• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6067-6072
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• 2012

Background: Breast cancer in developing countries is on the rise. There are currently no guidelines to screen women at risk in India. Since mammography in the western world is a well-accepted screening tool to prevent late presentation of breast cancer and improve mortality, it is intuitive to adopt mammography as a screening tool of choice. However, it is expensive and fraught with logistical issues in developing countries like India. Materials and Methods: Our breast cancer screening camp was done at a local district hospital in India after approval from the director and administrators. After initial training of local health care workers, a one-day camp was held. Clinical breast examination, mammograms, as well as diagnostic evaluation with ultrasound and fine needle aspiration biopsy were utilized. Results: Out of total 68 women screened only 2 women with previous history of breast cancer were diagnosed with breast cancer recurrence. None of the women in other groups were diagnosed with breast cancer despite suspicious lesions either on clinical exam, mammogram or ultrasound. Most suspicious lesions were fibroadenomas. The average cost of screening women who underwent mammography, ultrasound and fine needle aspiration was $30 dollars, whereas it was $16 in women who had simple clinical breast examination. Conclusions: Local camps act as catalysts for women to seek medical attention or discuss with local health care workers concerns of discovering new lumps or developing breast symptoms. Our camp did diagnose recurrence of breast cancer in two previously treated breast cancer patients, who were promptly referred to a regional cancer hospital. Further studies are needed in countries like India to identify the best screening tool to decrease the presentation of breast cancer in advanced stages and to reduce mortality.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6783-6790
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• 2013

Background: Breast cancer is the commonest type of cancer among women, and in Malaysia 50-60% of the new cases are being detected at late stages. Do age, education level, income, ethnicity, relationship with breast cancer patients and knowledge of breast cancer risk factors influence breast screening practices? This study revealed interesting but significant differences. Objectives: To assess the knowledge of breast cancer risk factors and early detection measures among women in a high risk group. Materials and Methods: A cross sectional survey of one hundred and thirty one women relatives of breast cancer patients was carried out. Participants were selected through purposive sampling, during hospital visits. A self-administered questionnaire was used for data collection. Results: The majority of the respondents (71%) had poor knowledge of the risk factors for breast cancer. Income, relationship with a patient and practise of breast cancer screening predicted performance of mammography, $R^2$=0.467, F=12.568, p<0.0001. Conclusions: The finding shows inadequate knowledge of breast cancer risk factors and poor cancer screening practise among women with family history of breast cancer. Poor knowledge and practise of breast screening are likely to lead to late stage presentation of breast cancer disease. Some important predictors of breast cancer screening behaviour among women with positive family history of breast cancer were identified. An understanding of the strengths and significance of the association between these factors and breast screening behaviour is vital for developing more targeted breast health promotion.

• 보건교육건강증진학회지
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• 제29권3호
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• pp.75-89
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• 2012

Objectives: This study was performed to identify the level of health literacy and to investigate the relationship between the health literacy and preventive health care use in middle-aged adults in Korea. Methods: A total of 315 adults aged 40 to 64 years living in Seoul participated in the study. Data were collected from December 15-24, 2010 from outpatient hospitals, clinics, workplaces and other locations in the community. Health literacy was measured using the Functional Health Literacy and Self-rated Health Literacy Questionnaires. Preventive health service use was defined as receiving screening (general health checkups, gastric and colorectal cancer, mammogram, and pap smear) and influenza vaccination. Descriptive analysis, t-test, and ANOVA were used. Results: The mean of functional health literacy was 3.87 (score range 0-6) and the self-rated health literacy was 60.08 (score range 16-80). The most difficult items of the self-rated questionnaires were patient educational materials provided by health care providers and medical forms. The most difficult items of functional health literacy were information-based, including nutritional facts and clinical schedules. Association between health literacy and preventive health service use was not found. Conclusions: Further study is necessary with larger samples and with considerations for their education level, age, and preventive health care use.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8719-8724
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• 2014

Background: Breast cancer incidence is increasing among South Asian migrants to the United States (US). However, their utilization of cancer screening services is poor. This study characterizes attitudes of South Asians towards breast health and screening in a community sample. Materials and Methods: A cross-sectional survey based on the Health Belief Model (HBM) was conducted among South Asians (n=124) in New Jersey and Chicago. The following beliefs and attitudes towards breast cancer screening were assessed-health motivation, breast self-examination confidence, breast cancer susceptibility and fear, and mammogram benefits and barriers. Descriptive statistics and Spearman rank correlation coefficients were computed for HBM subscales. Findings: Mean age of participants was 36 years with an average 10 years stay in the US. Most women strived to care for their health ($3.82{\pm}1.18$) and perceived high benefits of screening mammography ($3.94{\pm}0.95$). However, they perceived lower susceptibility to breast cancer in the future ($2.30{\pm}0.94$). Conclusions: Increasing awareness of breast cancer risk for South Asian women may have a beneficial effect on cancer incidence because of their positive attitudes towards health and breast cancer screening. This is especially relevant because South Asians now constitute one of the largest minority populations in the US and their incidence of breast cancer is steadily increasing.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6307-6313
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• 2014

The aim of this study was to examine the knowledge and awareness of women in Kuwait with regard to risk factors, symptoms and diagnostic procedures of breast cancer. A total of 521 questionnaires were distributed among women in Kuwait. Results showed that 72% of respondents linked breast cancer factors to family history, while 69.7% scored abnormal breast enlargement as the most detectable symptom of the disease. Some 84% of participants had heard about self-examination, but knowledge about mammograms was limited to 48.6% and only 22.2% were familiar with diagnostic procedures. Some 22.9% of respondents identified the age over 40 years as the reasonable age to start mammogram screening. Risk factor awareness was independent on age groups (p>0.05), but both high education and family history increased the likelihood of postivie answers; the majority knew about a few factors such as aging, pregnancy after age 30, breast feeding for short time, menopause after age of 50, early puberty, and poor personal hygiene. In conclusion, 43.1% of participants had an overall good knowledge of breast cancer with regards to symptoms, risk factors and breast examination. Very highly significant associations (p<0.005) were evident for all groups except for respondents distributed by nationality (p=0.444). Early campaigns for screening the breast should be recommended to eliminate the confusion of wrong perceptions about malignant mammary disease.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4647-4650
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• 2013

Background: Breast illumination was suggested as a simple method for breast cancer screening. BreastLight is a simple apparatus for this purpose. Objective: To evaluate the diagnostic performance of BreastLight as a screening tool of breast cancer in comparison to mammography and histopathology. Materials and Methods: This hospital-based cross sectional study was conducted in the mammography unit of the radiodiagnosis department at National Cancer Institute, Cairo University. All participants were subjected to breast examination with the BreastLight tool, mammography and ultrasonography. Suspicious cases were biopsied for histopathological examination which is considered as a gold standard. Results: The mean age of the participants was $46.3{\pm}12.4$ years. Breast illumination method had sensitivity, specificity, positive predictive value, negative predictive value and total accuracy of 93.0%, 73.7%, 91.4%, 77.8% and 88.2%, respectively in detection of breast cancer. Conclusions: Breast illumination method with BreastLight apparatus is a promising easy-to-use tool to screen for breast cancer suitable for primary health care physician or at-home use. It needs further evaluation especially in asymptomatic women.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5759-5765
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• 2014

Electrical impedance tomography (EIT) is a potential supplement for mammogram screening. This study aimed to evaluate and feasibility of EIT as opposed to mammography and to determine pain perception with both imaging methods. Women undergoing screening mammography at the Radiology Department of National University of Malaysia Medical Centre were randomly selected for EIT imaging. All women were requested to give a pain score after each imaging session. Two independent raters were chosen to define the image findings of EIT. A total of 164 women in the age range from 40 to 65-year-old participated and were divided into two groups; normal and abnormal. EIT sensitivity and specificity for rater 1 were 69.4% and 63.3, whereas for rater 2 they were 55.3% and 57.0% respectively. The reliability for each rater ranged between good to very good (p<0.05). Quantitative values of EIT showed there were significant differences in all values between groups (ANCOVA, p<0.05). Interestingly, EIT scored a median pain score of $1.51{\pm}0.75$ whereas mammography scored $4.15{\pm}0.87$ (Mann Whitney U test, p<0.05). From these quantitative values, EIT has the potential as a health discriminating index. Its ability to replace image findings from mammography needs further investigation.

• 한국멀티미디어학회논문지
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• 제13권5호
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• pp.702-709
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• 2010

Mass형 종양 분할의 성능은 mass의 초기 위치에 큰 영향을 받는다. 따라서 몇몇의 논문들은 방사선 전문의로부터 획득한 mass의 초기 위치를 이용하여 종양의 분할을 진행하였다. 그러나, 본 논문은 mass 검출을 위한 부가정보 없이 디지털 마모그램만을 이용한 컴퓨터 지원 진단 시스템을 구성하여 방사선 전문의에게 mass로 추정되는 곳의 위치를 제시함을 목표로 한다. 제안된 시스템은 영역 확장 기법과 열림 연산을 통한 유방 영역 분할, 분할된 유방영역에서 mass 특성을 갖는 위치의 시드 설정, 설정된 시드 기반 레벨 셋을 통한 mass 영역 분할로 구성된다. Mass 분할을 위한 시드 설정은 부표본화된 유방영상에 대해 블록기반 분산 정보와 마스킹 정보를 이용하는 Mass Scoring Measure(MSM) system을 통하여 수행되었다. 테스트에 사용된 이미지는 DDSM 데이터베이스를 사용하였으며, 실험 결과 종양검출의 정확도는 4 FP/image에서 78%의 민감도를 나타내었고, 상하방향(CC)과 내외사방향(MLO) 이미지를 동시 고려시 92%의 민감도를 보였다.

• 대한의용생체공학회:의공학회지
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• 제32권2호
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• pp.158-164
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• 2011

Breast cancer is the most frequently appearing cancer in women, these days. To reduce mortality of breast cancer, periodic check-up is strongly recommended. X-ray mammography is one of powerful diagnostic imaging systems to detect 50~100 um micro-calcification which is the early sign of breast cancer. Although x-ray mammography has very high spatial resolution, it is not easy yet to distinguish cancerous tissue from normal tissues in mammograms and new tissue characterizing methods are required. Recently ultrasound elastography technique has been developed, which uses the phenomenon that cancerous tissue is harder than normal tissues. However its spatial resolution is not enough to detect breast cancer. In order to develop a new elastography system with high resolution we are developing x-ray elasticity imaging technique. It uses the small differences of tissue positions with and without external breast compression and requires an algorithm to detect tissue displacement. In this paper, computer simulation is done for preliminary study of x-ray elasticity imaging. First, 3D x-ray breast phantom for modeling woman's breast is created and its elastic model for FEM (finite element method) is generated. After then, FEM experiment is performed under the compression of the breast phantom. Using the obtained displacement data, 3D x-ray phantom is deformed and the final mammogram under the compression is generated. The simulation result shows the feasibility of x-ray elasticity imaging. We think that this preliminary study is helpful for developing and verifying a new algorithm of x-ray elasticity imaging.