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  1 / 28840 MEDLINE  
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PMID:28470951
Autor:Posso M; Corominas JM; Serrano L; Román M; Torá-Rocamora I; Domingo L; Romero A; Quintana MJ; Vernet-Tomas M; Baré M; Vidal C; Sánchez M; Saladié F; Natal C; Ferrer J; Servitja S; Sala M; Castells X; BELE Study Group
Dirección:Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Título:Biomarkers expression in benign breast diseases and risk of subsequent breast cancer: a case-control study.
Fuente:Cancer Med; 6(6):1482-1489, 2017 Jun.
ISSN:2045-7634
País de publicación:United States
Idioma:eng
Resumen:Women with benign breast diseases (BBD) have a high risk of breast cancer. However, no biomarkers have been clearly established to predict cancer in these women. Our aim was to explore whether estrogen receptor (ER), progesterone receptor (PR), and Ki67 expression stratify risk of breast cancer in screened women with BBD. We conducted a nested case-control study. Women with breast cancer and prior BBDs (86 cases) were matched to women with prior BBDs who were free from breast cancer (172 controls). The matching factors were age at BBD diagnosis, type of BBD, and follow-up time since BBD diagnosis. ER, PR, and Ki67 expression were obtained from BBDs' specimens. Conditional logistic regression was used to estimate odds ratios (ORs), and 95% confidence intervals (CIs) of breast cancer risk according to ER, PR, and Ki67 expression. Women with >90% of ER expression had a higher risk of breast cancer (OR = 2.63; 95% CI: 1.26-5.51) than women with ≤70% of ER expression. Similarly, women with >80% of PR expression had a higher risk of breast cancer (OR = 2.22; 95% CI: 1.15-4.27) than women with ≤40% of PR expression. Women with proliferative disease and ≥1% of Ki67 expression had a nonsignificantly increased risk of breast cancer (OR = 1.16; 95% CI: 0.46-2.90) than women with <1% of Ki67 expression. A high expression of ER and PR in BBD is associated with an increased risk of subsequent breast cancer. In proliferative disease, high Ki67 expression may also have an increased risk. This information is helpful to better characterize BBD and is one more step toward personalizing the clinical management of these women.
Tipo de publicación:JOURNAL ARTICLE
Nombre de substancia:0 (Biomarkers); 0 (Ki-67 Antigen); 0 (Receptors, Estrogen); 0 (Receptors, Progesterone)


  2 / 28840 MEDLINE  
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PMID:28465449
Autor:Geller BM; Nelson HD; Weaver DL; Frederick PD; Allison KH; Onega T; Carney PA; Tosteson ANA; Elmore JG
Dirección:Department of Family Medicine, University of Vermont, Burlington, Vermont, USA.
Título:Characteristics associated with requests by pathologists for second opinions on breast biopsies.
Fuente:J Clin Pathol; 70(11):947-953, 2017 Nov.
ISSN:1472-4146
País de publicación:England
Idioma:eng
Resumen:AIMS: Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. METHODS: Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. RESULTS: 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. CONCLUSIONS: Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions.
Tipo de publicación:JOURNAL ARTICLE; OBSERVATIONAL STUDY


  3 / 28840 MEDLINE  
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PMID:29351560
Autor:Vreemann S; Gubern-Mérida A; Borelli C; Bult P; Karssemeijer N; Mann RM
Dirección:Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein 10, Nijmegen, the Netherlands.
Título:The correlation of background parenchymal enhancement in the contralateral breast with patient and tumor characteristics of MRI-screen detected breast cancers.
Fuente:PLoS One; 13(1):e0191399, 2018.
ISSN:1932-6203
País de publicación:United States
Idioma:eng
Resumen:PURPOSE: Higher background parenchymal enhancement (BPE) could be used for stratification of MRI screening programs since it might be related to a higher breast cancer risk. Therefore, the purpose of this study is to correlate BPE to patient and tumor characteristics in women with unilateral MRI-screen detected breast cancer who participated in an intermediate and high risk screening program. As BPE in the affected breast may be difficult to discern from enhancing cancer, we assumed that BPE in the contralateral breast is a representative measure for BPE in women with unilateral breast cancer. MATERIALS AND METHODS: This retrospective study was approved by our local institutional board and a waiver for consent was granted. MR-examinations of women with unilateral breast cancers screen-detected on breast MRI were evaluated by two readers. BPE in the contralateral breast was rated according to BI-RADS. Univariate analyses were performed to study associations. Observer variability was computed. RESULTS: Analysis included 77 breast cancers in 76 patients (age: 48±9.8 years), including 62 invasive and 15 pure ductal carcinoma in-situ cases. A negative association between BPE and tumor grade (p≤0.016) and a positive association with progesterone status (p≤0.021) was found. The correlation was stronger when only considering invasive disease. Inter-reader agreement was substantial. CONCLUSION: Lower BPE in the contralateral breast in women with unilateral breast cancer might be associated to higher tumor grade and progesterone receptor negativity. Great care should be taken using BPE for stratification of patients to tailored screening programs.
Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
Nombre de substancia:0 (Contrast Media)


  4 / 28840 MEDLINE  
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PMID:29458952
Autor:Yen P; Dumas S; Albert A; Gordon P
Dirección:Department of Diagnostic Radiology, Nanaimo Regional General Hospital, Nanaimo, British Columbia, Canada. Electronic address: peggy_yen@live.com.
Título:Post-Vacuum-Assisted Stereotactic Core Biopsy Clip Displacement: A Comparison Between Commercially Available Clips and Surgical Clip.
Fuente:Can Assoc Radiol J; 69(1):10-15, 2018 Feb.
ISSN:1488-2361
País de publicación:Canada
Idioma:eng
Resumen:PURPOSE: The placement of localization clips following percutaneous biopsy is a standard practice for a variety of situations. Subsequent clip displacement creates challenges for imaging surveillance and surgical planning, and may cause confusion amongst radiologists and between surgeons and radiologists. Many causes have been attributed for this phenomenon including the commonly accepted "accordion effect." Herein, we investigate the performance of a low cost surgical clip system against 4 commercially available clips. METHODS: We retrospectively reviewed 2112 patients who underwent stereotactic vacuum-assisted core biopsy followed by clip placement between January 2013 and June 2016. The primary performance parameter compared was displacement >10 mm following vacuum-assisted stereotactic core biopsy. Within the group of clips that had displaced, the magnitude of displacement was compared. RESULTS: There was a significant difference in displacement among the clip types (P < .0001) with significant pairwise comparisons between pediatric surgical clips and SecureMark (38% vs 28%; P = .001) and SenoMark (38% vs 27%; P = .0001) in the proportion displaced. The surgical clips showed a significant magnitude of displacement of approximately 25% greater average distance displaced. CONCLUSIONS: As a whole, the commercial clips performed better than the surgical clip after stereotactic vacuum-assisted core biopsy suggesting the surrounding outer component acts to anchor the central clip and minimizes clip displacement. The same should apply to tomosynthesis-guided biopsy.
Tipo de publicación:COMPARATIVE STUDY; JOURNAL ARTICLE


  5 / 28840 MEDLINE  
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PMID:29458953
Autor:Théberge I; Guertin MH; Vandal N; Daigle JM; Dufresne MP; Wadden N; Shumak R; Samson C; Langlois A; Larocque I; Perron L; Pelletier É; Brisson J
Dirección:Institut national de santé publique du Québec, Quebec City, Québec, Canada; Département de médecine sociale et préventive, Faculté de Médecine, Université Laval, Quebec City, Québec, Canada. Electronic address: isabelle.theberge@inspq.qc.ca.
Título:Clinical Image Quality and Sensitivity in an Organized Mammography Screening Program.
Fuente:Can Assoc Radiol J; 69(1):16-23, 2018 Feb.
ISSN:1488-2361
País de publicación:Canada
Idioma:eng
Resumen:PURPOSE: The study sought to examine the association between clinical image quality of mammograms and screening sensitivity. METHODS: Four radiologists evaluated the clinical image quality of 374 invasive screen-detected cancers and 356 invasive interval breast cancers for which quality evaluation of screening mammograms could be assessed from cancers diagnosed among participants in the Quebec Breast Cancer Screening Program in 2007. Quality evaluation was based on the Canadian Association of Radiologists accreditation criteria, which are similar to those of the American College of Radiology. The association between clinical quality and screening sensitivity was assessed by logistic regression. Adjusted sensitivity and adjusted sensitivity ratios were obtained through marginal standardization. No institutional review board approval was required. RESULTS: A proportion of 28% (206 of 730) of screening mammograms had lower overall quality for the majority of assessments. Positioning was the quality attribute that was the most frequently deficient. The 2-year screening sensitivity reached 68%. Sensitivity of screening was not statistically associated with the overall quality (ratio of 2-year sensitivity = 1.03; 95% confidence interval: 0.93-1.15) or with any quality attributes (positioning, exposure, compression, sharpness, artifacts, contrast). Results were similar for the 1-year sensitivity. CONCLUSIONS: Although not all mammograms in the Quebec screening program met the optimum quality required by the Canadian Association of Radiologists or American College of Radiology accreditation, the screening mammograms produced in this population-based organized screening program reached a high enough level of quality so that the remaining variation in quality is too little to impair screening sensitivity.
Tipo de publicación:JOURNAL ARTICLE


  6 / 28840 MEDLINE  
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PMID:28463150
Autor:Gay HA; Sanda MG; Liu J; Wu N; Hamstra DA; Wei JT; Dunn RL; Klein EA; Sandler HM; Saigal CS; Litwin MS; Kuban DA; Hembroff L; Regan MM; Chang P; Michalski JM; Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium
Dirección:Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri. Electronic address: hiramgay@wustl.edu.
Título:External Beam Radiation Therapy or Brachytherapy With or Without Short-course Neoadjuvant Androgen Deprivation Therapy: Results of a Multicenter, Prospective Study of Quality of Life.
Fuente:Int J Radiat Oncol Biol Phys; 98(2):304-317, 2017 06 01.
ISSN:1879-355X
País de publicación:United States
Idioma:eng
Resumen:PURPOSE: The long-term effects of neoadjuvant androgen deprivation therapy (NADT) with radiation therapy on participant-reported health-related quality of life (HRQOL) have not been characterized in prospective multicenter studies. We evaluated HRQOL for 2 years among participants undergoing radiation therapy (RT) with or without NADT for newly diagnosed, early-stage prostate cancer. METHODS AND MATERIALS: We analyzed longitudinal cohort data from the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium to ascertain the HRQOL trajectory of men receiving NADT with external beam RT (EBRT) or brachytherapy. HRQOL was measured using the expanded prostate cancer index composite 26-item questionnaire at 2, 6, 12, and 24 months after the initiation of NADT. We used the χ or Fisher exact test to compare the shift in percentages between groups that did or did not receive NADT. Analyses were conducted at the 2-sided 5% significance level. RESULTS: For subjects receiving EBRT, questions regarding the ability to have an erection, ability to reach an orgasm, quality of erections, frequency of erections, ability to function sexually, and lack of energy were in a significantly worse dichotomized category for the patients receiving NADT. Comparing the baseline versus 24-month outcomes, 24%, 23%, and 30% of participants receiving EBRT plus NADT shifted to the worse dichotomized category for the ability to reach an orgasm, quality of erections, and ability to function sexually compared with 14%, 13%, and 16% in the EBRT group, respectively. CONCLUSIONS: Compared with baseline, at 2 years, participants receiving NADT plus EBRT compared with EBRT alone had worse HRQOL, as measured by the ability to reach orgasm, quality of erections, and ability to function sexually. However, no difference was found in the ability to have an erection, frequency of erections, overall sexual function, hot flashes, breast tenderness/enlargement, depression, lack of energy, or change in body weight. The improved survival in intermediate- and high-risk patients receiving NADT and EBRT necessitates pretreatment counseling of the HRQOL effect of NADT and EBRT.
Tipo de publicación:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
Nombre de substancia:0 (Androgen Antagonists); EC 3.4.21.77 (Prostate-Specific Antigen)


  7 / 28840 MEDLINE  
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PMID:29337058
Autor:Kim K; Son MY; Jung CR; Kim DS; Cho HS
Dirección:Korea Research Institute of Bioscience and Biotechnology, Daejeon, 305-333, Republic of Korea.
Título:EHMT2 is a metastasis regulator in breast cancer.
Fuente:Biochem Biophys Res Commun; 496(2):758-762, 2018 02 05.
ISSN:1090-2104
País de publicación:United States
Idioma:eng
Resumen:Various modes of epigenetic regulation of breast cancer proliferation and metastasis have been investigated, but epigenetic mechanisms involved in breast cancer metastasis remain elusive. Thus, in this study, EHMT2 (a histone methyltransferase) was determined to be significantly overexpressed in breast cancer tissues and in Oncomine data. In addition, knockdown of EHMT2 reduced cell migration/invasion and regulated the expression of EMT-related markers (E-cadherin, Claudin 1, and Vimentin). Furthermore, treatment with BIX-01294, a specific inhibitor of EHMT2, affected migration/invasion in MDA-MB-231 cells. Therefore, our findings demonstrate functions of EHMT2 in breast cancer metastasis and suggest that targeting EHMT2 may be an effective therapeutic strategy for preventing breast cancer metastasis.
Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
Nombre de substancia:0 (Histocompatibility Antigens); EC 2.1.1.43 (EHMT2 protein, human); EC 2.1.1.43 (Histone-Lysine N-Methyltransferase)


  8 / 28840 MEDLINE  
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PMID:29293582
Autor:Spick C; Szolar DHM; Preidler KW; Reittner P; Rauch K; Brader P; Tillich M; Baltzer PA
Dirección:Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna (AKH), Vienna, Austria.
Título:3 Tesla breast MR imaging as a problem-solving tool: Diagnostic performance and incidental lesions.
Fuente:PLoS One; 13(1):e0190287, 2018.
ISSN:1932-6203
País de publicación:United States
Idioma:eng
Resumen:PURPOSE: To investigate the diagnostic performance and incidental lesion yield of 3T breast MRI if used as a problem-solving tool. METHODS: This retrospective, IRB-approved, cross-sectional, single-center study comprised 302 consecutive women (mean: 50±12 years; range: 20-79 years) who were undergoing 3T breast MRI between 03/2013-12/2014 for further workup of conventional and clinical breast findings. Images were read by experienced, board-certified radiologists. The reference standard was histopathology or follow-up ≥ two years. Sensitivity, specificity, PPV, and NPV were calculated. Results were stratified by conventional and clinical breast findings. RESULTS: The reference standard revealed 53 true-positive, 243 true-negative, 20 false-positive, and two false-negative breast MRI findings, resulting in a sensitivity, specificity, PPV, and NPV of 96.4% (53/55), 92.4% (243/263), 72.6% (53/73), and 99.2% (243/245), respectively. In 5.3% (16/302) of all patients, incidental MRI lesions classified BI-RADS 3-5 were detected, 37.5% (6/16) of which were malignant. Breast composition and the imaging findings that had led to referral had no significant influence on the diagnostic performance of breast MR imaging (p>0.05). CONCLUSION: 3T breast MRI yields excellent diagnostic results if used as a problem-solving tool independent of referral reasons. The number of suspicious incidental lesions detected by MRI is low, but is associated with a substantial malignancy rate.
Tipo de publicación:JOURNAL ARTICLE


  9 / 28840 MEDLINE  
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PMID:29419702
Autor:Baradwan S; Wadi KA
Título:Unilateral ectopic breast tissue on vulva in postpartum woman: A case report.
Fuente:Medicine (Baltimore); 97(6):e9887, 2018 Feb.
ISSN:1536-5964
País de publicación:United States
Idioma:eng
Resumen:RATIONALE: Ectopic mammary gland tissues occur in about 2% to 6% of women in general population. Vulva is considered a rare site for the ectopic breast tissue. PATIENT CONCERNS: We report a rare case of a 27 year-old woman, para 2 and presenting as a vulvar mass in the postpartum period. DIAGNOSES: Ectopic mammary tissue in vulva. INTERVENTIONS: The mass was removed by wide local excision. Histopathological assessment revealed features of ectopic mammary tissue CONCLUSION:: The vulvar region is one of the reported sites for ectopic breast tissue in the body. The presence of a rapidly enlarging, well-encapsulated mass in the vulvar region associated with recent delivery or lactation is suggestive of ectopic breast tissue. LESSONS: It is important for clinicians to get a good history and consider ectopic breast tissue on vulva in postpartum women and confirm diagnosis via biopsy with histopathological examination.
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE


  10 / 28840 MEDLINE  
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PMID:29391087
Autor:Abou-Zamzam A; Somers S; Cora C; Pairawan S; Lum S
Dirección:Department Surgery, Loma Linda University Medical Center, Loma Linda, California, USA.
Título:Percutaneous Needle Biopsies of the Breast in Women Younger than 35 Years: Minimally or Excessively Invasive?
Fuente:Am Surg; 83(10):1019-1023, 2017 Oct 01.
ISSN:1555-9823
País de publicación:United States
Idioma:eng
Resumen:Percutaneous needle biopsy (PNB) of the breast is commonly used for diagnosis of breast pathology, but has been less studied in young women. We sought to determine the effectiveness and necessity of PNB in patients younger than 35 years of age. The charts of sequential patients <35 years who underwent PNB between February 2013 and May 2016 were reviewed; 181 PNB were performed in 127 patients. Median age was 30 years (13-34). Indications for PNB were Breast Imaging Reporting and Data System (BIRADS) ≥4 in 137 (75.7%) cases, with mass on imaging in 139 (76.8%). Carcinoma was diagnosed in 12 (6.6%), PNB in eight unique patients (6.3%). Other PNB pathology included atypia in four (2.2%) patients; papillary lesion, five (2.8%); benign lymph node, 10 (5.5%); fibroepithelial lesion, 15 (8.3%); benign breast tissue, 63 (34.8%); and fibroadenoma, 72 (39.8%). Women with atypia or malignancy were older than those with benign findings (30.9 vs 28.0 years, P = 0.002). No other patient or imaging factors were significantly associated with pathologic diagnosis on PNB. Routine PNB for all BIRADS 4 findings may be over-used in young women as most results are benign and subsequent surgical findings are concordant. Improved diagnostic accuracy of breast imaging is warranted to reduce unnecessary procedures.
Tipo de publicación:JOURNAL ARTICLE



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