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Physics in Medicine and Biology Aug 2017To characterize and develop a patient-based 3D model of the compressed breast undergoing mammography and breast tomosynthesis. During this IRB-approved, HIPAA-compliant...
To characterize and develop a patient-based 3D model of the compressed breast undergoing mammography and breast tomosynthesis. During this IRB-approved, HIPAA-compliant study, 50 women were recruited to undergo 3D breast surface imaging with structured light (SL) during breast compression, along with simultaneous acquisition of a tomosynthesis image. A pair of SL systems were used to acquire 3D surface images by projecting 24 different patterns onto the compressed breast and capturing their reflection off the breast surface in approximately 12-16 s. The 3D surface was characterized and modeled via principal component analysis. The resulting surface model was combined with a previously developed 2D model of projected compressed breast shapes to generate a full 3D model. Data from ten patients were discarded due to technical problems during image acquisition. The maximum breast thickness (found at the chest-wall) had an average value of 56 mm, and decreased 13% towards the nipple (breast tilt angle of 5.2°). The portion of the breast not in contact with the compression paddle or the support table extended on average 17 mm, 18% of the chest-wall to nipple distance. The outermost point along the breast surface lies below the midline of the total thickness. A complete 3D model of compressed breast shapes was created and implemented as a software application available for download, capable of generating new random realistic 3D shapes of breasts undergoing compression. Accurate characterization and modeling of the breast curvature and shape was achieved and will be used for various image processing and clinical tasks.
Topics: Adult; Aged; Breast; Breast Neoplasms; Female; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Mammography; Middle Aged; Models, Biological; Principal Component Analysis
PubMed: 28665291
DOI: 10.1088/1361-6560/aa7cd0 -
Plastic and Reconstructive Surgery Dec 2021This study aims to present normative values for satisfaction with breasts among preoperative breast reconstruction patients as assessed using the BREAST-Q instrument and...
BACKGROUND
This study aims to present normative values for satisfaction with breasts among preoperative breast reconstruction patients as assessed using the BREAST-Q instrument and to delineate factors associated with preoperative breast satisfaction.
METHODS
A retrospective analysis of prospectively collected data was performed examining women undergoing postmastectomy breast reconstruction at a tertiary care center who preoperatively completed the BREAST-Q from 2010 to 2017. Because breast satisfaction scores were nonnormally distributed, scores were categorized into quartiles for analysis. Patient- and treatment-level variables were tested in a multivariable ordinal logistic regression model as predictors of breast satisfaction. Preoperative satisfaction was also tested for association with choice of reconstructive modality.
RESULTS
Among 1306 postmastectomy reconstruction patients included in the study, mean preoperative Satisfaction with Breasts score was 61.8 ± 21.5 and the median score was 58.0 (interquartile range, 48 to 70). Factors associated with significantly lower preoperative satisfaction included history of psychiatric diagnosis, preoperative radiotherapy, marital status (married), and higher body mass index. Factors associated with significantly higher scores were malignancy (localized tumor), medium bra size (B to C cup), and self-identification as black. Preoperative breast satisfaction was lower among patients who elected autologous reconstruction than among those with implant reconstruction (p < 0.001).
CONCLUSIONS
Preoperative breast satisfaction is influenced by multiple factors. Understanding these factors may improve preoperative counseling and expectation management for patients who undergo postmastectomy breast reconstruction.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Risk, III.
Topics: Adult; Aged; Breast; Breast Neoplasms; Counseling; Family Characteristics; Female; Humans; Mammaplasty; Mastectomy; Middle Aged; Motivation; Neoadjuvant Therapy; Patient Reported Outcome Measures; Patient Satisfaction; Personal Satisfaction; Preoperative Period; Prospective Studies; Psychometrics; Radiotherapy, Adjuvant; Retrospective Studies; Surveys and Questionnaires; Treatment Outcome; Young Adult
PubMed: 34847108
DOI: 10.1097/PRS.0000000000008521 -
Journal of Nurse-midwifery 1998Breast health care was rarely acknowledged in the health and science fields prior to this century and has only begun, in recent years, to receive attention outside of... (Review)
Review
Breast health care was rarely acknowledged in the health and science fields prior to this century and has only begun, in recent years, to receive attention outside of pregnancy/lactation or cancer screening and treatment. Yet much health care is involved with regard to this reproductive and sexual organ. With any group of clients, practitioners of women's health care must address an assortment of breast health matters. This article offers an overview of the history of breast health care, the epidemiology of benign breast conditions and cancer, the anatomy and physiology of the breast, and breast development over the lifespan. Also presented are a review of breast assessment and examination, suggestions for routine care of the breast, and an overview of major health issues related to this reproductive organ. Health issues addressed include, among others, nodular and cystic changes, nipple discharge, breast/nipple pain, mastitis, elective alterations, and cancer. Discussion is focused on the latest approaches to optimal breast health care.
Topics: Breast; Breast Diseases; Female; Humans; Nursing Assessment; Physical Examination
PubMed: 9871376
DOI: 10.1016/s0091-2182(98)00065-2 -
Breast Cancer Research : BCR Aug 2017Accurately identifying women with dense breasts (Breast Imaging Reporting and Data System [BI-RADS] heterogeneously or extremely dense) who are at high breast cancer...
BACKGROUND
Accurately identifying women with dense breasts (Breast Imaging Reporting and Data System [BI-RADS] heterogeneously or extremely dense) who are at high breast cancer risk will facilitate discussions of supplemental imaging and primary prevention. We examined the independent contribution of dense breast volume and BI-RADS breast density to predict invasive breast cancer and whether dense breast volume combined with Breast Cancer Surveillance Consortium (BCSC) risk model factors (age, race/ethnicity, family history of breast cancer, history of breast biopsy, and BI-RADS breast density) improves identifying women with dense breasts at high breast cancer risk.
METHODS
We conducted a case-control study of 1720 women with invasive cancer and 3686 control subjects. We calculated ORs and 95% CIs for the effect of BI-RADS breast density and Volpara™ automated dense breast volume on invasive cancer risk, adjusting for other BCSC risk model factors plus body mass index (BMI), and we compared C-statistics between models. We calculated BCSC 5-year breast cancer risk, incorporating the adjusted ORs associated with dense breast volume.
RESULTS
Compared with women with BI-RADS scattered fibroglandular densities and second-quartile dense breast volume, women with BI-RADS extremely dense breasts and third- or fourth-quartile dense breast volume (75% of women with extremely dense breasts) had high breast cancer risk (OR 2.87, 95% CI 1.84-4.47, and OR 2.56, 95% CI 1.87-3.52, respectively), whereas women with extremely dense breasts and first- or second-quartile dense breast volume were not at significantly increased breast cancer risk (OR 1.53, 95% CI 0.75-3.09, and OR 1.50, 95% CI 0.82-2.73, respectively). Adding continuous dense breast volume to a model with BCSC risk model factors and BMI increased discriminatory accuracy compared with a model with only BCSC risk model factors (C-statistic 0.639, 95% CI 0.623-0.654, vs. C-statistic 0.614, 95% CI 0.598-0.630, respectively; P < 0.001). Women with dense breasts and fourth-quartile dense breast volume had a BCSC 5-year risk of 2.5%, whereas women with dense breasts and first-quartile dense breast volume had a 5-year risk ≤ 1.8%.
CONCLUSIONS
Risk models with automated dense breast volume combined with BI-RADS breast density may better identify women with dense breasts at high breast cancer risk than risk models with either measure alone.
Topics: Aged; Breast; Breast Density; Breast Neoplasms; Case-Control Studies; Early Detection of Cancer; Female; Humans; Middle Aged; Neoplasm Staging; Odds Ratio; Public Health Surveillance; Risk Assessment; Risk Factors
PubMed: 28830497
DOI: 10.1186/s13058-017-0887-5 -
Nigerian Journal of Clinical Practice Oct 2023Different imaging techniques are used in the diagnosis of breast cancer. The low sensitivity of mammography to detect cancer in the dense breast parenchyma and the lack...
BACKGROUND
Different imaging techniques are used in the diagnosis of breast cancer. The low sensitivity of mammography to detect cancer in the dense breast parenchyma and the lack of standard application of digital breast tomosynthesis (DBT) are some of the problems. Therefore, breast cancer imaging techniques should be compared in terms of conspicuity and characterization of lesions.
AIM
Full-field digital mammography (DM) and synthetic mammography (SM) which are obtained from the slices of digital breast tomosynthesis (DBT) give similar results in terms of conspicuity and characterization of the lesions in detecting breast cancer.
PATIENTS AND METHODS
In this retrospective study, 47 women diagnosed with breast cancer were included in the study. DM, SM, and DBT images were evaluated by scoring the conspicuity of the index lesion in the parenchyma and its characterization in terms of contour and shape with a 4-point scale. In addition, the conspicuity of the lesions in relation to lesion size and breast density was examined with these three techniques.
RESULTS
There is no significant difference between DM and SM techniques for index lesion conspicuity and characterization; however, the imaging score of DBT is significantly higher than other techniques for the conspicuity and characterization of the lesions. In terms of the conspicuity of the lesions in relation to lesion size, DM and SM techniques show significant difference according to the size of the lesion, whereas the DBT technique did not show significant difference. While mammography type is a determinant of lesion conspicuity in only DM and SM techniques, conspicuity findings do not differ significantly in the DBT technique.
CONCLUSION
In conclusion, it was shown that standard images and SM images obtained from DBT did not differ significantly in terms of conspicuity and characterization of lesions. Thus, DBT is significantly superior to the DM and SM images. While the DM and SM images are more successful in showing large lesions and lesion detection in nondense breasts, DBT images were not affected by lesion size and breast density.
Topics: Humans; Female; Breast Neoplasms; Mammography; Breast Density; Retrospective Studies; Breast
PubMed: 37929519
DOI: 10.4103/njcp.njcp_532_22 -
Frontiers in Public Health 2020Many females experience breast-related issues that are considered to negatively impact health and well-being. These include breast cancer, issues related to incorrect...
Many females experience breast-related issues that are considered to negatively impact health and well-being. These include breast cancer, issues related to incorrect bra fit, and issues related to breast movement including an increased incidence of breast pain, breast sag, and embarrassment, which can be a barrier to physical activity participation. Knowledge and awareness of these breast issues among females is low. Furthermore, these breast concerns are more prevalent in adolescent girls compared to adult females, with 87% of girls reporting ≥ one breast concern. This study evaluated the short- and longer-term impact of a 50 min breast education intervention on adolescent girls' (11 to 14 years) breast knowledge, attitudes to breasts and engagement with positive breast habits. A mixed methods, controlled, longitudinal, cohort design was employed, using two control schools (: 412; receiving no intervention) and two intervention schools (: 375; receiving the intervention) from privileged and less privileged areas. Adolescent girls in four schools completed a validated breast survey pre- and immediately post-intervention as well as 3 and 6 months post-intervention. Additionally, in one intervention school, six focus groups were conducted immediately and 4 months after the intervention. The intervention was equally effective in the two intervention schools. Following the intervention, participants in the intervention schools significantly improved their breast knowledge, their attitudes to breasts and their engagement with positive breast habits, compared to participants in the control schools, < 0.01 (with large effect sizes). These improvements were sustained 6 months post-intervention. Participants described the session as "informative," it made them "feel less embarrassed" about their breasts; they also reported wanting to do more exercise and to change their bra purchasing and bra wearing habits. These novel, positive findings provide insight into the benefits of teaching adolescent girls about breasts from a young age and can be used to inform effective breast education in schools. It is recommended that education on multiple breast topics should be introduced in schools, preferably being first introduced in primary schools, with a modular structure and progressive information.
Topics: Adolescent; Adult; Breast; Exercise; Female; Habits; Health Knowledge, Attitudes, Practice; Humans; Schools
PubMed: 33194996
DOI: 10.3389/fpubh.2020.591927 -
Tomography (Ann Arbor, Mich.) Jan 2023Mammography is the gold standard technology for breast screening, which has been demonstrated through different randomized controlled trials to reduce breast cancer...
Mammography is the gold standard technology for breast screening, which has been demonstrated through different randomized controlled trials to reduce breast cancer mortality. However, mammography has limitations and potential harms, such as the use of ionizing radiation. To overcome the ionizing radiation exposure issues, a novel device (i.e. MammoWave) based on low-power radio-frequency signals has been developed for breast lesion detection. The MammoWave is a microwave device and is under clinical validation phase in several hospitals across Europe. The device transmits non-invasive microwave signals through the breast and accumulates the backscattered (returned) signatures, commonly denoted as the S21 signals in engineering terminology. Backscattered (complex) S21 signals exploit the contrast in dielectric properties of breasts with and without lesions. The proposed research is aimed to automatically segregate these two types of signal responses by applying appropriate supervised machine learning (ML) algorithm for the data emerging from this research. The support vector machine with radial basis function has been employed here. The proposed algorithm has been trained and tested using microwave breast response data collected at one of the clinical validation centres. Statistical evaluation indicates that the proposed ML model can recognise the MammoWave breasts signal with no radiological finding (NF) and with radiological findings (WF), i.e., may be the presence of benign or malignant lesions. A sensitivity of 84.40% and a specificity of 95.50% have been achieved in NF/WF recognition using the proposed ML model.
Topics: Humans; Female; Microwaves; Breast; Breast Neoplasms; Supervised Machine Learning; Technology
PubMed: 36648997
DOI: 10.3390/tomography9010010 -
Breast Cancer Research and Treatment Jun 2024Age and body mass index (BMI) are critical considerations when assessing individual breast cancer risk, particularly for women with dense breasts. However, age- and...
PURPOSE
Age and body mass index (BMI) are critical considerations when assessing individual breast cancer risk, particularly for women with dense breasts. However, age- and BMI-standardized estimates of breast density are not available for screen-aged women, and little is known about the distribution of breast density in women aged < 40. This cross-sectional study uses three different modalities: optical breast spectroscopy (OBS), dual-energy X-ray absorptiometry (DXA), and mammography, to describe the distributions of breast density across categories of age and BMI.
METHODS
Breast density measures were estimated for 1,961 Australian women aged 18-97 years using OBS (%water and %water + %collagen). Of these, 935 women had DXA measures (percent and absolute fibroglandular dense volume, %FGV and FGV, respectively) and 354 had conventional mammographic measures (percent and absolute dense area). The distributions for each breast density measure were described across categories of age and BMI.
RESULTS
The mean age was 38 years (standard deviation = 15). Median breast density measures decreased with age and BMI for all three modalities, except for DXA-FGV, which increased with BMI and decreased after age 30. The variation in breast density measures was largest for younger women and decreased with increasing age and BMI.
CONCLUSION
This unique study describes the distribution of breast density measures for women aged 18-97 using alternative and conventional modalities of measurement. While this study is the largest of its kind, larger sample sizes are needed to provide clinically useful age-standardized measures to identify women with high breast density for their age or BMI.
Topics: Humans; Female; Adult; Middle Aged; Breast Density; Aged; Absorptiometry, Photon; Adolescent; Body Mass Index; Young Adult; Mammography; Aged, 80 and over; Cross-Sectional Studies; Breast Neoplasms; Australia; Age Factors; Breast
PubMed: 38498102
DOI: 10.1007/s10549-024-07269-y -
Breast Cancer (Tokyo, Japan) Jan 2024Breast cancer mortality has not been reduced in Japan despite more than 20 years of population-based screening mammography. Screening mammography might not be suitable... (Review)
Review
Breast cancer mortality has not been reduced in Japan despite more than 20 years of population-based screening mammography. Screening mammography might not be suitable for Japanese women who often have dense breasts, thus decreasing mammography sensitivity because of masking. The J-START study showed that breast ultrasonography increases the sensitivity and the detection rate for early invasive cancers and lowers the rate of interval cancers for Japanese women in their 40 s. Breast awareness and breast cancer survival are directly correlated; however, breast awareness is not widely known in Japan. Next-generation breast cancer screening in Japan should consist of breast awareness campaigns for improving breast cancer literacy and supplemental breast ultrasonography to address the problem of false-negative mammograms attributable to dense breasts.
Topics: Female; Humans; Breast Neoplasms; Mammography; Japan; Early Detection of Cancer; Breast; Ultrasonography; Ultrasonography, Mammary; Mass Screening
PubMed: 37823977
DOI: 10.1007/s12282-023-01506-w -
Breast Cancer Research and Treatment Feb 2020Tumor microenvironment, including inflammatory cells, adipocytes and extracellular matrix constituents such as hyaluronan (HA), impacts on cancer progression. Systemic...
PURPOSE
Tumor microenvironment, including inflammatory cells, adipocytes and extracellular matrix constituents such as hyaluronan (HA), impacts on cancer progression. Systemic metabolism also influences tumor growth e.g. obesity and type 2 diabetes (T2D) are risk factors for breast cancer. Here, in 262 breast cancer cases, we explored the combined impacts on survival of M2-like tumor associated macrophages (TAMs), the abundance of breast fat visualized as low density in mammograms, and tumor HA, and their associations with T2D.
METHODS
Mammographic densities were assessed visually from the diagnostic images and dichotomized into very low density (VLD, density ≤ 10%, "fatty breast") and mixed density (MID, density > 10%). The amounts of TAMs (CD163+ and CD68+) and tumor HA were determined by immunohistochemistry. The data of T2D was collected from the patient records. Statistical differences between the parameters were calculated with Chi square or Mann-Whitney test and survival analyses with Cox's model.
RESULTS
A combination of fatty breasts (VLD), abundance of M2-like TAMs (CD163+) and tumor HA associated with poor survival, as survival was 88-89% in the absence of these factors but only 40-47% when all three factors were present (p < 0.001). Also, an association between T2D and fatty breasts was found (p < 0.01). Furthermore, tumors in fatty breasts contained more frequently high levels of M2-like TAMs than tumors in MID breasts (p = 0.01).
CONCLUSIONS
Our results demonstrate a dramatic effect of the tumor microenvironment on breast cancer progression. We hypothesize that T2D as well as obesity increase the fat content of the breasts, subsequently enhancing local pro-tumoral inflammation.
Topics: Adipocytes; Adipose Tissue; Adult; Aged; Aged, 80 and over; Breast; Breast Density; Breast Neoplasms; Diabetes Mellitus, Type 2; Disease-Free Survival; Female; Humans; Hyaluronic Acid; Macrophages; Middle Aged; Obesity; Retrospective Studies; Survival Analysis; Tumor Microenvironment
PubMed: 31720917
DOI: 10.1007/s10549-019-05491-7