factor (TF) activity in patients with occult cancer was 5.38 pM vs. 2.40 pM in those without cancer (p = 0.03). Limitation of FDG-PET/CT screening to patients with TF activity > 2.8 pM would improve the PPV to 37.5% and reduce the costs of a single cancer diagnosis from 20,711€ to 11,670€. FDG-PET/CT is feasible for the screening of occult cancer in patients with unprovoked VTE, showing high S and NPV. The addition of TF activity determination may be useful for patient selection.

  16. Wave Optics Based LEO-LEO Radio Occultation Retrieval

    DEFF Research Database (Denmark)

    von Benzon, Hans-Henrik; Høeg, Per

    2016-01-01

    This paper describes the theory for performing retrieval of radio occultations that use probing frequencies in the XK and KM band. Normally radio occultations use frequencies in the L band and GPS satellites are used as the transmitting source and the occultation signals are received by a GPS...... in the signal amplitude caused by atmospheric absorption. The radio wave transmitter is placed on one of these satellites while the receiver is placed on the other LEO satellite. One of the drawbacks of normal GPS based radio occultations is that external information is needed to calculate some...... chain is therefore a wave optics based retrieval chain and it is therefore possible to process measurements that include multipath. In this paper simulated LEO to LEO radio occultations based on 5 different frequencies are used. The 5 frequencies are placed in the XK or KM frequency band. This new wave...

  17. A digital video system for observing and recording occultations

    CERN Document Server

    Barry, M A; Pavlov, Hristo; Hanna, William; McEwan, Alistair; Filipovic, Miroslav

    2015-01-01

    Stellar occultations by asteroids and outer solar system bodies can offer ground based observers with modest telescopes and camera equipment the opportunity to probe the shape, size, atmosphere and attendant moons or rings of these distant objects. The essential requirements of the camera and recording equipment are: good quantum efficiency and low noise, minimal dead time between images, good horological faithfulness of the image time stamps, robustness of the recording to unexpected failure, and low cost. We describe the Astronomical Digital Video occultation observing and recording System (ADVS) which attempts to fulfil these requirements and compare the system with other reported camera and recorder systems. Five systems have been built, deployed and tested over the past three years, and we report on three representative occultation observations: one being a 9 +/-1.5 second occultation of the trans-Neptunian object 28978 Ixion (mv=15.2) at 3 seconds per frame, one being a 1.51 +/-0.017 second occultation ...

  18. Simulations of X-ray spectrum and HVL for mammographic equipment using MCNP5 code

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Rafael Toledo F. de; Alvarez, Matheus; Velo, Alexandre F.; Oliveira, Marcela de; Miranda, Jose Ricardo A. [Universidade Estadual Paulista Julio de mesquita Filho (UNESP), Botucatu, SP (Brazil). Inst. de Biociencias de Botucatu. Dept. de Fisica e Biofisica; Pina, Diana R. [Universidade Estadual Paulista Julio de mesquita Filho (UNESP), Botucatu, SP (Brazil). Fac. de Medicina. Dept. de Doencas Tropicais e Diagnostico por Imagem

    2012-07-01

    Full text: The main goal of mammography is early detection of breast cancer. Thus, the mammograph should be designed so that the X-ray photons are emitted within an appropriate energy range, to distinguish the normal breast tissue and cancerous tissue. The distribution of the photons amount of X-ray beam, with their respective energies, is called the spectrum. From the spectrum it is possible to estimate the quality of the X-ray beam from the Half Value Layer (HVL). Objectives: This study aims to simulate the Senographe 600T mammography unit, manufactured by General Electric (GE), using the MCNP5 Monte Carlo code, to obtain its spectrum and HVL, and compare the HVL of the simulated model with experimental data. Method: the mammography unit was simulated using a simplified model which a beam of 2x10{sup 8} electrons focuses on a Mo target angled 12 degrees, within a capsule filled with vacuum. The incident electrons were converted into photons. The capsule has a beryllium window, allowing the passage of the X-ray beam. The beam is detected by an air cylinder with 1 cm thickness placed 60 cm from the target. On the path of X-ray beam, is inserted a 0.03 mm Mo filter located 1.6 cm after the beryllium window. The space between the capsule and the detector cylinder was filled with air. The quality of X-ray beam was verified from the HVL using the MCNP5 code and the experimental method for the voltage range typically used in clinical routine (26-31 kVp). Results and discussion: the X-ray spectrum of the mammography device is satisfactorily simulated by MCNP5, showing the characteristic radiation peaks of molybdenum at 17.479 keV and 19.602 keV, the filtered spectrum generated by Bremsstrahlung, and reducing the total number of photons with the decrease in applied tension (kVp). The HVL obtained by MCNP5 and experimental measurements show a maximum difference of 5.31% (for 31 kVp). The result of both methods are within acceptable limits established by national

  19. Radio occultation experiments with INAF-IRA radiotelescopes.

    Science.gov (United States)

    Pluchino, S.; Schillirò, F.; Salerno, E.; Pupillo, G.

    The Radio Occultation research program performed at the Medicina and Noto Radioastronomical Stations of the Istituto Nazionale di Astrofisica (INAF) - Istituto di Radioastronomia (IRA) includes observations of spacecraft by satellite and satellite by satellite events. The Lunar Radio Occultation (LRO) part of the program consists in collecting data of the lunar Total Electron Content (TEC), at different limb longitudes and at different time, in order to study long term variation of the Moon's ionosphere. The LRO program started at Medicina in September 2006 with the observation of the European probe SMART-1 during its impact on the lunar soil. It proceeded in 2007 with the observation of the lunar occultations of Saturn and Venus, and with the observation of Mars in 2008. On this occasion the probes Cassini, Venus Express, Mars Express, Mars Reconaissance Orbiter and Mars Odissey were respectively occulted by the moon. On Dec 1st 2008 a Venus lunar occultation occurred. On that occasion we performed the first Italian-VLBI (I-VLBI) tracking experiment by detecting the carrier signals coming from the Venus Express (VEX) spacecraft with both the IRA radiotelescopes together with the Matera antenna of the Italian Space Agency. The second part of the radio occultation program includes the observation of satellite by satellite occultation events, as well as mutual occultations of Jupiter satellites. These events are referred to as mutual phenomena (PHEMU). These observations are aimed to measure the radio flux variation during the occultation and to derive surface spatial characteristics such as Io's hot spots. In this work preliminary results of the Radio Occultation program will be presented.

  20. Ovarian pathology in risk-reducing salpingo-oophorectomies from women with BRCA mutations, emphasizing the differential diagnosis of occult primary and metastatic carcinoma.

    Science.gov (United States)

    Rabban, Joseph T; Barnes, Michael; Chen, Lee-May; Powell, Catherine B; Crawford, Beth; Zaloudek, Charles J

    2009-08-01

    Risk-reducing salpingo-oophorectomy (RRSO) is an effective prophylactic procedure for women with mutations in BRCA1 or BRCA2 genes, both of which confer an increased lifetime risk for ovarian, tubal, peritoneal, and breast cancer. In addition to lowering this risk, RRSO also offers the opportunity to detect occult early-stage fallopian tube or ovarian carcinoma. The differential diagnosis of occult tubal/ovarian cancer includes a spectrum of benign tubal and ovarian alterations and also occult metastatic breast cancer, although only rare cases of the latter have been reported in RRSO. Neoadjuvant breast cancer chemotherapy may contribute to diagnostic difficulty due to treatment-induced cytologic alterations. With the aim of elucidating features which may help with differential diagnosis, this study reports the incidence and pathologic features of benign ovarian alterations, benign ovarian tumors, and occult primary and metastatic malignancies in prophylactic oophorectomies from 108 women with a BRCA mutation and from 35 women with other strong risk factors for hereditary breast/ovarian carcinoma. We direct particular emphasis on morphologic features of primary ovarian lesions that may mimic occult metastatic breast cancer. We also evaluate histologic alterations due to neoadjuvant breast cancer chemotherapy in the ovary and fallopian tube of patients who received such treatment immediately preceding RRSO. Comparison is made to ovarian metastases of breast cancer in our hospital-based population of breast cancer patients, none of whom underwent RRSO. Overall, 69% of RRSO patients had a personal history of breast cancer. Neoadjuvant breast cancer chemotherapy was administered in 15%. Occult primary carcinoma occurred in 7 (6.5%) BRCA patients (5 in fallopian tube, 1 in fallopian tube and ovary, 1 in ovary). Ovarian metastasis of breast cancer occurred in 1 (1%) BRCA patient undergoing RRSO and in up to a similar proportion (0.8%) of the hospital-based population of

  1. 隐性胰胆反流75例分析%Occult pancreatobiliary reflux

    Institute of Scientific and Technical Information of China (English)

    钟征翔; 邬万新; 赵凤庆; 邹洪兴; 俞方荣; 周俊; 许浏; 徐鹿平; 孙建良

    2008-01-01

    目的 研究隐性胰胆反流的发生率及其对胆囊上皮不典型增生和癌变的影响.方法 对2006年7月至2008年2月期间择期行胆道手术或行ERCP检查的956例患者常规作胆汁淀粉酶测定,对手术切除胆囊标本行病理检查,观察不典型增生和癌变的发生率.结果 754例患者中发现隐性胰胆反流75例,发生率为9.9%.反流组和对照组胆汁淀粉酶分别为(7701±20 378)IU/L和(16±51)IU/L,差异有统计学意义(P<0.01).反流组中胆囊癌及不典型增生发生率分别为3.4%(2/58)和31.0%(18/58),均高于对照组(P<0.05).反流组中伴有癌变和不典型增生病例的胆汁淀粉酶值高于不伴有癌变和不典型增生的病例(9194±10 399 IU/L vs.2388±2745 IU/L,P<0.01).结论 在胆胰管汇合正常者中隐性胰胆反流是客观存在的,它促进了胆囊不典型增生和癌变的发生.%Objective To investigate the incidence of occult pancreatobiliary reflux and to evaluate its relation to gallbladder epithelial dysplasia and cancer. Methods From July 2006 to Feb 2008,956 cases underwent selective biliary procedure or preoperative endoscopic retrograde cholangiopanereatography (ERCP), bile was collected and amylase was measured. All removed gallbladders were pathologically examined for dysplasia and cancer. Results Occult pancreatobihary reflux was found in 75 of 754 patients in this study, with an incidence of 9. 9%. The biliary amylase values in the patients with occult pancreatobiliary reflux and in controls were 7701±20 378 IU/L and 16±51 IU/L, respectively ( P <0. 01 ).Gallbladder dysplasia and cancer were found in 31.0% and 3.4% of the patients with occult pancreatobiliaryreflux, respectively, and both were higher than those in the patients without pancreatobiliary reflux ( P <0. 05). In the patients with occult pancreatobiliary reflux, the biliary amylase level with gallbladder dysplasia or cancer was 2388 ± 2745 IU/L and was higher than those without gallbladder

  2. Response functions of Si(Li), SDD and CdTe detectors for mammographic x-ray spectroscopy.

    Science.gov (United States)

    Tomal, A; Cunha, D M; Antoniassi, M; Poletti, M E

    2012-07-01

    In this work, the energy response functions of Si(Li), SDD and CdTe detectors were studied in the mammographic energy range through Monte Carlo simulation. The code was modified to take into account carrier transport effects and the finite detector energy resolution. The results obtained show that all detectors exhibit good energy response at low energies. The most important corrections for each detector were discussed, and the corrected mammographic x-ray spectra obtained with each one were compared. Results showed that all detectors provided similar corrected spectra, and, therefore, they could be used to accurate mammographic x-ray spectroscopy. Nevertheless, the SDD is particularly suitable for clinic mammographic x-ray spectroscopy due to the easier correction procedure and portability.

  3. Occult hepatitis B virus and hepatitis C virus infections.

    Science.gov (United States)

    Carreño, Vicente; Bartolomé, Javier; Castillo, Inmaculada; Quiroga, Juan Antonio

    2008-01-01

    Occult HBV infection is a well-recognised clinical entity characterised by the detection of HBV-DNA in serum and/or in liver in the absence of detectable hepatitis B surface antigen (HBsAg). Occult HBV infection has been described not only in patients who have resolved an acute or chronic HBV infection but also in patients without any serological markers of a past HBV infection. Occult HBV infection in patients with chronic HCV infection may induce more severe liver disease and lower response rate to interferon treatment. The existence of occult HCV infections has been also reported more recently. Occult HCV infection is characterised by the presence of HCV-RNA in liver and peripheral blood mononuclear cells in the absence of detectable serum HCV-RNA. Occult HCV infection may occur under two different clinical situations: in hepatitis C antibody-(anti-HCV) negative and serum HCV-RNA-negative patients with abnormal liver function tests and in anti-HCV-positive patients who have no detectable serum HCV-RNA and who have normal liver enzymes. The clinical relevance of occult HCV infections is still under investigation.

  4. Review: Occult hepatitis C virus infection: still remains a controversy.

    Science.gov (United States)

    Vidimliski, Pavlina Dzekova; Nikolov, Igor; Geshkovska, Nadica Matevska; Dimovski, Aleksandar; Rostaing, Lionel; Sikole, Aleksandar

    2014-09-01

    Occult hepatitis C virus (HCV) infection is characterized by the presence of HCV RNA in the liver cells or peripheral blood mononuclear cells of the patients whose serum samples test negative for HCV RNA, with or without presence of HCV antibodies. The present study reviews the existing literature on the persistence of occult hepatitis C virus infection, with description of the clinical characteristics and methods for identification of occult hepatitis C. Occult hepatitis C virus infection was detected in patients with abnormal results of liver function tests of unknown origin, with HCV antibodies and HCV RNA negativity in serum, and also in patients with spontaneous or treatment-induced recovery from hepatitis C. The viral replication in the liver cells and/or peripheral blood mononuclear cells was present in all clinical presentations of occult hepatitis C. The peripheral blood mononuclear cells represent an extra-hepatic site of HCV replication. The reason why HCV RNA was not detectable in the serum of patients with occult hepatitis C, could be the low number of circulating viral particles not detectable by the diagnostic tests with low sensitivity. It is uncertain whether occult hepatitis C is a different clinical entity or just a form of chronic hepatitis C virus infection. Data accumulated over the last decade demonstrated that an effective approach to the diagnosis of HCV infection would be the implementation of more sensitive HCV RNA diagnostic assays, and also, examination of the presence of viral particles in the cells of the immune system.

  5. A Clinicopathologic Correlation of Mammographic Parenchymal Patterns and Associated Risk Factors for Human Mammary Carcinoma

    Science.gov (United States)

    Bland, Kirby I.; Kuhns, James G.; Buchanan, Jerry B.; Dwyer, Patricia A.; Heuser, Louis F.; O'Connor, Carol A.; Gray, Laman A.; Polk, Hiram C.

    1982-01-01

    The five-year screening experience for 10,131 asymptomatic women evaluated at the Louisville Breast Cancer Detection Demonstration Project (LBCDDP) disclosed 144 breast carcinomas in 1,209 patients (12%) aged 35 to 74 years in whom 904 biopsies and 305 aspirations were performed. This study included 44,711 high-quality xeromammograms (XM) prospectively classified by the modified Wolfe mammographic parenchymal patterns into low-risk (N1, P1) versus high-risk (P2, DY) groups, with expansion of the P2 cohort into three additional categories. Using BMDP computer-program analysis, each XM pattern was collated with 21 nonneoplastic and 18 malignant pathologic variables and commonly associated risk factors. A separate analysis of epithelial proliferative and nonproliferative fibrocystic disease of the breast (FCDB) was performed. The histopathology for each biopsy, with distinction of FCDB and neoplasms, was analyzed with regard to the statistical probability of influencing the XM pattern. An average of 1.05 biopsies per patient were performed in women with findings suggestive of carcinoma at clinical and/or XM examinations. An equal distribution of the N1, P1, and P2 DYXM patterns was observed in the 10,131 screenees. Of 8.5% of the screened population having biopsies, 623 were observed to have nonproliferative FCDB and 137, proliferative FCDB. For women 50 years of age or younger, these pathologic variables were seen more frequently in the P2 DY patterns (p < 0.001), whereas no difference in XM pattern distribution was observed for the screenee 50 years of age or older for proliferative FCDB (p = 0.65). Sixteen percent of the biopsied/aspirated lesions were carcinomas, yielding a biopsy/cancer ratio of 6.25:1. These in situ and invasive neoplasms were more commonly (p < 0.04) observed in 55% of the P2 (P2f, P2n, P2c) categories, while 64% of all cancers appeared more frequently in the P2 DY subgroup (p <0.001), compared with this pattern in the screened population. An

  6. The Research and Education Collaborative Occultation Network: A System for Coordinated TNO Occultation Observations

    Science.gov (United States)

    Buie, Marc W.; Keller, John M.

    2016-03-01

    We describe a new system and method for collecting coordinated occultation observations of trans-Neptunian objects (TNOs). Occultations by objects in the outer solar system are more difficult to predict due to their large distance and limited span of the astrometric data used to determine their orbits and positions. This project brings together the research and educational community into a unique citizen-science partnership to overcome the difficulties of observing these distant objects. The goal of the project is to get sizes and shapes for TNOs with diameters larger than 100 km. As a result of the system design it will also serve as a probe for binary systems with spatial separations as small as contact systems. Traditional occultation efforts strive to get a prediction sufficiently good to place mobile ground stations in the shadow track. Our system takes a new approach of setting up a large number of fixed observing stations and letting the shadows come to the network. The nominal spacing of the stations is 50 km so that we ensure two chords at our limiting size. The spread of the network is roughly 2000 km along a roughly north-south line in the western United States. The network contains 56 stations that are committed to the project and we get additional ad hoc support from International Occultation Timing Association members. At our minimum size, two stations will record an event while the other stations will be probing the inner regions for secondary events. Larger objects will get more chords and will allow determination of shape profiles. The stations are almost exclusively sited and associated with schools, usually at the 9-12 grade level. We present a full description of the system we have developed for the continued exploration of the Kuiper Belt.

  7. Scattering and extinction: interpreting hazes in stellar occultation data

    Science.gov (United States)

    Bosh, Amanda S.; Levine, Stephen; Sickafoose, Amanda A.; Person, Michael J.

    2016-10-01

    There has been debate concerning interpretation of stellar occultation data and whether those data contain evidence for hazes within Pluto's atmosphere. Multiple layers of haze have been imaged in at Pluto with the New Horizons spacecraft; color-dependent differences in minimum flux from stellar occultations also suggests haze. We look at a purely geometric approach, to evaluate whether it is valid to sidestep details of atmospheric temperature structure and, in an approximate manner, conduct an analysis of the 2015 stellar occultation data that is consistent with the New Horizons imaging results. Support for this work was provided by NASA SSO grant NNX15AJ82G to Lowell Observatory.

  8. Accuracy and reading time for six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts.

    Science.gov (United States)

    Tagliafico, Alberto Stefano; Calabrese, Massimo; Bignotti, Bianca; Signori, Alessio; Fisci, Erica; Rossi, Federica; Valdora, Francesca; Houssami, Nehmat

    2017-06-22

    To compare six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts. This is a substudy of the 'ASTOUND' trial. 163 women who underwent tomosynthesis with synthetically reconstructed projection images (S-2D) inclusive of 13 (7.9%) cases diagnosed with breast cancer at histopathology after surgery were evaluated. Accuracy measures and screen-reading time of six reading strategies were assessed: (A) Single reading of S-2D alone, (B) single reading of tomosynthesis alone, (C) single reading of joint interpretation of tomosynthesis + S-2D, (D) double-reading of S-2D alone, (E) double reading of tomosynthesis alone, (F) double reading of joint interpretation of tomosynthesis + S-2D. The median age of the patients was 53 years (range, 36-88 years). The highest global accuracy was obtained with double reading of tomosynthesis + S2D (F) with an AUC of 0.979 (preading time of 154 s versus 34 s for the fastest strategy (single reading of S-2D alone). The AUCs for the other five strategies did not differ from each other. Double reading of tomosynthesis+ S2D had the best accuracy of six screen-reading strategies although it had the longest reading time. • Tomosynthesis acquisitions are progressively implemented with reconstructed synthesized 2D images • Double reading using S-2D plus tomosynthesis had the highest global accuracy (preading of S-2D plus tomosynthesis increased reading time.

  9. Cancer

    Science.gov (United States)

    ... cancer Non-Hodgkin lymphoma Ovarian cancer Pancreatic cancer Testicular cancer Thyroid cancer Uterine cancer Symptoms Symptoms of cancer ... tumor Obesity Pancreatic cancer Prostate cancer Stomach cancer Testicular cancer Throat or larynx cancer Thyroid cancer Patient Instructions ...

  10. Verifying timestamps of occultation observation systems

    CERN Document Server

    A., M; Gault, Dave; Bolt, Greg; McEwan, Alistair; Filipovic, Miroslav D; White, Graeme L

    2015-01-01

    We describe an image timestamp verification system to determine the exposure timing characteristics and continuity of images made by an imaging camera and recorder, with reference to Coordinated Universal Time (UTC). The original use was to verify the timestamps of stellar occultation recording systems, but the system is applicable to lunar flashes, planetary transits, sprite recording, or any area where reliable timestamps are required. The system offers good temporal resolution (down to 2 msec, referred to UTC) and provides exposure duration and interframe dead time information. The system uses inexpensive, off-the- shelf components, requires minimal assembly and requires no high-voltage components or connections. We also describe an application to load FITS (and other format) image files, which can decode the verification image timestamp. Source code, wiring diagrams and built applications are provided to aid the construction and use of the device.

  11. Convective towers detection using GPS radio occultations

    DEFF Research Database (Denmark)

    Biondi, Riccardo; Neubert, Torsten; Syndergaard, S.

    The tropical deep convection affects the radiation balance of the atmosphere changing the water vapour mixing ratio and the temperature of the upper troposphere and lower stratosphere. To gain a better understanding of deep convective processes, the study of tropical cyclones could play an import...... (ACES) payload on the International Space Station....... 1194 profiles in a time window of 3 hours and a space window of 300 km from the eye of the cyclone. We show that the bending angle anomaly of a GPS RO signal is typically larger than the climatology above the tropopause. Comparisons with co-located radiosondes, climatology of tropopause altitudes...... and GOES analyses will also be shown to support our hypothesis and to corroborate the idea that the bending angle anomaly can be used as an indicator of convective towers. The results are discussed in connection to the GPS radio occultation receiver which will be part of the Atomic Clock Ensemble in Space...

  12. What can the occult do for you?

    Science.gov (United States)

    Holwerda, B. W.; Keel, W. C.

    2017-03-01

    Interstellar dust is still a dominant uncertainty in Astronomy, limiting precision in e.g., cosmological distance estimates and models of how light is re-processed within a galaxy. When a foreground galaxy serendipitously overlaps a more distant one, the latter backlights the dusty structures in the nearer foreground galaxy. Such an overlapping or occulting galaxy pair can be used to measure the distribution of dust in the closest galaxy with great accuracy. The STARSMOG program uses Hubble to map the distribution of dust in foreground galaxies in fine (<100 pc) detail. Integral Field Unit (IFU) observations will map the effective extinction curve, disentangling the role of fine-scale geometry and grain composition on the path of light through a galaxy. The overlapping galaxy technique promises to deliver a clear understanding of the dust in galaxies: geometry, a probability function of dimming as a function of galaxy mass and radius, and its dependence on wavelength.

  13. Occult hepatitis B virus infection in Egypt

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    The emerging evidence of the potentially clinicalimportance of occult hepatitis B virus (HBV) infection(OBI) increases the interest in this topic. OBI mayimpact in several clinical contexts, which include thepossible transmission of the infection, the contributionto liver disease progression, the development ofhepatocellular carcinoma, and the risk of reactivation.There are several articles that have published on OBI inEgyptian populations. A review of MEDLINE databasewas undertaken for relevant articles to clarify theepidemiology of OBI in Egypt. HBV genotype D is theonly detectable genotype among Egyptian OBI patients.Higher rates of OBI reported among Egyptian chronicHCV, hemodialysis, children with malignant disorders, andcryptogenic liver disease patients. There is an evidenceof OBI reactivation after treatment with chemotherapy.The available data suggested that screening for OBI mustbe a routine practice in these groups of patients. Furtherstudies needed for better understand of the epidemiologyof OBI among Egyptian young generations after the eraof hepatitis B vaccination.

  14. What can the occult do for you?

    CERN Document Server

    Holwerda, B W

    2016-01-01

    Interstellar dust is still a dominant uncertainty in Astronomy, limiting precision in e.g., cosmological distance estimates and models of how light is re-processed within a galaxy. When a foreground galaxy serendipitously overlaps a more distant one, the latter backlights the dusty structures in the nearer foreground galaxy. Such an overlapping or occulting galaxy pair can be used to measure the distribution of dust in the closest galaxy with great accuracy. The STARSMOG program uses Hubble to map the distribution of dust in foreground galaxies in fine (<100 pc) detail. Integral Field Unit (IFU) observations will map the effective extinction curve, disentangling the role of fine-scale geometry and grain composition on the path of light through a galaxy. The overlapping galaxy technique promises to deliver a clear understanding of the dust in galaxies: geometry, a probability function of dimming as a function of galaxy mass and radius, and its dependence on wavelength.

  15. Theory of radio occultation by Saturn's rings

    Science.gov (United States)

    Marouf, E. A.; Tyler, G. L.; Eshleman, V. R.

    1982-01-01

    The radio occultation technique, as applied to Saturn's rings, is developed as a new method for the study of the physical properties of planetary ring systems. The rings are treated as a Doppler-spread radar target composed of an ensemble of discrete scatterers. The mathematical formulation of the received signal as a random-phasor-sum process is carried out following a conventional radar theory approach, providing a convenient starting point for deriving coherent signal parameters. A classical result is rederived for the equivalent refractive index of the medium. The analysis is generalized to include ringlets of arbitrary width and it is shown that when the width is such that two adjacent rays are differentially perturbed in phase, ray bending that causes focusing of the coherent signal may result. The diffuse component is also treated in detail.

  16. Vitamin D intake, month the mammogram was taken and