• Title/Summary/Keyword: Breast Neoplasms

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Positive Predictive Values of Abnormality Scores From a Commercial Artificial Intelligence-Based Computer-Aided Diagnosis for Mammography

  • Si Eun Lee;Hanpyo Hong;Eun-Kyung Kim
    • Korean Journal of Radiology
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    • v.25 no.4
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    • pp.343-350
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    • 2024
  • Objective: Artificial intelligence-based computer-aided diagnosis (AI-CAD) is increasingly used in mammography. While the continuous scores of AI-CAD have been related to malignancy risk, the understanding of how to interpret and apply these scores remains limited. We investigated the positive predictive values (PPVs) of the abnormality scores generated by a deep learning-based commercial AI-CAD system and analyzed them in relation to clinical and radiological findings. Materials and Methods: From March 2020 to May 2022, 656 breasts from 599 women (mean age 52.6 ± 11.5 years, including 0.6% [4/599] high-risk women) who underwent mammography and received positive AI-CAD results (Lunit Insight MMG, abnormality score ≥ 10) were retrospectively included in this study. Univariable and multivariable analyses were performed to evaluate the associations between the AI-CAD abnormality scores and clinical and radiological factors. The breasts were subdivided according to the abnormality scores into groups 1 (10-49), 2 (50-69), 3 (70-89), and 4 (90-100) using the optimal binning method. The PPVs were calculated for all breasts and subgroups. Results: Diagnostic indications and positive imaging findings by radiologists were associated with higher abnormality scores in the multivariable regression analysis. The overall PPV of AI-CAD was 32.5% (213/656) for all breasts, including 213 breast cancers, 129 breasts with benign biopsy results, and 314 breasts with benign outcomes in the follow-up or diagnostic studies. In the screening mammography subgroup, the PPVs were 18.6% (58/312) overall and 5.1% (12/235), 29.0% (9/31), 57.9% (11/19), and 96.3% (26/27) for score groups 1, 2, 3, and 4, respectively. The PPVs were significantly higher in women with diagnostic indications (45.1% [155/344]), palpability (51.9% [149/287]), fatty breasts (61.2% [60/98]), and certain imaging findings (masses with or without calcifications and distortion). Conclusion: PPV increased with increasing AI-CAD abnormality scores. The PPVs of AI-CAD satisfied the acceptable PPV range according to Breast Imaging-Reporting and Data System for screening mammography and were higher for diagnostic mammography.

Contrast-Enhanced Spectral Mammography Versus Ultrasonography: Diagnostic Performance in Symptomatic Patients with Dense Breasts

  • Zhongfei Lu;Cuijuan Hao;Yan Pan;Ning Mao;Xin Wang;Xundi Yin
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.442-449
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    • 2020
  • Objective: To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) versus ultrasonography (US) in symptomatic patients with dense breasts, while using histology as the gold standard. Materials and Methods: After obtaining approval from the local ethics board, this prospective study collected data from patients with symptomatic breasts who underwent CESM and US examinations from May 1, 2017 to September 30, 2017. We then selected those with dense breasts and pathological results as our sample population. Both CESM and US results were classified by a radiologist through the Breast Imaging Reporting and Data System, and the results were compared with their corresponding histological results. The chi-square test was conducted to compare the diagnostic performance of CESM and US, and the receiver operating characteristic curves for the two imaging modalities were obtained. Results: A total of 131 lesions from 115 patients with dense breasts were included in this study. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 93.8%, 88.1%, 88.2%, 93.7%, and 90.8% for CESM, and 90.6%, 82.1%, 82.9%, 90.2%, and 86.3% for US, respectively. The p values for sensitivity, specificity, PPV, NPV, and accuracy were 0.687, 0.388, 0.370, 0.702, and 0.238, respectively. The area under the curve of CESM (0.917) was comparable with that of US (0.884); however, the differences between CESM and US were not statistically significant (p = 0.225). Eight false-positive cases and 4 false-negative cases for breast cancer were found in CESM, while 12 false-positive cases and 6 false-negative cases were found in US. Conclusion: The diagnostic performances of CESM and US are comparable in symptomatic women with dense breasts; however, the routine use of additional US imaging is questionable for lesions that can be detected by CESM.

Metastatic gastric adenocarcinoma to the mandible (하악에 전이된 위 선양암종)

  • Lee Ji-Un;Kwon Ki-Jeong;Ahn Hyoung-Suk;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.35 no.3
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    • pp.179-183
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    • 2005
  • Metastatic tumors to the jaw bones are uncommon. The most common metastatic tumors to the jaw bones are the breast, lung and kidney. In the jaw bones, the common location of the lesions is the mandible, and the posterior area of the mandible is more commonly affected. The radiographic appearance is quite variable. In this report, a very rare case of metastatic gastric adenocarcinoma to the mandible is presented. The patient had undergone a gastrectomy 3 years ago.

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WAVEs: A Novel and Promising Weapon in the Cancer Therapy Tool Box

  • Sakthivel, K.M.;Prabhu, V. Vinod;Guruvayoorappan, C.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1719-1722
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    • 2012
  • The Wiskott-Aldrich Syndrome Protein family Verprolin - homologous proteins (WAVEs), encoded by a metastasis promoter gene, play considerable roles in adhesion of immune cells, cell proliferation, migration and destruction of foreign agents by reactive oxygen species. These diverse functions have lead to the hypothesis that WAVE proteins have multi-functional roles in regulating cancer invasiveness, metastasis, development of tumor vasculature and angiogenesis. Differentials in expression of WAVE proteins are associated with a number of neoplasms include colorectal cancer, hepatocellular cancer, lung squamous cell carcinoma, human breast adenocarcinoma and prostate cancer. In this review we attempt to unify our knowledge regarding WAVE proteins, focusing on their potentials as diagnostic markers and molecular targets for cancer therapy.

Alcohol Consumption and Risk of Cancer: a Systematic Literature Review

  • de Menezes, Raquel Ferreira;Bergmann, Anke;Thuler, Luiz Claudio Santos
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.4965-4972
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    • 2013
  • This study aimed to discuss the consumption of alcohol as a risk factor for major cancers. We performed a search in the PubMed database, using the following inclusion criteria: meta-analysis published in English in the last 10 years that addressed the relationship between alcohol and the risk of developing cancer. The results indicate that moderate to heavy consumption of alcohol increases the risk of developing cancer of the oral cavity and pharynx, esophagus, stomach, larynx, colorectum, central nervous system, pancreas, breast and prostate. This review did not find any association between alcohol consumption and an increased risk of cancers of the lung, bladder, endometrium and ovary. It was also observed that alcohol consumption may be inversely related to thyroid cancer. Our systematic review has confirmed consumption of alcohol as a risk factor for the development of several types of cancer.

An update on immunotherapy with PD-1 and PD-L1 blockade

  • Koh, Sung Ae
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.308-317
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    • 2021
  • Cancer is the leading cause of death and is on the rise worldwide. Until 2010, the development of targeted treatment was mainly focused on the growth mechanisms of cancer. Since then, drugs with mechanisms related to tumor immunity, especially immune checkpoint inhibitors, have proven effective, and most pharmaceutical companies are striving to develop related drugs. Programmed cell death-1 and programmed cell death ligand-1 inhibitors have shown great success in various cancer types. They showed durable and sustainable responses and were approved by the U.S. Food and Drug Administration. However, the response to inhibitors showed low percentages of cancer patients; 15% to 20%. Therefore, combination strategies with immunotherapy and conventional treatments were used to overcome the low response rate. Studies on combination therapy have typically reported improvements in the response rate and efficacy in several cancers, including non-small cell lung cancer, small cell lung cancer, breast cancer, and urogenital cancers. The combination of chemotherapy or targeted agents with immunotherapy is one of the leading pathways for cancer treatment.

Development and Evaluation of a Navigation Program for Newly Diagnosed Cancer Patients (암을 처음 진단받은 환자를 위한 신환 네비게이션 프로그램 개발 및 효과 평가)

  • Kwon, In Gak;Hong, Jin Young;Baek, Hye Jin;Kim, Sung;Nam, Seok Jin;Kim, Im Ryung;Kim, Hye Jung;Kim, Ae Ran
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.111-125
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    • 2012
  • Purpose: The purposes of this study were to develop a navigation program for newly diagnosed cancer patients and to evaluate its effects. Methods: The navigation program was based upon Professional Navigation Framework. Patients were asked to complete self-administered questionnaires on satisfaction, distress, anxiety and depression for evaluating the program. Results: The navigation program consisted of facilitating two concepts: continuity of care and empowerment of patients. Information-education package, telephone counseling and navigator's phone number were provided to the newly diagnosed cancer patients for care continuity. Self-care diary and emotional support by telephone counseling were provided to the patients for empowerment of patients. A total of 163 patients - 78 control and 85 experimental participants - were included in the study. The mean scores of satisfaction, distress, anxiety and depression had no statistical differences between the two groups after program implementation. In patients with longer waiting days, the experimental group with the navigation program showed higher relational continuity than the control group after program implementation(p=.023). In patients with longer waiting days or with higher distress, satisfaction of relational continuity was improved after program implementation in the experimental group. Conclusion: The navigation program in this study has applied the concept of patient navigation into oncology clinical setting in Korea. Navigation program can play a significant role in assisting patients navigating across the care continuum.

Cytologic Analysis of Metastatic Malignant Tumor in Pleural and Ascitic Fluid (흉수 및 복수로 전이된 암종의 세포학적 분석)

  • Joo, Mee;Cho, Hye-Je
    • The Korean Journal of Cytopathology
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    • v.6 no.2
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    • pp.125-132
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    • 1995
  • Cytodiagnosis of pleural and ascitic fluid is a commonly performed laboratory examination. Especially, positivity for malignant cells in effusion cytology is very effective and also presents the first sign of malignancy in unknown primary site of the tumor. We examined each 34 cases of pleural and ascitic fluid cytologic specimen diagnosed as metastatic tumor, which was selected among 964 pleural fluid cytology cases and 662 ascitic fluid cytology cases from September 1989 to June 1995. Among the pleural fluid cytology specimens examined, 34 specimens were positive in 27 patients. The lung was the most frequent primary site(44%), followed by the stomach (12%), lymphoreticular neoplasm(12%), pancreas(3%) and colon(3%). And the cases of unknown primary site with positive pleural biopsy alone were 24%. Among trio ascitic fluid cytology specimens examined, 34 specimens were positive in 29 patients. The most common primary neoplasms. were carcinomas of ovary(32%), stomach(22%), colon(6%), breast(3%), pancreas(3%), and lung(3%) and lymphoreticular neoplasms(3%) The metastatic tumor was predominantly adenocarcinoma type in both pleural(82%) and ascitic(91%) fluid. The study of metastatic adeno- carcinoma in effusion from lung, ovary, and stomach was undertaken to find distinctive features for the identification of the primary site. The smears of metastatic pulmonary adenocarcinoma had a tendency to show high grade pleomorphism and many large tight cell clusters, whereas that of the ovarian adenocarcinoma showed low grade pleomorphism with abundant intracytoplasmic vacuoles in relatively clear background. That of the stomach revealed the intermediate features.

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Granular Cell Tumor Arising from the Left Main Bronchus - A case report- (좌측 주기관지에서 발생한 과립 세포종 -1예 보고-)

  • Sea Yeon Ho;Kim Kyung Hwa;Kim Nan Yeol;Kuh Ja Hong
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.244-247
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    • 2006
  • Granular cell tumors (GCT) are uncommon benign neoplasms. Their location is mostly in the the skin, tongue, and breast; appearance in other parts of the body is rare, but it has been reported. They have also been reported to occur synchronously in multiple organs and metachronously in a single organ. The incidence of GCTs in the tracheobronchial tree is unknown and pulmonary GCTs are uncommon, with approximately 100 reported cases in the literature. We present the case of a 33-year-old man with a granular cell tumor of the left main bronchus. The tumor was found at bronchoscopy performed to exclude suspected endobronchial mass with symptoms of pneumonia. Biopsies revealed the histological pattern of a benign granular cell tumor. He underwent resection of the left main bronchus followed by end to end anastomosis of left main bronchus. He has not had any recurrence of the tumor during the 1 year follow-up.

Significance of Hormone Receptor Status in Comparison of 18F -FDG-PET/CT and 99mTc-MDP Bone Scintigraphy for Evaluating Bone Metastases in Patients with Breast Cancer: Single Center Experience

  • Teke, Fatma;Teke, Memik;Inal, Ali;Kaplan, Muhammed Ali;Kucukoner, Mehmet;Aksu, Ramazan;Urakci, Zuhat;Tasdemir, Bekir;Isikdogan, Abdurrahman
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.387-391
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    • 2015
  • Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous. Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study. Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDGPET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. ${\kappa}$ statistics were calculated for 18F-FDGPET/CT and BS. The ${\kappa}$-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the ${\kappa}$-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The ${\kappa}$-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the ${\kappa}$-values suggested good agreement in the hormone receptor (-) group. Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.