Background: Since introducing stereotactic core biopsy (SCB) on breast lesions in Denmark, no national follow-up of the procedure has been executed. Purpose: To evaluate performance of SCB in Danish mammography screen...Background: Since introducing stereotactic core biopsy (SCB) on breast lesions in Denmark, no national follow-up of the procedure has been executed. Purpose: To evaluate performance of SCB in Danish mammography screening. 3 areas were selected for evaluation: diagnostic value of SCB, performance of the Danish 7-tier mamma-radiological classifications system, DKBI-RADS, and diagnostic delay for SCB-diagnosis. Materials & Methods: Danish retrospective national cohort study including 2195 screening patients undergoing SCB. Study period: 01.01.2010 to 30.09.2012. Patients were identified from The Danish National Patient Register. Pathology-data were obtained from the Danish Pathology Database. Radiological-data according to DKBI-RADS were recorded. Diagnostic delay from clinical mammography until diagnosis was registered. Results: 173 SCBs indicated cancer;all operated with 3 cases finalized as benign. 1296 cases were determined benign with diagnostic surgery in 81 cases of which 31 were concluded pre-malignant/malignant. Correlation between DKBI-RADS and pathology diagnosis: 329 of 485 DKBI-RADS3, 227 of 450 DKBI-RADS4 were benign. 4 of 16 DKBI-RADS5 were benign. The diagnostic value of pre-malignant/malignant SCB related to results from surgery showed 94.4% sensitivity and a positive predictive value of 93.9%. Median diagnostic-time of single-biopsy was 13 days. Conclusion: The performance of SCB in Denmark is comparable to international studies regarding the diagnostic value of malignant SCB. The study indicates that DKBI-RADS classifications are not used consistently regarding micro-calcifications selected in screening-mammographies. Diagnostic delay is acceptable, subject to EUSOMA specifications, regarding single-biopsy.展开更多
Breast cancer deaths are more common among Black American women than White women. In 2012, the Centers for Disease Control and Prevention reported that Black American women had a higher incidence rate (130.0) compared...Breast cancer deaths are more common among Black American women than White women. In 2012, the Centers for Disease Control and Prevention reported that Black American women had a higher incidence rate (130.0) compared to White women (128.9). But it is the double burden of incidence and low survival that is particularly alarming (American Cancer Society, 2011). While research is underway to better understand the role that genes play, such as those that are associated with the aggressive triple negative breast cancer which is more commonly diagnosed in Black American women, there is more to learn about the utilization of the screening mammography. At the time this study was conducted the age controversy to receive a baseline screening was just beginning. The American Medical Association, the American College of Radiology, and the American Cancer Society all supported baseline screenings at age 40 but, currently the United States Preventive Services Task Force guidelines recommend biennial screening for women aged 50 to 74 years who are at average risk for breast cancer. Furthermore, mammograms are not routinely recommended for women age 40 to 49 because they are more likely to have false biopsies. We do not yet know the long-term impact of implementing a longer timeline to screen for breast cancer. Although Black American women, have narrowed the gap, they still lag behind regarding mammography screening and are more likely to be diagnosed with an aggressive form of breast cancer. This paper investigates the predictors of mammography use among a small, low-income, U.S. community-based sample of Black African American women age 42 and older.展开更多
Purpose： The impact of the USPSTF （US Preventive Services Task Force） recommendation that 40-49 year old women should no longer routinely receive screening mammography in November 2009 in different regions of the U...Purpose： The impact of the USPSTF （US Preventive Services Task Force） recommendation that 40-49 year old women should no longer routinely receive screening mammography in November 2009 in different regions of the US is unknown. Methods： The authors conducted a retrospective cohort study using medical claims from administrative health records from privately insured 40-59 year old women enrolled between 2005 and 2012 to evaluate biennial screening trends. Results： There was a slight decrease in mammography usage among 40-49 year old US women after the 2008-2009 biennial period （p 〈 0.001）. There were some regional differences in mammography trends, with the West showing the greatest difference in odds of 40-49 year olds receiving a mammography in 2011-2012 compared to 2008-2009 （OR： 0.93; 95% CI： 0.91-0.94）. Although trends for 50-59 year olds mirrored that of 40-49 year olds, the younger age group had a stronger decline in 2009-2010 and 2010-2011. Conclusions： These findings show that USPSTF guideline changes made some differences in mammography usage among 40-49 year olds, but adherence was uneven across regions.展开更多
Breast cancer(BC)is the most prevalent and destructive tumor in developing countries.The implementation of mammography screening programs has enabled access to appropriate therapeutic interventions,including adjuvant ...Breast cancer(BC)is the most prevalent and destructive tumor in developing countries.The implementation of mammography screening programs has enabled access to appropriate therapeutic interventions,including adjuvant endocrine therapy and breast-conserving surgery;earlier diagnosis translates into a wider survival-rate range,making hypofractionated radiotherapy(HFRT)the preferred option.This review examines the current literature comparing the two radiation therapies,HFRT and conventional radiotherapy(CR),with reconstructed breasts,focusing on efficacy,toxicity,cosmetic outcomes,quality of life(QOL),and cost-effectiveness.A comprehensive literature search was conducted using major scientific databases,including PubMed,Scopus,Web of Science,and Google Scholar.The search focused on articles published primarily in English,from 2010 to 2024,and the period is about 15 years.The following search terms and Boolean operators were used:“hypofractionated radiotherapy”OR“hypofractionation”AND“breast cancer”AND“toxicity”OR“complications”OR“reconstruction”OR“quality of life”OR“HFRT versus CFRT”OR“intensitymodulated radiation therapy”OR“proton therapy”.CR can be safely replaced with HFRT in terms of overall survival and local recurrence rates.HFRT is associated with lesser risks of both acute and chronic side effects,breast complications,increased patient satisfaction,and reduced breast problems.In addition,new radiotherapy modalities,such as intensitymodulated radiation therapy,have shown great potential in targeting tumors.In treating BC,HFRT is gradually becoming standard,especially for patients who undergo reconstruction after surgery.Its low toxicity and equal effectiveness make it a key element in improving the QOL of BC survivors.It is recommended that future studies focus on long-term outcomes to provide better care to patients.展开更多
基金Region of Southern DenmarkDepartment of Breast Surgery, Lillebaelt Hospital, Vejle Research Council Lillebaelt Hospital
文摘Background: Since introducing stereotactic core biopsy (SCB) on breast lesions in Denmark, no national follow-up of the procedure has been executed. Purpose: To evaluate performance of SCB in Danish mammography screening. 3 areas were selected for evaluation: diagnostic value of SCB, performance of the Danish 7-tier mamma-radiological classifications system, DKBI-RADS, and diagnostic delay for SCB-diagnosis. Materials & Methods: Danish retrospective national cohort study including 2195 screening patients undergoing SCB. Study period: 01.01.2010 to 30.09.2012. Patients were identified from The Danish National Patient Register. Pathology-data were obtained from the Danish Pathology Database. Radiological-data according to DKBI-RADS were recorded. Diagnostic delay from clinical mammography until diagnosis was registered. Results: 173 SCBs indicated cancer;all operated with 3 cases finalized as benign. 1296 cases were determined benign with diagnostic surgery in 81 cases of which 31 were concluded pre-malignant/malignant. Correlation between DKBI-RADS and pathology diagnosis: 329 of 485 DKBI-RADS3, 227 of 450 DKBI-RADS4 were benign. 4 of 16 DKBI-RADS5 were benign. The diagnostic value of pre-malignant/malignant SCB related to results from surgery showed 94.4% sensitivity and a positive predictive value of 93.9%. Median diagnostic-time of single-biopsy was 13 days. Conclusion: The performance of SCB in Denmark is comparable to international studies regarding the diagnostic value of malignant SCB. The study indicates that DKBI-RADS classifications are not used consistently regarding micro-calcifications selected in screening-mammographies. Diagnostic delay is acceptable, subject to EUSOMA specifications, regarding single-biopsy.
文摘Breast cancer deaths are more common among Black American women than White women. In 2012, the Centers for Disease Control and Prevention reported that Black American women had a higher incidence rate (130.0) compared to White women (128.9). But it is the double burden of incidence and low survival that is particularly alarming (American Cancer Society, 2011). While research is underway to better understand the role that genes play, such as those that are associated with the aggressive triple negative breast cancer which is more commonly diagnosed in Black American women, there is more to learn about the utilization of the screening mammography. At the time this study was conducted the age controversy to receive a baseline screening was just beginning. The American Medical Association, the American College of Radiology, and the American Cancer Society all supported baseline screenings at age 40 but, currently the United States Preventive Services Task Force guidelines recommend biennial screening for women aged 50 to 74 years who are at average risk for breast cancer. Furthermore, mammograms are not routinely recommended for women age 40 to 49 because they are more likely to have false biopsies. We do not yet know the long-term impact of implementing a longer timeline to screen for breast cancer. Although Black American women, have narrowed the gap, they still lag behind regarding mammography screening and are more likely to be diagnosed with an aggressive form of breast cancer. This paper investigates the predictors of mammography use among a small, low-income, U.S. community-based sample of Black African American women age 42 and older.
文摘Purpose： The impact of the USPSTF （US Preventive Services Task Force） recommendation that 40-49 year old women should no longer routinely receive screening mammography in November 2009 in different regions of the US is unknown. Methods： The authors conducted a retrospective cohort study using medical claims from administrative health records from privately insured 40-59 year old women enrolled between 2005 and 2012 to evaluate biennial screening trends. Results： There was a slight decrease in mammography usage among 40-49 year old US women after the 2008-2009 biennial period （p 〈 0.001）. There were some regional differences in mammography trends, with the West showing the greatest difference in odds of 40-49 year olds receiving a mammography in 2011-2012 compared to 2008-2009 （OR： 0.93; 95% CI： 0.91-0.94）. Although trends for 50-59 year olds mirrored that of 40-49 year olds, the younger age group had a stronger decline in 2009-2010 and 2010-2011. Conclusions： These findings show that USPSTF guideline changes made some differences in mammography usage among 40-49 year olds, but adherence was uneven across regions.
文摘Breast cancer(BC)is the most prevalent and destructive tumor in developing countries.The implementation of mammography screening programs has enabled access to appropriate therapeutic interventions,including adjuvant endocrine therapy and breast-conserving surgery;earlier diagnosis translates into a wider survival-rate range,making hypofractionated radiotherapy(HFRT)the preferred option.This review examines the current literature comparing the two radiation therapies,HFRT and conventional radiotherapy(CR),with reconstructed breasts,focusing on efficacy,toxicity,cosmetic outcomes,quality of life(QOL),and cost-effectiveness.A comprehensive literature search was conducted using major scientific databases,including PubMed,Scopus,Web of Science,and Google Scholar.The search focused on articles published primarily in English,from 2010 to 2024,and the period is about 15 years.The following search terms and Boolean operators were used:“hypofractionated radiotherapy”OR“hypofractionation”AND“breast cancer”AND“toxicity”OR“complications”OR“reconstruction”OR“quality of life”OR“HFRT versus CFRT”OR“intensitymodulated radiation therapy”OR“proton therapy”.CR can be safely replaced with HFRT in terms of overall survival and local recurrence rates.HFRT is associated with lesser risks of both acute and chronic side effects,breast complications,increased patient satisfaction,and reduced breast problems.In addition,new radiotherapy modalities,such as intensitymodulated radiation therapy,have shown great potential in targeting tumors.In treating BC,HFRT is gradually becoming standard,especially for patients who undergo reconstruction after surgery.Its low toxicity and equal effectiveness make it a key element in improving the QOL of BC survivors.It is recommended that future studies focus on long-term outcomes to provide better care to patients.
