• 제목/요약/키워드: Mammography screening

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Development and Validation of a Breast Cancer Risk Prediction Model for Thai Women: A Cross-Sectional Study

  • Anothaisintawee, Thunyarat;Teerawattananon, Yot;Wiratkapun, Cholatip;Srinakarin, Jiraporn;Woodtichartpreecha, Piyanoot;Hirunpat, Siriporn;Wongwaisayawan, Sansanee;Lertsithichai, Panuwat;Kasamesup, Vijj;Thakkinstian, Ammarin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권16호
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    • pp.6811-6817
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    • 2014
  • Background: Breast cancer risk prediction models are widely used in clinical practice. They should be useful in identifying high risk women for screening in limited-resource countries. However, previous models showed poor performance in derived and validated settings. Therefore, we aimed to develop and validate a breast cancer risk prediction model for Thai women. Materials and Methods: This cross-sectional study consisted of derived and validation phases. Data collected at Ramathibodi and other two hospitals were used for deriving and externally validating models, respectively. Multiple logistic regression was applied to construct the model. Calibration and discrimination performances were assessed using the observed/expected ratio and concordance statistic (C-statistic), respectively. A bootstrap with 200 repetitions was applied for internal validation. Results: Age, menopausal status, body mass index, and use of oral contraceptives were significantly associated with breast cancer and were included in the model. Observed/expected ratio and C-statistic were 1.00 (95% CI: 0.82, 1.21) and 0.651 (95% CI: 0.595, 0.707), respectively. Internal validation showed good performance with a bias of 0.010 (95% CI: 0.002, 0.018) and C-statistic of 0.646(95% CI: 0.642, 0.650). The observed/expected ratio and C-statistic from external validation were 0.97 (95% CI: 0.68, 1.35) and 0.609 (95% CI: 0.511, 0.706), respectively. Risk scores were created and was stratified as low (0-0.86), low-intermediate (0.87-1.14), intermediate-high (1.15-1.52), and high-risk (1.53-3.40) groups. Conclusions: A Thai breast cancer risk prediction model was created with good calibration and fair discrimination performance. Risk stratification should aid to prioritize high risk women to receive an organized breast cancer screening program in Thailand and other limited-resource countries.

컴퓨터보조진단을 이용한 유방 초음파영상에서의 미세석회화 검출 효율 (Detection Efficiency of Microcalcification using Computer Aided Diagnosis in the Breast Ultrasonography Images)

  • 이진수;고성진;강세식;김정훈;박형후;최석윤;김창수
    • 대한방사선기술학회지:방사선기술과학
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    • 제35권3호
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    • pp.227-235
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    • 2012
  • 유방영상은 유방 전체의 재현 가능한 영상을 만들며, 만져지지 않는 조기 유방암의 가장 중요한 소견인 미세석회화와 종괴를 발견할 수 있어 유방 질환의 일차적인 선별검사로 이용되고 있다. 유방 병변의 미세석회화는 조기 유방암의 진단에 있어서 중요한 병변으로 보고되고 있지만 유방초음파 검사에서 검출이 어렵다. 본 연구에서는 유방초음파 영상에서 미세석회화 검출을 위해 6가지의 질감분석 파라미터를 이용하였으며, 정상 초음파영상과 미세석회화가 보이는 초음파 영상 간의 병변인식률을 알아보았다. 실험결과로는 유방촬영영상과 유방 초음파영상에서 병변을 구별하는 컴퓨터자동진단 인식률은 70~98%로 상당히 높은 결과를 나타내었다. ROC 분석에서도 평균대조도와 엔트로피 파라미터의 특이도는 다소 낮게 나타났으나, 나머지 4개 파라미터의 민감도와 특이도는 90% 이상을 나타내어 초음파영상에서 미세석회화 검출의 가능성을 보였다. 향후 6가지 질감분석 알고리즘들 외에 추가적인 파라미터 알고리즘의 연구가 계속 진행되어 컴퓨터자동진단의 실용화기반을 마련한다면 전문의 진단의 예비단계로서 더욱 중요한 의미를 가질 것이며, 유방암의 조기진단에 매우 유용할 것으로 사료된다.

Risk Factors for Stage IV Breast Cancer at the Time of Presentation in Turkey

  • Uyeturk, Ummugul;Tatli, Ali Murat;Gucuk, Sebahat;Oksuzoglu, Berna;Ulas, Arife;Avci, Nilufer;Ozbay, Mehmet Fatih;Gunduz, Seyda;Akinci, Muhammed Bulent;Salim, Derya Kivrak;Sonmez, Ozlem Uysal;Akdag, Fatma;Ergenc, Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7445-7449
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    • 2013
  • Background: Breast cancer (BC) is the one of the most common cancers in women. It is also a leading cause of death. Unfortunately, some patients initially present with distant metastases and are diagnosed with stage IV disease that is nearly always, by then, incurable. This retrospective analysis investigated the risk factors for stage IV BC that may underlie such late presentation. Materials and Methods: In all, 916 patients with BC who visited the medical oncology polyclinic of eight different centres in Turkeybetween December 2011 and January 2013 were analysed. Results: A total of 115 patients (12.6%) presented with stage IV disease. In univariate analysis; to comparing these with patients at other stages, no statistical difference was found for median diagnosis age or age at menarche (p=0.611 and p=0.820), whereas age at menopause and age at first live birth were significant (p=0.018 and p=0.003). No difference was detected in terms of accompanying diseases, use of oral contraceptives and hormone replacement therapy, smoking, alcohol consumption and the rate of family history of BC between the patients (p=0.655, p=0.389, p=0.762, p=0.813, p=0.229, p=0.737). However, screening methods were employed less often, the rate of illiteracy was higher, and the rate of other cancers was higher in patients with stage IV BC (p=0.022, p=0.022, p=0.018). No statistical difference was observed between the patients in terms of tumour histopathology, and status of oestrogen receptor, progesterone receptor, or human epidermal growth factor-2 receptor (p=0.389, p=0.326, p=0.949, p=0.326). Grade 3 tumours were more frequent in patients with stage IV disease (p<0.001). On multivariate analysis, risk factors for stage IV breast cancer at the time of presentation were found to be age at first live birth and educational level (p=0.003 and p=0.047). Conclusions: Efforts should be made to perform mammography scans, in particular, at regular intervals through national training programs for all women, particularly those with family histories of breast and other types of cancer, and to establish early diagnosis of BC long before it proceeds to stage IV. Additionally, women's education had better be upgraded. In order to make women aware of BC, national education-programmes must be organised.

Beliefs, Attitudes, and Behavior of Turkish Women about Breast Cancer and Breast Self-Examination According to a Turkish Version of the Champion Health Belief Model Scale

  • Erbil, Nulufer;Bolukbas, Nurgul
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5823-5828
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    • 2012
  • Background: Breast cancer (BC) is one of the most common cancer affecting women worldwide. Although a great deal of progress has been made in the health sciences, early diagnosis, and increasing community awareness, breast cancer remains a life-threatening illness. In order to reduce this threat, breast cancer screening needs to be implemented in all communities where possible. Objective: The purpose of this study was to examine health beliefs, attitudes and behaviors about breast cancer and breast self-examination of Turkish women. Methods: Data were collected from a sample of 656 women, using an adapted Turkish version of Champion's Health Belief Model Scale (CHBMS), between January and May 2011, in Ordu province of Turkey. Results: The results showed that 67.7% of women had knowledge about and 55.8% performed BSE, however 60.6% of those who indicated they practiced BSE reported they did so at irregular intervals. CHBMS subscales scores of women according to women's age, education level, occupation, family income and education level of the women's mothers, family history of breast cancer, friend and an acquaintance with breast cancer, knowledge about breast cancer, BSE and mammography were significantly different. Conclusion: Knowledge of women about the risks and benefits of early detection of breast cancer positively affect their health beliefs, attitudes, and behaviors. Health care professionals can develop effective breast health programs and can help women to gain good health behavior and to maintain health.

Survival Rate of Breast Cancer in Iran: A Meta-Analysis

  • Abedi, Ghasem;Janbabai, Ghasem;Moosazadeh, Mahmood;Farshidi, Fereshte;Amiri, Mohammad;Khosravi, Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권10호
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    • pp.4615-4621
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    • 2016
  • Background: There has not been a general estimation about survival rates of breast cancer cases in Iran. Therefore, the present study aimed to assess survival using a meta-analysis. Materials and Methods: International credible databases such as Scopus, Web of Science, PubMed, Science direct and Google Scholar and Iranian databases such as Magiran, Irandoc and SID, from 1997 to 2015 were searched. All articles covering survival rate of breast cancer were entered into the study without any limits. Quality assessment of the articles and data extraction were performed by two researchers using the modified STROBE checklist, which includes 12 questions. Articles with scores greater than 8 were included in the analysis. A limitation of this meta-analysis was different methods for presenting of results in the papers surveyed. Results: A total of 21 articles with a sample of 12,195 people were analyzed. The one-year, three-year, five-year and ten-year survival rates of breast cancer in Iran were estimated to be 95.8% (94.6-97.0), 82.4% (79.0-85.8), 69.5% (64.5-74.5), 58.1% (39.6-76.6), respectively. The most important factors affecting survival of breast cancer were age, number of lymph nodes involved, size of the tumor and the stage of the disease. Conclusion: The five- and ten- year survival rates in Iran are lower than in developed countries. Conducting breast cancer screening plan support (including regular clinical examination, mammography), public training and raising awareness should be helpful in facilitating early diagnosis and increasing survival rates for Iranian women.

Breast Imaging Using Electrical Impedance Tomography: Correlation of Quantitative Assessment with Visual Interpretation

  • Zain, Norhayati Mohd;Chelliah, Kanaga Kumari
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권3호
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    • pp.1327-1331
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    • 2014
  • Background: Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does not use ionizing radiation to the human breast; allows conducting quantitative assessment of the images besides the visual interpretation. The aim of this study was to correlate the quantitative assessment and visual interpretation of breast electrical impedance tomographs and associated factors. Materials and Methods: One hundred and fifty mammography patients above 40 years and undergoing EIT were chosen using convenient sampling. Visual interpretation of the images was carried out by a radiologist with minimum of three years experience using the breast imaging - electrical impedance (BI-EIM) classification for detection of abnormalities. A set of thirty blinded EIT images were reinterpreted to determine the intra-rater reliability using kappa. Quantitative assessment was by comparison of the breast average electric conductivity with the norm and correlations with visual interpretation of the images were determined using Chi-square. One-way ANOVA was used to compare the mean electrical conductivity between groups and t-test was used for comparisons with pre-existing Caucasians statistics. Independent t-tests were applied to compare the mean electrical conductivity of women with factors like exogenous hormone use and family history of breast cancer. Results: The mean electrical conductivity of Malaysian women was significantly lower than that of Caucasians (p<0.05). Quantitative assessment of electrical impedance tomography was significantly related with visual interpretation of images of the breast (p<0.05). Conclusions: Quantitative assessment of electrical impedance tomography images was significantly related with visual interpretation.

Breast and Cervical Cancer Related Practices of Female Doctors and Nurses Working at a University Hospital in Turkey

  • Kabacaoglu, Meryem;Oral, Belgin;Balci, Elcin;Gunay, Osman
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5869-5873
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    • 2015
  • Background: Breast and cervical cancers are among the most frequent and most fatal cancers in women. Life span of patients may be increased and quality of life improved through early diagnosis and treatment. This investigation was performed in order to determine knowledge and practices of female health personnel working at a university hospital regarding breast and cervical cancers. Materials and Methods: This descriptive investigation was performed in Erciyes University Hospitals in 2014. A total of 524 female health personnel were included in the study. Data were collected through a questionnaire of 36 questions prepared by the researchers. The Chi square test and logistic regression were used for statistical analyses. Results: The mean age of the study group was $32.8{\pm}6.9$ years, 18.3% being doctors and 81.7% nurses. Of the study group, 60.5% stated that they performed self breast-examination, 4.4% underwent HPV testing, 26.3% thought about taking an HPV test, 34.7% of those who are 40 years and over had mammography regularly and 19.5% of those who were married had a Pap smear conducted regularly. Most important causes of not performing the methods for early diagnosis of breast and cervical cancers are "forget and neglect". Conclusions: It was concluded that female doctors and nurses do not pay sufficient attention to screening programs for breast and cervical cancers. The importance of early diagnosis and treatment should be emphasized during the undergraduate education and in-service training programs. Health condition of personnel and their utilization of preventive health care should be followed by occupational physicians.

Breast Cancer Awareness at the Community Level among Women in Delhi, India

  • Dey, Subhojit;Mishra, Arti;Govil, Jyotsna;Dhillon, Preet K
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5243-5251
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    • 2015
  • Background: To assess women's awareness from diverse sections of society in Delhi regarding various aspects of breast cancer (BC) - perceptions, signs and symptoms, risk factors, prevention, screening and treatment. Materials and Methods: Community-level survey was undertaken in association with the Indian Cancer Society (ICS), Delhi during May 2013-March 2014. Women attending BC awareness workshops by ICS were given self-administered questionnaires before the workshop in the local language to assess BC literacy. Information provided by 2017 women was converted into awareness scores (aware=1) for analysis using SPSS. Awareness scores were dichotomized with median score=19 as cut off, create more aware and less aware categories. Bivariate and multivariate analysis provided P-values, odds ratios (ORs) and 95% confidence intervals (CIs). Results: Broadly, 53.4% women were aware about various aspects of BC. Notably, 49.1% women believed that BC was incurable and 73.9% women believed pain to be an initial BC symptom. Only 34.9% women performed breast self-examination (BSE) and 6.9% women had undergone clinical breast-examination/mammography. 40.5% women had higher awareness (awareness score > median score of 19), which was associated with education [graduates (OR=2.31; 95%CI=1.78, 3.16), post-graduates (OR=7.06; 95%CI=4.14, 12.05) compared to ${\leq}$ high school] and socio-economic status (SES) [low-middle (OR=4.20; 95%CI=2.72, 6.49), middle (OR=6.00; 95%CI=3.82, 9.42) and upper (OR=6.97; 95%CI=4.10, 11.84) compared to low SES]. Conclusions: BC awareness of women in Delhi was suboptimal and was associated with low SES and education. Awareness must be drastically increased via community outreach and use of media as a first step in the fight against BC.

Comparison of Male and Female Breast Cancer Incidence and Mortality Trends in Central Serbia

  • Sipetic-Grujicic, Sandra;Murtezani, Zafir;Ratkov, Isidora;Grgurevic, Anita;Marinkovic, Jelena;Bjekic, Milan;Miljus, Dragan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5681-5685
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    • 2013
  • Background: To compare breast cancer incidence and mortality trends in Central Serbia between males and females in the period 1999-2009. Materials and Methods: In this descriptive study, mortality data were obtained from the National Statistics Institute and morbidity data were derived from Institute of Public Health of Serbia for the period of interest. Results: Breast cancer is a leading cancer in the female population of Central Serbia, whereas in male population it is not on the list of 10 leading localizations, concerning both incidence as well as mortality. In the period 1999-2009 the average standardized incidence rates of breast cancer were 60.5/100,000 in women and 1.4/100,000 in men, while average standardized mortality rates were 20.4/100,000 and 0.4/100,000. The average standardized incidence and mortality rates were about 45 times higher in females than males. Male breast cancer comprises approximately 2.1% of all breast cancer cases. The average age-specific mortality and incidence rates increased with age in both sexes. In the observed period standardized mortality rates of breast cancer increased significantly only in men ($y=0.320+0.0215{\times}$, p=0.044). Conclusions: The increase of breast cancer incidence in both sexes and mortality in men, indicate an urgent need for Serbian health professionals to apply existing cancer control and preventive measures. Male breast cancer is more present than in other world regions, with an outstanding increase of mortality, which demands a timely identification (screening) and adequate treatment. A national policy including mammography should be considered in the light of the newest findings.

피셔 분별 사전학습을 이용해 개선된 Sparse 표현 기반 악성 종괴 검출 (Improvement of Sparse Representation based Classifier using Fisher Discrimination Dictionary Learning for Malignant Mass Detection)

  • 김성태;이승현;민현석;노용만
    • 한국멀티미디어학회논문지
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    • 제16권5호
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    • pp.558-565
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    • 2013
  • X-ray를 이용한 여성의 유방암 검사인 유방조영술은 유방암의 초기 단계에서의 진단을 위한 효과적인 방법이다. 컴퓨터 지원 검출(CAD) 시스템은 유방조영술을 통한 진단 시 의사가 놓치기 쉬운 유방암의 징후인 종괴의 검출을 도와 유방암 진단율을 높이는 수단이다. 종괴는 다양한 모양을 지니며 경계가 뚜렷하지 않기 때문에 검출이 어렵고 결과적으로 비-종괴 영역을 포함한 많은 수의 종괴 후보영역이 CAD 시스템에서 검출된다. 따라서 CAD 시스템 설계 시 검출된 많은 수의 종괴 후보영역으로부터 실제 악성 종괴 영역을 분류할 수 있도록 우수한 성능의 분류기가 요구된다. 본 논문에서는 피셔 분별 사전학습을 통해 개선된 Sparse 표현(SR) 기반 분류방법을 제안한다. 개선된 SR 기반 분류기가 기존의 CAD 시스템에서 주로 사용되어온 Support Vector Machine (SVM) 분류기 보다 우수함을 비교실험을 통해 확인했다.