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Cancer Causes & Control : CCC Nov 2023It may be important for women to have mammograms at different points in time to track changes in breast density, as fluctuations in breast density can affect breast... (Review)
Review
PURPOSE
It may be important for women to have mammograms at different points in time to track changes in breast density, as fluctuations in breast density can affect breast cancer risk. This systematic review aimed to assess methods used to relate repeated mammographic images to breast cancer risk.
METHODS
The databases including Medline (Ovid) 1946-, Embase.com 1947-, CINAHL Plus 1937-, Scopus 1823-, Cochrane Library (including CENTRAL), and Clinicaltrials.gov were searched through October 2021. Eligibility criteria included published articles in English describing the relationship of change in mammographic features with risk of breast cancer. Risk of bias was assessed using the Quality in Prognostic Studies tool.
RESULTS
Twenty articles were included. The Breast Imaging Reporting and Data System and Cumulus were most commonly used for classifying mammographic density and automated assessment was used on more recent digital mammograms. Time between mammograms varied from 1 year to a median of 4.1, and only nine of the studies used more than two mammograms. Several studies showed that adding change of density or mammographic features improved model performance. Variation in risk of bias of studies was highest in prognostic factor measurement and study confounding.
CONCLUSION
This review provided an updated overview and revealed research gaps in assessment of the use of texture features, risk prediction, and AUC. We provide recommendations for future studies using repeated measure methods for mammogram images to improve risk classification and risk prediction for women to tailor screening and prevention strategies to level of risk.
Topics: Female; Humans; Breast Density; Breast Neoplasms; Mammography; Breast; Risk; Risk Factors
PubMed: 37340148
DOI: 10.1007/s10552-023-01739-2 -
Journal of Clinical Epidemiology Jun 2024Observational cohort studies are used to evaluate the effectiveness of screening mammography in women offered screening. Because screening mammography has no effect on...
OBJECTIVE
Observational cohort studies are used to evaluate the effectiveness of screening mammography in women offered screening. Because screening mammography has no effect on causes of death other than breast cancer, cohort studies should show reductions in the risk of breast cancer death substantially greater than possible reductions in the risk of all cause death. We assessed the risk of breast cancer death and of all-cause (or of non-breast cancer) death associated with screening mammography attendance reported in cohort studies.
STUDY DESIGN AND SETTING
Cohort studies published from 2002 to 2022 on women invited to screening mammography were searched in PubMed, Web of Sciences, Scopus and in review articles. Random effect meta-analyses were performed using relative risks of death between women who attended screening compared to women who did not attend screening.
RESULTS
Eighteen cohort studies were identified, nine that reported relative risks of breast cancer death only, five that reported relative risks of all cause death only, and four that reported relative risks for both breast cancer death and all cause death. The latter four cohort studies reported 12 to 76 times more all-cause deaths than breast cancer deaths. The random-effect summary relative risk for breast cancer mortality in screening attenders vs. nonattenders was 0.55 (95% CI: 0.50-0.60) in 13 cohort studies. The summary relative risk for all-cause mortality was 0.54 (0.50-0.58) in 10 cohort studies. In the four cohort studies that evaluated both outcomes, the summary relative risks were 0.63 (0.43-0.83) for breast cancer mortality and of 0.54 (0.44-0.64) for all-cause mortality.
CONCLUSION
The similar relative reductions in breast- and all-cause (or non-breast cancer) mortality indicates that screening mammography attendance is an indicator of characteristics associated with a lower risk of dying from any cause, including from breast cancer, which observational studies have falsely interpreted as a screening effect.
PubMed: 38878837
DOI: 10.1016/j.jclinepi.2024.111426 -
Journal of Clinical Epidemiology Apr 2024Film mammography has been replaced by digital mammography in breast screening programs globally. This led to a small increase in the rate of detection, but whether the...
Systematic review and meta-analysis of prognostic characteristics for breast cancers in populations with digital vs film mammography indicate the transition may have increased both early detection and overdiagnosis.
OBJECTIVES
Film mammography has been replaced by digital mammography in breast screening programs globally. This led to a small increase in the rate of detection, but whether the detection of clinically important cancers increased is uncertain. We aimed to assess the impact on tumor characteristics of screen-detected and interval breast cancers.
STUDY DESIGN AND SETTING
We searched seven databases from inception to October 08, 2023, for publications comparing film and digital mammography within the same population of asymptomatic women at population (average) risk of breast cancer. We recorded reported tumor characteristics and assessed risk of bias using the Risk Of Bias In Non-randomised Studies - of Interventions tool. We synthesized results using meta-analyses of random effects.
RESULTS
Eighteen studies were included in the analysis from 8 countries, including 11,592,225 screening examinations (8,117,781 film; 3,474,444 digital). There were no differences in tumor size, morphology, grade, node status, receptor status, or stage in the pooled differences for screen-detected and interval invasive cancer tumor characteristics. There were statistically significant increases in screen-detected ductal carcinoma in situ (DCIS) across all grades: 0.05 (0.00-0.11), 0.14 (0.05-0.22), and 0.19 (0.05-0.33) per 1000 screens for low, intermediate, and high-grade DCIS, respectively. There were similar (non-statistically significant) increases in screen-detected invasive cancer across all grades.
CONCLUSION
The increased detection of all grades of DCIS and invasive cancer may indicate both increased early detection of more aggressive disease and increased overdiagnosis.
PubMed: 38570078
DOI: 10.1016/j.jclinepi.2024.111339 -
In Vivo (Athens, Greece) 2023COVID-19 has dramatically impacted non-pandemic-related care, including preventive medicine. Our objective was to quantify the alterations in the volume of screening... (Review)
Review
BACKGROUND/AIM
COVID-19 has dramatically impacted non-pandemic-related care, including preventive medicine. Our objective was to quantify the alterations in the volume of screening tests for breast and cervical cancer during the COVID-19 era compared to pre-pandemic levels. Secondarily, we discussed the causes responsible for this change, presented suggestions for screening optimization and conducted a targeted search of the relevant literature for worsening of future mortality due to screening setback.
MATERIALS AND METHODS
We systematically searched Pubmed, Google Scholar and Epistemonikos for articles in English or Greek, published from March 11th, 2020, until September 14th, 2022, that illustrated quantitative variations of mammograms or Pap/HPV tests. Preprint articles, editorials and speeches were excluded. Quality of included studies was assessed via the JBI critical appraisal checklist for studies reporting prevalence data. The evidence was narratively synthesized.
RESULTS
A total of 56 articles were included, being either observational studies or reports from cancer registries. Large reductions were universally identified, peaked during the first wave but partially persisted after easing of the restrictions.
CONCLUSION
Our systematic review provides an updated record of the variations in screening volume and approaches screening neglect from a multidimensional perspective answering why it happened and how we could achieve recovery. A strong awareness campaign is proposed, in conjunction with triaging citizens more likely to benefit from screening. Cervical self-sampling is emphasized in the literature. Various studies displayed a potential increase in cancer mortality in the future based on predictive statistical models.
Topics: Female; Humans; Uterine Cervical Neoplasms; Early Detection of Cancer; Pandemics; COVID-19; Mammography
PubMed: 37369493
DOI: 10.21873/invivo.13230 -
Breast (Edinburgh, Scotland) Apr 2024High breast density is an independent risk factor for breast cancer and decreases the sensitivity of mammography. This systematic review synthesizes the evidence on the... (Review)
Review
BACKGROUND
High breast density is an independent risk factor for breast cancer and decreases the sensitivity of mammography. This systematic review synthesizes the evidence on the impact of breast density (BD) information and/or notification on women's psychosocial outcomes among women from racial and ethnic minority groups.
METHODS
A systematic search was performed in March 2023, and the articles were identified using CINHAL, Embase, Medline, and PsychInfo databases. The search strategy combined the terms "breast", "density", "notification" and synonyms. The authors specifically kept the search terms broad and did not include terms related to race and ethnicity. Full-text articles were reviewed for analysis by race, ethnicity and primary language of participants. Two authors evaluated the eligibility of studies with verification from the study team, extracted and crosschecked data, and assessed the risk of bias.
RESULTS
Of 1784 articles, 32 articles published from 2003 to 2023 were included. Thirty-one studies were conducted in the United States and one in Australia, with 28 quantitative and four qualitative methodologies. The overall results in terms of breast density awareness, knowledge, communication with healthcare professionals, screening intentions and supplemental screening practice were heterogenous across studies. Barriers to understanding BD notifications and intentions/access to supplemental screening among racial and ethnic minorities included socioeconomic factors, language, health literacy and medical mistrust.
CONCLUSIONS
A one-size approach to inform women about their BD may further disadvantage racial and ethnic minority women. BD notification and accompanying information should be tailored and translated to ensure readability and understandability by all women.
Topics: Female; Humans; United States; Breast Density; Breast Neoplasms; Ethnicity; Ethnic and Racial Minorities; Trust; Minority Groups
PubMed: 38430905
DOI: 10.1016/j.breast.2024.103693 -
PloS One 2024To evaluate the effect of olfactory and/or gustatory stimulation interventions on feeding outcomes in preterm infants. (Meta-Analysis)
Meta-Analysis
AIM
To evaluate the effect of olfactory and/or gustatory stimulation interventions on feeding outcomes in preterm infants.
METHODS
We conducted systematic searches across various academic databases, including PubMed, Embase, Web of Science, the Cochrane Library, the Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, the Wanfang Database, and the Wipu Database. These searches aimed to identify randomized controlled trials investigating the impact of olfactory and/or gustatory stimulation on preterm infants. The search period spanned from the inception of the databases until December 2022. Two independent evaluators autonomously reviewed the literature, extracted pertinent data, assessed the quality of the included studies, and conducted a meta-analysis using RevMan 5.3 software.
RESULTS
A total of 7 randomized controlled trials or quasi-experimental studies were included, with a total of 871 participants. Olfactory and gustatory stimulation demonstrated a reduction in the time to full enteral feeds in preterm infants when compared to usual care (MD = -1.60 days; 95% CI = -2.31, -0.89; p<0.0001). No substantial evidence was identified regarding the influence of olfactory and gustatory stimulation on the duration of gastric tube placement, length of hospitalization, incidence of necrotizing enterocolitis, or occurrence of spontaneous bowel perforation in preterm infants.
CONCLUSIONS
Olfactory and gustatory stimulation show potential benefits for preterm infants. However, due to the low to very low level of certainty associated with the available data, our ability to assess the effects is limited. Further trials and studies are essential to enhance our understanding of the mechanisms and effectiveness of olfactory and gustatory stimulation therapies.
Topics: Humans; Infant, Premature; Infant, Newborn; Enteral Nutrition; Smell; Taste; Randomized Controlled Trials as Topic
PubMed: 38713686
DOI: 10.1371/journal.pone.0301186 -
Cureus Apr 2024The number one cause of cancer in women worldwide is breast cancer. Over the last three decades, the use of traditional screen-film mammography has increased, but in... (Review)
Review
The number one cause of cancer in women worldwide is breast cancer. Over the last three decades, the use of traditional screen-film mammography has increased, but in recent years, digital mammography and 3D tomosynthesis have become standard procedures for breast cancer screening. With the advancement of technology, the interpretation of images using automated algorithms has become a subject of interest. Initially, computer-aided detection (CAD) was introduced; however, it did not show any long-term benefit in clinical practice. With recent advances in artificial intelligence (AI) methods, these technologies are showing promising potential for more accurate and efficient automated breast cancer detection and treatment. While AI promises widespread integration in breast cancer detection and treatment, challenges such as data quality, regulatory, ethical implications, and algorithm validation are crucial. Addressing these is essential for fully realizing AI's potential in enhancing early diagnosis and improving patient outcomes in breast cancer management. In this review article, we aim to provide an overview of the latest developments and applications of AI in breast cancer screening and treatment. While the existing literature primarily consists of retrospective studies, ongoing and future prospective research is poised to offer deeper insights. Artificial intelligence is on the verge of widespread integration into breast cancer detection and treatment, holding the potential to enhance early diagnosis and improve patient outcomes.
PubMed: 38711711
DOI: 10.7759/cureus.57619 -
BMC Women's Health Feb 2024Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in... (Meta-Analysis)
Meta-Analysis
PURPOSE
Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in Chinese women and there is not yet a unified view. This study investigated the association between mammographic density (MD) and breast cancer risk in Chinese women.
METHODS
The PubMed, Cochrane Library, Embase, and Wanfang databases were systematically searched in June 2023 to include all studies on the association between MD and breast cancer risk in Chinese women. A total of 13,977 breast cancer cases from 14 studies were chosen, including 10 case-control/cross-sectional studies, and 4 case-only studies. For case-control/cross-sectional studies, the odds ratios (ORs) of MD were combined using random effects models, and for case-only studies, relative odds ratios (RORs) were combinations of premenopausal versus postmenopausal breast cancer cases.
RESULTS
Women with BI-RADS density category II-IV in case-control/cross-sectional studies had a 0.93-fold (95% confidence interval [CI] 0.55, 1.57), 1.08-fold (95% CI 0.40, 2.94), and 1.24-fold (95% CI 0.42, 3.69) higher risk compared to women with the lowest density category. Combined RORs for premenopausal versus postmenopausal women in case-only studies were 3.84 (95% CI 2.92, 5.05), 22.65 (95% CI 7.21, 71.13), and 42.06 (95% CI 4.22, 419.52), respectively, for BI-RADS density category II-IV versus I.
CONCLUSIONS
For Chinese women, breast cancer risk is weakly associated with MD; however, breast cancer risk is more strongly correlated with mammographic density in premenopausal women than postmenopausal women. Further research on the factors influencing MD in premenopausal women may provide meaningful insights into breast cancer prevention in China.
Topics: Female; Humans; Breast Neoplasms; Breast Density; Mammography; Cross-Sectional Studies; Breast; Risk Factors
PubMed: 38378562
DOI: 10.1186/s12905-024-02960-0 -
Frontiers in Public Health 2024This scoping review aims to highlight key social determinants of health associated with breast cancer screening behavior in United States women aged ≥40 years old,...
INTRODUCTION
This scoping review aims to highlight key social determinants of health associated with breast cancer screening behavior in United States women aged ≥40 years old, identify public and private databases with SDOH data at city, state, and national levels, and share lessons learned from United States based observational studies in addressing SDOH in underserved women influencing breast cancer screening behaviors.
METHODS
The Arksey and O'Malley York methodology was used as guidance for this review: (1) identifying research questions; (2) searching for relevant studies; (3) selecting studies relevant to the research questions; (4) charting the data; and (5) collating, summarizing, and reporting results.
RESULTS
The 72 included studies were published between 2013 and 2023. Among the various SDOH identified, those related to socioeconomic status ( = 96) exhibited the highest frequency. The Health Care Access and Quality category was reported in the highest number of studies ( = 44; 61%), showing its statistical significance in relation to access to mammography. Insurance status was the most reported sub-categorical factor of Health Care Access and Quality.
DISCUSSION
Results may inform future evidence-based interventions aiming to address the underlying factors contributing to low screening rates for breast cancer in the United States.
Topics: Humans; Female; United States; Adult; Breast Neoplasms; Social Determinants of Health; Early Detection of Cancer; Mammography; Health Inequities
PubMed: 38375339
DOI: 10.3389/fpubh.2024.1354717 -
Cureus Sep 2023Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are...
Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are treated by surgical excision. The diagnosis of MFB is made through immunohistochemical (IHC) analysis, with the most common biomarkers being CD34+, desmin+, smooth muscle actin+, and vimentin+. In this article, we describe a case of an MFB in a premenopausal female with variance from classic IHC findings. We also performed a systemic review of the MFB of the breast. The systemic review compiles the most common IHC findings of MFB, patient demographics, treatment methods, lesion size, and the presence or absence of pain associated with the lesion. As MFB can share many features with other breast lesions, including potentially malignant ones, this article sought to underline the most common IHC findings and characteristics of MFB to aid in the proper diagnosis of MFB.
PubMed: 37900540
DOI: 10.7759/cureus.46125