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Archives of Sexual Behavior Apr 2020Breast size varies substantially among women and influences perception of the woman by other people with regard to her attractiveness and other characteristics that are...
Breast size varies substantially among women and influences perception of the woman by other people with regard to her attractiveness and other characteristics that are important in social contexts, including mating. The theory of sexual selection predicts that physical criteria of partner selection should be markers of the candidate's desirable properties, mainly biological quality. Few studies, however, have examined whether breast size really signals biological quality or its components and whether observers accurately interpret these signals. Our first study encompassed 163 young women and aimed to establish actual correlates of breast size. The aim of the second study was to determine preferences and stereotypes related to breast size: 252-265 women and men evaluated female digital figures varying in, among other characteristics, breast size. Breast size (breast circumference minus chest circumference) was negatively associated with body asymmetry and positively associated with infections of the respiratory system, but did not correlate with infections of the digestive system, openness to casual sex, and testosterone and estradiol level. Women and men perceived breasts in a similar way to each other: the bigger the breasts the higher the reproductive efficiency, lactational efficiency, sexual desire, and promiscuity attributed to the woman. Nevertheless, large breasts were not regarded more attractive than average ones, though small breasts were the least attractive. In addition, big-breasted women were perceived as less faithful and less intelligent than women with average or small breasts. We discuss our results from the perspectives of evolutionary psychology, perceptual biases, and social stereotypes.
Topics: Adolescent; Adult; Breast; Female; Humans; Male; Middle Aged; Stereotyped Behavior; Young Adult
PubMed: 31562583
DOI: 10.1007/s10508-019-1464-z -
Human Reproduction (Oxford, England) Dec 2019What are the levels of breast development and satisfaction in women with a Disorder/Difference of Sex Development (DSD)? (Comparative Study)
Comparative Study
STUDY QUESTION
What are the levels of breast development and satisfaction in women with a Disorder/Difference of Sex Development (DSD)?
SUMMARY ANSWER
Compared with normative data, women with DSD reached lower Tanner stages and reported less breast satisfaction.
WHAT IS KNOWN ALREADY
Women with DSD may have chromosomal and hormonal variations that can impact typical breast development. While much emphasis is placed on genital development in this group, little is known about breast development, satisfaction and their association.
STUDY DESIGN, SIZE, DURATION
Data collection was part of the cross-sectional European multicenter dsd-LIFE study. Fourteen recruiting sites included 1040 participants between February 2014 and September 2015.
PARTICIPANTS/MATERIALS, SETTING, METHODS
A total of 695 female-identifying participants were included (Turner n = 332, 46,XY DSD n = 141 and congenital adrenal hyperplasia n = 222), with a median age of 28 years. Clinical (i.e. history of hormone and surgical treatments, Tanner breast examination) and patient-reported (i.e. breast satisfaction, relationship status, sexual satisfaction and experienced femininity) data was collected by independent trained research staff. The relationship between breast development, satisfaction and femininity was assessed. Control data on breast development and satisfaction in women without DSD was retrieved from the literature.
MAIN RESULTS AND THE ROLE OF CHANCE
Of the 695 participants, 61% had received estrogen replacement and 51% puberty induction therapy, whereas 2% had received breast augmentation surgery. Approximately 65% of participants had reached Tanner breast stage 5, which is substantially less than the general population (90%). Breast satisfaction was lower than normative data as well (P < 0.001, Cohen's d = 0.45). Breast size and breast satisfaction were associated with feelings of femininity.
LIMITATIONS, REASONS FOR CAUTION
Limitations include the sample representativeness (e.g. regarding the clinical heterogeneity) and the limited in-depth knowledge on (prior) hormonal regimens. Furthermore, no (matched) control data was collected as part of this study.
WIDER IMPLICATIONS OF THE FINDINGS
In order to support the psychosexual well-being of women with DSD, enhancing breast development by sufficient hormone replacement and possible augmentation surgery is advocated. The scope of DSD management should be beyond genital development only and consider breasts as well.
STUDY FUNDING/COMPETING INTEREST(S)
The study was funded by the European Union Seventh Framework Program (FP7/2007-2013) under grant agreement no. 305 373. There are no competing interests.
TRIAL REGISTRATION NUMBER
German Clinical Trials Register: Registration identification number: DRKS00006072.
Topics: Adult; Breast; Cross-Sectional Studies; Disorders of Sex Development; Female; Humans; Mammaplasty; Young Adult
PubMed: 31774116
DOI: 10.1093/humrep/dez230 -
World Journal of Surgical Oncology Feb 2017Relative to Western women, Korean women show several differences in breast-related characteristics, including higher rates of dense breasts and small breasts. We...
Radiation dose affected by mammographic composition and breast size: first application of a radiation dose management system for full-field digital mammography in Korean women.
BACKGROUND
Relative to Western women, Korean women show several differences in breast-related characteristics, including higher rates of dense breasts and small breasts. We investigated how mammographic composition and breast size affect the glandular dose during full-field digital mammography (FFDM) in Korean women using a radiation dose management system.
METHODS
From June 1 to June 30, 2015, 2120 FFDM images from 560 patients were acquired and mammographic breast composition and breast size were assessed. We analyzed the correlations of patient age, peak kilovoltage (kVp), current (mAs), compressed breast thickness, compression force, mammographic breast composition, and mammographic breast size with the mean glandular dose (MGD) of the breast using a radiation dose management system. The causes of increased radiation were investigated, among patients with radiation doses above the diagnostic reference level (4th quartile, ≥75%).
RESULTS
The MGD per view of 2120 images was 1.81 ± 0.70 mGy. In multivariate linear regression analysis, age was negatively associated with MGD (p < 0.05). The mAs, kVp, compressed breast thickness, and mammographic breast size were positively associated with MGD (p < 0.05). The "dense" group had a significantly higher MGD than the "non-dense" group (p < 0.05). Patients with radiation dose values above the diagnostic reference value had large breasts of dense composition.
CONCLUSIONS
Among Korean women, patients with large and dense breasts should be more carefully managed to ensure that a constant radiation dose is maintained.
Topics: Adult; Breast; Breast Neoplasms; Female; Follow-Up Studies; Humans; Hypertrophy; Mammography; Middle Aged; Neoplasm Staging; Prognosis; Prospective Studies; Radiation Dosage; Radiographic Image Enhancement; Republic of Korea; Tomography, X-Ray Computed
PubMed: 28153022
DOI: 10.1186/s12957-017-1107-6 -
BioMed Research International 2017One-stage direct-to-implant immediate breast reconstruction (IBR) is performed simultaneously with breast cancer resection. We explored indications, techniques, and... (Review)
Review
BACKGROUND
One-stage direct-to-implant immediate breast reconstruction (IBR) is performed simultaneously with breast cancer resection. We explored indications, techniques, and outcomes of IBR to determine its feasibility, safety, and effectiveness.
MATERIAL AND METHODS
We reviewed the available literature on one-stage direct-to-implant IBR, with or without acellular dermal matrix (ADM), synthetic mesh, or autologous fat grafting. We analyzed the indications, preoperative work-up, surgical technique, postoperative care, outcomes, and complications.
RESULTS
IBR is indicated for small-to-medium nonptotic breasts and contraindicated in patients who require or have undergone radiotherapy, due to unacceptably high complications rates. Only patients with thick, well-vascularized mastectomy flaps are IBR candidates. Expandable implants should be used for ptotic breasts, while anatomical shaped implants should be used to reconstruct small-to-medium nonptotic breasts. ADMs can be used to cover the implant during IBR and avoid muscle elevation, thereby minimizing postoperative pain. Flap necrosis, reoperation, and implant loss are more common with IBR than conventional two-staged reconstruction, but IBR has advantages such as lack of secondary surgery, faster recovery, and better quality of life.
CONCLUSIONS
IBR has good outcomes and patient-satisfaction rates. With ADM use, a shift from conventional reconstruction to IBR has occurred. Drawbacks of IBR can be overcome by careful patient selection.
Topics: Breast; Breast Implants; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Quality of Life; Surgical Flaps
PubMed: 29098159
DOI: 10.1155/2017/6486859 -
European Radiology Nov 2023To assess whether mammographic breast density in women diagnosed with breast cancer correlates with the total number of incidental magnetic resonance imaging...
OBJECTIVES
To assess whether mammographic breast density in women diagnosed with breast cancer correlates with the total number of incidental magnetic resonance imaging (MRI)-detected lesions and the likelihood of the lesions being malignant.
METHODS
Patients diagnosed with breast cancer meeting the EUSOBI and EUSOMA criteria for preoperative breast MRI routinely undergo mammography and ultrasound before MRI at our institution. Incidental suspicious breast lesions detected in MRI are biopsied. We included patients diagnosed with invasive breast cancers between 2014 and 2019 who underwent preoperative breast MRI. One reader retrospectively determined breast density categories according to the 5 edition of the BI-RADS lexicon.
RESULTS
Of 946 patients with 973 malignant primary breast tumors, 166 (17.5%) had a total of 175 (18.0%) incidental MRI-detected lesions (82 (46.9%) malignant and 93 (53.1%) benign). High breast density according to BI-RADS was associated with higher incidence of all incidental enhancing lesions in preoperative breast MRIs: 2.66 (95% confidence interval: 1.03-6.86) higher for BI-RADS density category B, 2.68 (1.04-6.92) for category C, and 3.67 (1.36-9.93) for category D compared to category A (p < 0.05). However, high breast density did not predict higher incidence of malignant incidental lesions (p = 0.741). Incidental MRI-detected lesions in the contralateral breast were more likely benign (p < 0.001): 18 (27.3%)/48 (72.7%) vs. 64 (58.7%)/45 (41.3%) malignant/benign incidental lesions in contralateral vs. ipsilateral breasts.
CONCLUSION
Women diagnosed with breast cancer who have dense breasts have more incidental MRI-detected lesions, but higher breast density does not translate to increased likelihood of malignant incidental lesions.
CLINICAL RELEVANCE STATEMENT
Dense breasts should not be considered as an indication for preoperative breast MRI in women diagnosed with breast cancer.
KEY POINTS
• The role of preoperative MRI of patients with dense breasts diagnosed with breast cancer is under debate. • Women with denser breasts have a higher incidence of all MRI-detected incidental breast lesions, but the incidence of malignant MRI-detected incidental lesions is not higher than in women with fatty breasts. • High breast density alone should not indicate preoperative breast MRI.
Topics: Female; Humans; Breast Neoplasms; Breast Density; Retrospective Studies; Breast; Mammography; Magnetic Resonance Imaging
PubMed: 37646814
DOI: 10.1007/s00330-023-10072-w -
Academic Radiology Nov 2019Breast segmentation using the U-net architecture was implemented and tested in independent validation datasets to quantify fibroglandular tissue volume in breast MRI.
RATIONALE AND OBJECTIVES
Breast segmentation using the U-net architecture was implemented and tested in independent validation datasets to quantify fibroglandular tissue volume in breast MRI.
MATERIALS AND METHODS
Two datasets were used. The training set was MRI of 286 patients with unilateral breast cancer. The segmentation was done on the contralateral normal breasts. The ground truth for the breast and fibroglandular tissue (FGT) was obtained by using a template-based segmentation method. The U-net deep learning algorithm was implemented to analyze the training set, and the final model was obtained using 10-fold cross-validation. The independent validation set was MRI of 28 normal volunteers acquired using four different MR scanners. Dice Similarity Coefficient (DSC), voxel-based accuracy, and Pearson's correlation were used to evaluate the performance.
RESULTS
For the 10-fold cross-validation in the initial training set of 286 patients, the DSC range was 0.83-0.98 (mean 0.95 ± 0.02) for breast and 0.73-0.97 (mean 0.91 ± 0.03) for FGT; and the accuracy range was 0.92-0.99 (mean 0.98 ± 0.01) for breast and 0.87-0.99 (mean 0.97 ± 0.01) for FGT. For the entire 224 testing breasts of the 28 normal volunteers in the validation datasets, the mean DSC was 0.86 ± 0.05 for breast, 0.83 ± 0.06 for FGT; and the mean accuracy was 0.94 ± 0.03 for breast and 0.93 ± 0.04 for FGT. The testing results for MRI acquired using four different scanners were comparable.
CONCLUSION
Deep learning based on the U-net algorithm can achieve accurate segmentation results for the breast and FGT on MRI. It may provide a reliable and efficient method to process large number of MR images for quantitative analysis of breast density.
Topics: Adult; Algorithms; Breast; Breast Density; Breast Neoplasms; Deep Learning; Disease Progression; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Neural Networks, Computer; Young Adult
PubMed: 30713130
DOI: 10.1016/j.acra.2019.01.012 -
Journal of the American College of... May 2022Women are increasingly informed about their breast density due to state density reporting laws. However, accuracy of personal breast density knowledge remains unclear....
OBJECTIVE
Women are increasingly informed about their breast density due to state density reporting laws. However, accuracy of personal breast density knowledge remains unclear. We compared self-reported with clinically assessed breast density and assessed knowledge of density implications and feelings about future screening.
METHODS
From December 2017 to January 2020, we surveyed women aged 40 to 74 years without prior breast cancer, with a normal screening mammogram in the prior year, and ≥1 recorded breast density measures in four Breast Cancer Surveillance Consortium registries with density reporting laws. We measured agreement between self-reported and BI-RADS breast density categorized as "ever-dense" if heterogeneously or extremely dense within the past 5 years or "never-dense" otherwise, knowledge of dense breast implications, and feelings about future screening.
RESULTS
Survey participation was 28% (1,528 of 5,408), and 59% (896 of 1,528) of participants had ever-dense breasts. Concordance between self-report versus clinical density was 76% (677 of 896) among women with ever-dense breasts and 14% (89 of 632) among women with never-dense breasts, and 34% (217 of 632) with never-dense breasts reported being told they had dense breasts. Desire for supplemental screening was more frequent among those who reported having dense breasts 29% (256 of 893) or asked to imagine having dense breasts 30% (152 of 513) versus those reporting nondense breasts 15% (15 of 102) (P = .003, P = .002, respectively). Women with never-dense breasts had 6.3-fold higher odds (95% confidence interval:3.39-11.80) of accurate knowledge in states reporting density to all compared to states reporting only to women with dense breasts.
DISCUSSION
Standardized communications of breast density results to all women may increase density knowledge and are needed to support informed screening decisions.
Topics: Breast; Breast Density; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Male; Mammography; Mass Screening
PubMed: 35341697
DOI: 10.1016/j.jacr.2022.02.025 -
Endokrynologia Polska 2020Not required for Clinical Vignette.
Not required for Clinical Vignette.
Topics: Breast; Child; Estrogen Antagonists; Female; Humans; Hypertrophy
PubMed: 31909454
DOI: 10.5603/EP.a2019.0063 -
Korean Journal of Radiology Jan 2019To compare digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) in the detectability of breast cancers in patients with dense breast... (Comparative Study)
Comparative Study
OBJECTIVE
To compare digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) in the detectability of breast cancers in patients with dense breast tissue, and to determine the influencing factors in the detection of breast cancers using the two techniques.
MATERIALS AND METHODS
Three blinded radiologists independently graded cancer detectability of 300 breast cancers (288 women with dense breasts) on DBT and conventional FFDM images, retrospectively. Hormone status, histologic grade, T stage, and breast cancer subtype were recorded to identify factors affecting cancer detectability. The Wilcoxon signed-rank test was used to compare cancer detectability by DBT and conventional FFDM. Fisher's exact tests were used to determine differences in cancer characteristics between detectability groups. Kruskal-Wallis tests were used to determine whether the detectability score differed according to cancer characteristics.
RESULTS
Forty breast cancers (13.3%) were detectable only with DBT; 191 (63.7%) breast cancers were detected with both FFDM and DBT, and 69 (23%) were not detected with either. Cancer detectability scores were significantly higher for DBT than for conventional FFDM (median score, 6; range, 0-6; < 0.001). The DBT-only cancer group had more invasive lobular-type breast cancers (22.5%) than the other two groups (i.e., cancer detected on both types of image [both-detected group], 5.2%; cancer not detected on either type of image [both-non-detected group], 7.3%), and less detectability of ductal carcinoma (5% vs. 16.8% [both-detected group] vs. 27.5% [both-non-detected group]). Low-grade cancers were more often detected in the DBT-only group than in the both-detected group (22.5% vs. 10%, = 0.026). Human epidermal growth factor receptor-2 (HER-2)-negative cancers were more often detected in the DBT-only group than in the both-detected group (92.3% vs. 70.5%, = 0.004). Cancers surrounded by mostly glandular tissue were detected less often in the DBT only group than in the both-non-detected group (10% vs. 31.9%, = 0.016). DBT cancer detectability scores were significantly associated with cancer type ( = 0.012), histologic grade ( = 0.013), T and N stage ( = 0.001, = 0.024), proportion of glandular tissue surrounding lesions ( = 0.013), and lesion type ( < 0.001).
CONCLUSION
Invasive lobular, low-grade, or HER-2-negative cancer is more detectable with DBT than with conventional FFDM in patients with dense breasts, but cancers surrounded by mostly glandular tissue might be missed with both techniques.
Topics: Adult; Aged; Breast; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; Mammography; Middle Aged; Neoplasm Staging; Radiographic Image Enhancement; Retrospective Studies
PubMed: 30627022
DOI: 10.3348/kjr.2018.0012 -
Medicina (Kaunas, Lithuania) Oct 2020Radiation therapy is frequently a critical component of breast cancer care but carries with it side effects that are particularly damaging to reconstructive efforts.... (Review)
Review
Radiation therapy is frequently a critical component of breast cancer care but carries with it side effects that are particularly damaging to reconstructive efforts. Autologous lipotransfer has the ability to improve radiated skin throughout the body due to the pluripotent stem cells and multiple growth factors transferred therein. The oncologic safety of lipotransfer to the breasts is demonstrated in the literature and is frequently considered an adjunctive procedure for improving the aesthetic outcomes of breast reconstruction. Using lipotransfer as an integral rather than adjunctive step in the reconstructive process for breast cancer patients requiring radiation results in improved complication rates equivalent to those of nonradiated breasts, expanding options in these otherwise complicated cases. Herein, we provide a detailed review of the cellular toxicity conferred by radiotherapy and describe at length our approach to autologous lipotransfer in radiated breasts.
Topics: Breast; Breast Neoplasms; Humans; Mammaplasty; Mastectomy; Retrospective Studies; Treatment Outcome
PubMed: 33019768
DOI: 10.3390/medicina56100516