• 제목/요약/키워드: clinical breast-examination

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Elastography for Breast Cancer Diagnosis: a Useful Tool for Small and BI-RADS 4 Lesions

  • Liu, Xue-Jing;Zhu, Ying;Liu, Pei-Fang;Xu, Yi-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10739-10743
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    • 2015
  • The present study aimed at evaluating and comparing the diagnostic performance of B-mode ultrasound (US), elastography score (ES), and strain ratio (SR) for the differentiation of breast lesions. This retrospective study enrolled 431 lesions from 417 in-hospital patients. All patients were examined with both conventional ultrasound and elastography. Two experienced radiologists reviewed ultrasound and elasticity images. The histopathologic result obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard. Pathologic examination revealed 276 malignant lesions (64%) and 155 benign lesions (36%). A cut-off point of 4.15 (area under the curve, 0.891) allowed significant differentiation of malignant and benign lesions. ROC (receiver-operating characteristic) curves showed a higher value for combination of B-mode ultrasound and elastography for the diagnosis of breast lesions. Conventional ultrasound combined elastography showed high sensitivity, specificity, and accuracy for group II lesions (10mm${\leq}20mm$). Elastography combined with conventional ultrasound show high specificity and accuracy for differentiation of benign and malignant breast lesions. Elastography is particularly important for the diagnosis of BI-RADS 4 and small breast lesions.

Clinical and Ultrasonographic Changes of the Breast after Use of Soy Isoflavones

  • Alipour, Sadaf;Afshar, Somayeh;Moini, Ashraf;Dastjerdi, Marzieh Vahid;Saberi, Azin;Bayani, Leila;Eslami, Bita;Hosseini, Ladan
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권12호
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    • pp.6093-6095
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    • 2012
  • Background: Phytoestrogens may be an alternative therapy in control of menopausal symptoms but their definite effects on breast tissue must be determined. Our study aimed to define the clinical and ultrasonographic changes of the breast after use of soy isoflavones in menopausal women. Materials and Methods: Menopausal women with hot flashes were randomly grouped as cases and controls and cases received soy isoflavones for 12 weeks. Breast examination (BE) and ultrasonography (US) were done at 0, 6 and 12 weeks. Tenderness and nodularity on BE were graded 1-4 by breast surgeons. Results: There were 30 women in the case and 26 in the control group. The mean age was 51.3 years and the mean age of menopause was 49.2 years. There was no change in the BE and US at 6 weeks in controls. In the case group, 10% had grade 1 tenderness and 13.3% grade 2 tenderness and grade 1 nodularity in BE accompanied with diffuse small cysts in US. At 12 weeks, there was no change in BE and US in the 2 groups. Conclusions: There was no statistically significant difference in the BE of the 2 groups at 6 and 12 weeks (p value=0.36 and 0.41 for nodularity and tenderness respectively) and in the US results. Although the literature contains many facts concerning PEs and the breast, further prospective studies are needed to identify structural breast changes produced by PEs in order to identify the appropriate dosage and indications of use.

Socio-economic Factors Influencing Tumor Presentation and Treatment Options in Chinese Breast Cancer Patients

  • Wang, Ke;Li, Xiao;Zhou, Can;Ren, Yu;Wang, Xian-Bing;He, Jian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.267-274
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    • 2013
  • The impact of income and education level on the clinical and pathologic characteristics, implementation of clinical breast examination (CBE), and treatment patterns of a small population of Chinese female breast cancer patients was studeied in order to provide a theoretical basis and statistical reference for further nationwide research. We included 484 pathologically confirmed female primary breast cancer inpatients of the First Affiliated Hospital of Medical College of Xi'an Jiaotong University from February 2003 to January 2004. All cases were reviewed and relevant information was collected using a designed case report form (CRF). Chisquare tests, rank-sum tests, and Fisher's exact tests were used in the analysis. Our analysis showed that: (1) women in different occupation groups had significant differences in tumor size, pre-operative mammography, surgical options, post-operative estrogen receptor (ER), progestin receptor (PR) and human epidermal growth factor receptor 2 (Her2) status, and post-operative radiotherapy and chemotherapy (P < 0.05); and (2) women with different education levels had statistically significant differences in tumor size, post-operative ER, PR and Her2 status, and post-operative chemotherapy, radiotherapy, and endocrine therapy (P < 0.05). In Xi'an, China, women in low-income occupations or with low education levels are more likely to have advanced tumor stages at presentation, lower implementation rate of clinical breast examination, and less treatment.

Sentinel Node Biopsy Examination for Breast Cancer in a Routine Laboratory Practice: Results of a Pilot Study

  • Khoo, Joon-Joon;Ng, Chen-Siew;Sabaratnam, Subathra;Arulanantham, Sarojah
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1149-1155
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    • 2016
  • Background: Examination of sentinel lymph node (SLN) biopsies provides accurate nodal staging for breast cancer and plays a key role in patient management. Procurement of SLNs and the methods used to process specimens are equally important. Increasing the level of detail in histopathological examination of SLNs increases detection of metastatic tumours but will also increase the burden of busy laboratories and thus may not be carried out routinely. Recommendation of a reasonable standard in SLN examination is required to ensure high sensitivity of results while maintaining a manageable practice workload. Materials and Methods: Twenty-four patients with clinically node-negative breast cancer were recruited. Combined radiotracer and blue dye methods were used for identification of SLNs. The nodes were thinly sliced and embedded. Serial sectioning and immunohistochemical (IHC) staining against AE1/AE3 were performed if initial H&E sections of the blocks were negative. Results: SLNs were successfully identified in all patients. Ten cases had nodal metastases with 7 detected in SLNs and 3 detected only in axillary nodes (false negative rate, FNR=30%). Some 5 out of 7 metastatic lesions in the SLNs (71.4%) were detected in initial sections of the thinly sliced tissue. Serial sectioning detected the remaining two cases with either micrometastases or isolated tumour cells (ITC). Conclusions: Thin slicing of tissue to 3-5mm thickness and serial sectioning improved the detection of micro and macro-metastases but the additional burden of serial sectioning gave low yield of micrometastases or ITC and may not be cost effective. IHC validation did not further increase sensitivity of detection. Therefore its use should only be limited to confirmation of suspicious lesions. False negative cases where SLNs were not involved could be due to skipped metastases to non-sentinel nodes or poor technique during procurement, resulting in missed detection of actual SLNs.

Organization and Evaluation of Performance Indicators of a Breast Cancer Screening Program in Meknes-Tafilalt Region, Morocco

  • Charaka, Hafida;Khalis, Mohamed;Elfakir, Samira;Khazraji, Youssef Chami;Zidouh, Ahmed;Abousselham, Loubna;El Rhazi, Karima;Lyoussi, Badiaa;Nejjari, Chakib
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권12호
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    • pp.5153-5157
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    • 2016
  • Objective: The benefits of screening and early detection of breast cancer, including reduced morbidity and mortality, have been well-reported in the literature. In 2011, a breast cancer screening program was launched in Meknes-Tafilalt region of Morocco. The aim of this study was to evaluate the early performance indicators of this program. Materials and Methods: This retrospective evaluative study was conducted between April 2012 and December 2014, in Meknes-Tafilalt region of Morocco. Several performance indicators of the breast cancer screening program were calculated: the compliance rate, the positivity rate, the referral rate, the cancer detection rate and the organizational indicators. Results: During 2012-2014, a total of 184,951 women participated in the breast cancer screening program. The compliance rate was 26%, the positive rate was 3.3%, the referral rate was 36.7%, and the cancer detection rate was 1.2 per 1,000 women. The median time between the date of clinical breast examination and the date of biopsy (or cyto-puncture) was 36 days. The median time between the date of positive mammography and the date of biopsy (or cyto-puncture) was 6 days. The median time between the date of clinical breast examination and the date of the first received treatment was 61 days. Conclusions: The program needs better monitoring, as well as implementation of quality assurance tools to improve performance in our country.

유방의 원발성 편평상피암종의 세침흡인 세포학적 소견 - 1예 보고 - (Fine Needle Aspiration Cytology of Squamous Cell Carcinoma of the Breast - Report of A Case -)

  • 김경미;이안희;이교영;서은주;심상인;문한림
    • 대한세포병리학회지
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    • 제7권1호
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    • pp.88-91
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    • 1996
  • A primary squamous cell carcinoma of the breast was evaluated by fine needle aspiration cytology in a 60 year-old female. Squamous cell carcinoma is a rarely encountered lesion in the breast and nine cases of cytologic findings of mammary squamous cell carcinoma have been reported in the world literature. Our case appears to be one of these rare pure squamous cell tumors. The cytologic diagnosis was possible because of the well defined characteristics of the malignant squamous cells, similar to those found in other locations. Thorough examination of the patient did not reveal squamous cell carcinoma elsewhere.

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자장의 세기에 따른 유방 확장기 주위의 인공물 평가 (Evaluation of artifacts around the breast expander according to magnetic field strength)

  • 정동일;김재석
    • 한국정보통신학회논문지
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    • 제24권9호
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    • pp.1144-1149
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    • 2020
  • 유방조직확장기의 Magnetic Valve는 MRI 검사 시 영상 인공물이 발생하여 MRI 검사가 제한적이다. MRI 검사가 필요한 유방조직확장기 삽입 환자에 대해 영상 인공물이 진단영역에 미치는 영향을 평가한다. 자체 제작한 팬텀과 실제 임상 조건을 이용하여 영상 인공물 측정을 실시하였다. 영상 인공물은 1.5 Tesla와 3.0 Tesla 환경에 따라 상이하게 측정되었으며, C-spine, L-spine 검사 시 영상 인공물의 영향이 T-spine에 비해 상대적으로 적었다. 유방암 전이로 인한 MRI 검사가 꼭 필요한 경우 주로 1.5 Tesla에서 Head & Neck 검사와 L-spine 아래 부위를 검사 할 수 있으나 일부 시퀀스에서는 영상 인공물로 인한 왜곡이 발생할 수 있다. 유방조직확장기 삽입 환자의 MRI 검사는 안전성 측면에서는 3.0T는 피하고 1.5T에서 조건부로 가능하다.

직장여성의 유방암 검진행위 분석 (Breast Cancer Screening Behaviors in Working Women)

  • 한미연;정재원
    • 여성건강간호학회지
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    • 제12권4호
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    • pp.363-370
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    • 2006
  • Purpose: The aim of this study was to analyze breast cancer screening behaviors in working women. Method: A total of 354 women over 20 years of age were recruited from three major occupational settings by convenience sampling. The Champion's Health Beliefs Model Scale-Korean version and a structured questionnaire for measuring regularity and accuracy of breast self-examination(BSE) were used. Data were analyzed using descriptive statistics, $x^$-test, ANOVA, and Duncan post hoc tests. Result: Women who have performed BSE and had both BSE and clinical tests were 49.2% and 32.8%, respectively, while 36.7% of the participants had none of the screening. The screening patterns were significantly different by individual characteristics of age, occupation, experiences of breast disease, education at workplace, and by the level of confidence in health beliefs (p<.01, p<.05). Only 4 % of women performed BSE regularly and the level of accuracy of the BSE was very low as well. Conclusion: Education at the workplace needs to emphasize the recommended guidelines and further increase the quality and results of the BSE for women's health.

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유방자가검진 이행정도별 건강신념의 차이와 이행요인 (Differences in Health Belief by Compliance Level with Breast Self-Examination and Predictors of BSE among Women)

  • 박경연
    • 기본간호학회지
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    • 제16권4호
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    • pp.472-480
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    • 2009
  • Purpose: The purpose of this study was to explore differences in health belief by compliance level with breast self-examination (BSE) and the predictors of BSE compliance among women. Method: Using a convenience sampling method, 163 women were selected for the sample. Data were measured for each participant during the period between December 2008 and February 2009, and analyzed by chi-square test, t-test, Kruskal-Wallis test with post hoc, and logistic regression analysis. Samples were categorized into three groups by the compliance level of BSE for the last 6 months: Never-performers (i.e, women who had never performed BSE), irregularly-performers (i.e, women who performed BSE at least once), and regularly-performers (i.e, women who performed monthly BSE). Result: Significant differences were reported among never-performers, irregularly-performers and regularly-performers correlated to age, level of education, mammography, ultrasonography, clinical examination, benefit, and confidence. There was no significant difference between irregularly-performers and regularly performers. The significant factor influencing compliance with BSE was 'confidence', which explained 33.7% of the variance in compliance with BSE. Conclusion: Women who had more confidence in their ability to perform BSE were more likely to practice BSE. It is necessary to develop the strategy to enforce woman's confidence in complying with BSE.

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Nine months versus 12 months of adjuvant trastuzumab for patients with HER2-positive breast cancer

  • El-Enbaby, Ashraf Mahmoud;El Moneim, Nadia Ahmed Abd;Khedr, Gehan Abd El atti;Elwany, Yasmine Mohamed Nagy
    • 대한종양외과학회지
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    • 제14권2호
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    • pp.108-115
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    • 2018
  • Purpose: This study aimed to compare the results of treatment with adjuvant trastuzumab for 9 months versus 12 months in human epidermal growth factor 2 (HER2)-positive breast cancer patients. The primary endpoint was disease-free survival. Secondary endpoints included cardiac safety, tolerability, and overall survival. Methods: The study included 60 non-metastatic HER2-positive breast cancer patients. All study patients underwent surgery, received adjuvant chemotherapy, radiotherapy and hormonal therapy if indicated. Thirty patients were randomized in each group. Group I patients received adjuvant trastuzumab for 12 months, while group II patients received adjuvant trastuzumab for 9 months. Patients were assessed by clinical examination and Echocardiography during treatment. Results: After median follow-up of 12 months, 90% of the patients in group I were disease free and 83.3% of patients in group II were disease free (P=0.402). All studied population in both groups I and II were alive at the end of the 1-year follow-up period after the completion of adjuvant trastuzumab treatment thus overall survival is 100%. Conclusion: Trastuzumab is tolerable and its side effects are reversible. Nine months of adjuvant trastuzumab treatment is more cost effective than the standard 12 months.