European journal of breast health最新文献

{"title":"Construction of Low-Cost Simulators for Training in Minimally Invasive Breast Procedures.","authors":"Mirian Khéde Careta, Maura Alambert, Rafael Da Silva Sá, Simone Elias","doi":"10.4274/ejbh.galenos.2023.2023-8-6","DOIUrl":"10.4274/ejbh.galenos.2023.2023-8-6","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this work was to describe a technique for building low-cost simulators for training in minimally invasive breast procedures guided by ultrasound (US) and stereotactic mammography (MMG), focusing mainly on training medical professionals studying related areas.</p><p><strong>Materials and methods: </strong>Low-cost phantoms were developed using organic structures that mimic breast tissue, such as chicken breast and eggplant, and materials that simulate breast lesions. A step-by-step description of the preparation and use of these simulators was made, enabling the reproducibility of the technique by the physicians in training themselves.</p><p><strong>Results: </strong>The low-cost phantoms showed a high degree of echogenic and radiological similarity with human breast tissue, allowing adequate training in minimally invasive procedures.</p><p><strong>Conclusion: </strong>It was possible to build low-cost phantoms that allow training in US- and stereotactic MMG-guided minimally invasive breast procedures.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"64-70"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Influence of Geodimensional and Histological Parameters on the Need for Margin Widening in Breast Lesions Marked With Magnetic Seeds.","authors":"João T Oliveira, Ana Munhoz, Jm Preza Fernandes, Cláudia Paiva, Tânia Teixeira, Susana Marta, José Polónia","doi":"10.4274/ejbh.galenos.2023.2023-11-5","DOIUrl":"10.4274/ejbh.galenos.2023.2023-11-5","url":null,"abstract":"<p><strong>Objective: </strong>Breast cancer is an important topic worldwide, posing morbidity and mortality to women. Considerable efforts have been put in the early recognition of malignancy through different screening methods, such as mammography and ultrasound. The precise localization of infraclinical malignant lesions is key in surgical management and magnetic seeds gather particular interest for this purpose. As with other systems, a need for reintervention may be needed to obtain adequate surgical margins. This work evaluated the relation between the need for surgical reintervention in order to obtain negative margins and geodimensional and histological parameters. The main objective was the identification of parameters significantly associated with reintervention for margin widening.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 198 patients from a single centre was performed. The association between pre-defined geodimensional and histological parameters and the need for margin widening in infraclinical lesions marked with magnetic seed was evaluated.</p><p><strong>Results: </strong>Results showed that reintervention to widen margins was significantly higher in patients with ductal carcinoma <i>in situ</i> (DCIS) in the pre-operative biopsy when compared with invasive carcinoma (<i>p</i> = 0.03) in the bivariate analysis. No statistically significant differences were observed between the need for reintervention and lesion size (<i>p</i> = 0.197), breast quadrant location (<i>p</i> = 0.626) and distance of skin to lesion (<i>p</i> = 0.356).</p><p><strong>Conclusion: </strong>This work suggests that a more invasive margin clearance in lesions with a pre-operative DCIS diagnosis might obviate the need for reintervention to obtain negative margins. On the other hand, it is not necessary to be surgically more invasive in larger lesions, deeply located or that are present in a certain quadrant, since there are no significant differences regarding the need for reintervention.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"31-37"},"PeriodicalIF":1.3,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Approaches in Breast Cancer Radiotherapy.","authors":"Niyazi Volkan Demircan, Nuran Bese","doi":"10.4274/ejbh.galenos.2023.2023-11-4","DOIUrl":"10.4274/ejbh.galenos.2023.2023-11-4","url":null,"abstract":"<p><p>Breast cancer stands as the most prevalent malignancy, necessitating a well-established approach to its management due to its sustained prevalence over decades. The implementation of intensive treatments, combining various modalities, has yielded excellent survival outcomes. Consequently, the optimization of quality of life and the mitigation of long-term side effects emerge as critical considerations for clinicians. As a result, discussions regarding treatment de-intensification strategies have been initiated for all treatment modalities, including surgery, radiotherapy (RT), and chemotherapy. RT plays a crucial role in adjuvant therapy. The efficacy of RT in disease control and overall survival across all stages of breast cancer has been demonstrated in numerous clinical trials and meta-analyses utilizing extensive datasets. However, advancements in genetic tumor profiling and improved identification of disease subgroups have prompted a reevaluation of RT omission in low-risk groups as a strategy for treatment de-intensification. Conversely, technological improvements and shortened total treatment times with hypofractionation make RT a secure and feasible option for enhancing local control and survival with minimal impact on the quality of life.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical and Pathological Characteristics That Differentiate Cases With \"Low Estrogen Receptor Expression\" From Triple-Negative Breast Cancer.","authors":"Cem Karaali, Mümin Emiroğlu, Mustafa Değirmenci, Murat Keser, Semra Salimoğlu, Canan Kelten Talu","doi":"10.4274/ejbh.galenos.2023.2023-6-3","DOIUrl":"10.4274/ejbh.galenos.2023.2023-6-3","url":null,"abstract":"<p><strong>Objective: </strong>Estrogen receptor (ER) expression is an immunohistochemical marker that is examined in all invasive breast cancers and has prognostic and predictive value. ER-positive breast cancers refer to those that show positivity for ER at 1% cellular expression or higher. The American Society of Clinical Oncology/College of American Pathologists guidelines suggest using the term \"low ER-positive breast cancer\" for tumors with ER expression between 1% and 10%. Low ER-positive breast cancers exhibit similarities, in terms of disease-free survival and overall survival rates, to triple-negative breast cancers (TNBCs) rather than ER-positive breast cancers. In this study, our aim was to compare the clinicopathological characteristics of low ER-positive breast cancer cases diagnosed and followed in our clinic with TNBCs.</p><p><strong>Materials and methods: </strong>A total of 26 cases of low ER-positive breast cancer diagnosed at University of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital between 2010 and 2016 were retrieved from hospital records. The relevant histopathology slides and blocks were retrieved and re-evaluated retrospectively through microscopic examination. Thirteen cases that met the criteria were included in the study. Additionally, a consecutive series of 13 TNBC cases that did not receive neoadjuvant treatment within the same time period were identified.</p><p><strong>Results: </strong>In the low ER-positive group, the presence of tumor necrosis, as well as histological grade, nuclear grade and Ki-67 proliferation index were significantly lower compared to the TNBC group. Ductal carcinoma <i>in situ</i> (DCIS) was significantly more common in the low ER-positive group compared to the TNBC group. There were no significant differences between the two groups in terms of tumor size, histological tumor type, axillary lymph node involvement, tumor margins, peritumoral and intratumoral inflammation, local recurrence, distant metastasis, survival, and other characteristics.</p><p><strong>Conclusion: </strong>Although our study consisted of a small number of cases, some features showed significant differences between low ER-positive breast cancers and TNBCs. Histological and nuclear grades, as well as the presence of a DCIS component, were associated with low ER-positive breast cancer. In contrast, the presence of tumor necrosis, as well as Grade 3 features and a high Ki-67 proliferation index indicated TNBC.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"19-24"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mastalgia - The Burden Beneath.","authors":"Akanksha Arvind Sharma, Ashwani Kumar, Dinesh Kumar Pasi, Parth Dhamija, Gurleen Kaur Garry, Anshu Saini, Ruchi Jakhar","doi":"10.4274/ejbh.galenos.2023.2023-3-10","DOIUrl":"10.4274/ejbh.galenos.2023.2023-3-10","url":null,"abstract":"<p><strong>Objective: </strong>Mastalgia is the most common breast-related complaint. A multitude of hormonal changes and lifestyle associated factors have been implicated in its causation. A long list of treatment modalities have been tried with varying success rates. To identify the most common risk factors and the most effective management strategies for mastalgia in our clinic population.</p><p><strong>Materials and methods: </strong>A total of 100 women between 18-65 years of age presenting to the breast clinic with mastalgia were followed throughout their course of diagnosis and management. Stepwise treatment was provided, starting with reassurance and breast support and progressing to include pharmacological measures, when necessary. The risk factors and outcomes of treatment were analysed.</p><p><strong>Results: </strong>The majority (66%) were aged 25-47 years and the left breast was found to be most frequently involved. Involvement of the upper outer quadrant was significantly more common. Lump/nodularity was the most prevalent risk factor. Most patients showed a positive response to non-steroid anti-inflammatories (NSAIDs) in addition to reassurance, breast support and dietary changes.</p><p><strong>Conclusion: </strong>A detailed history and clinical examination helps to identify the risk factors and the best approach for the management of mastalgia. Educating women regarding breast self-examination at regular intervals helps in early presentation and diagnosis of the underlying condition. Reassurance, breast support and lifestyle changes are the first line treatment and have good results in a significant number of patients. In our practice topical and oral NSAIDs, evening primrose oil and vitamin E were frequently used as additional treatments to non-pharmacological methods.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"15-18"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of the Radiofrequency Identification Technique in Breast Cancer Patients: A Single Institution Retrospective Study.","authors":"Mahmoud Kassem, Ahmed Kamr, Creighton B Wright, Anna P Sobolewski","doi":"10.4274/ejbh.galenos.2023.2023-10-9","DOIUrl":"10.4274/ejbh.galenos.2023.2023-10-9","url":null,"abstract":"<p><strong>Objective: </strong>Breast conserving surgery is an excellent option in the treatment of breast cancer. To achieve a good result with this modality, a surgeon needs to identify and excise the tumor with adequate margins. The radiofrequency identification (RFID) technique is a wireless localization technique used for intraoperative breast lesion identification. We assessed the efficacy and outcomes of the RFID technique in breast cancer patients at our institution.</p><p><strong>Materials and methods: </strong>This is a single institution, retrospective study (BSMH 22-02X-MWH) of 73 patients. We analyzed the medical records of women with biopsy-proven breast cancer from June 2020 to August 2022; participants received surgical care at Mercy Health West Hospital. Data collected included demographics, clinicopathological characteristics, and surgical procedure. The primary objective was to determine the safety and efficacy of RFID. The secondary objective was to assess the impact of obesity and breast density on the RFID outcomes.</p><p><strong>Results: </strong>A total of 73 female patients met the eligibility criteria with stage I (59%) and grade 1 (51%) breast cancer with mean age of at diagnosis of 66.8 years and mean body mass index of 31.4 kg/m2. Patients had invasive ductal carcinoma (61%), hormonal positive (56%), and human epidermal growth factor receptor 2 negative (68%) disease. All RFID tags were placed under image guidance with 100% accuracy of placement with no evidence of migration or procedure revision. Ninety percent of patients had free surgical margins and only seven patients needed margin re-excision with successful removal of the lesion and the tag.</p><p><strong>Conclusion: </strong>RFID localization technique is a safe, effective and reliable procedure that results in favorable patient outcomes and quality of life.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"52-56"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omission of Radiotherapy in Women >60 Years Old After Breast Conserving Surgery for Breast Cancer is Non-Inferior in Terms of Local Recurrence: A Retrospective Cohort Study.","authors":"Anna Sachoulidou, Fani Apostolidou, Charalambos Fronis, Despoina Misailidou, Aichan Bozoglou, Themis Anastasia Tataridou, Aristomenis Ampatzoglou, Ioannis Galanis","doi":"10.4274/ejbh.galenos.2023.2023-9-5","DOIUrl":"10.4274/ejbh.galenos.2023.2023-9-5","url":null,"abstract":"<p><strong>Objective: </strong>Local recurrence rate may show no significant differences between women aged 60 and older who receive breast-conserving surgery followed by radiotherapy and those in the same age group who undergo breast-conserving surgery without subsequent radiotherapy.</p><p><strong>Materials and methods: </strong>Retrospective cohort study from a single practice with median follow-up time 44 months (interquartile range: 16, 82), comparing women older than 60 years old at diagnosis of breast cancer, treated with breast conserving surgery and either receiving or not receiving radiation therapy postoperatively. The primary endpoint was local recurrence difference between the two groups.</p><p><strong>Results: </strong>Local recurrence did not differ significantly between the two groups in terms of radiotherapy or not [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.89-1.02, Fisher's exact test <i>p</i> = 0.388], nor between two age groups with cut-off at 65 years of age (OR: 0.99, 95% CI 0.92-1.07, Fisher's Exact test <i>p</i> = 0.6). Local recurrence also did not differ when subgroups of age (60-65 years and >66 years) were considered. All patients received 5 years of hormonal therapy.</p><p><strong>Conclusion: </strong>Omission of radiotherapy in selected patients is not inferior to radiotherapy after breast conserving surgery in terms of preventing local recurrence.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"38-44"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Usefulness a Coronal View using an Automated Breast Ultrasound System in Detecting Breast Lesions.","authors":"Megumi Suzuki, Ryohei Nakayama, Kiyoshi Namba, Hiroyuki Kawami, Mayumi Nara, Seigo Nakamura","doi":"10.4274/ejbh.galenos.2023.2023-11-6","DOIUrl":"10.4274/ejbh.galenos.2023.2023-11-6","url":null,"abstract":"<p><strong>Objective: </strong>An automated breast ultrasound system (ABUS) combined with screening mammography has increased cancer detection rates; however, supplemental ABUS use has increased recall rates. In this study, we aimed to identify an accurate and efficient method of ABUS interpretation and evaluate the potential usefulness of its coronal view versus the conventional transverse view.</p><p><strong>Materials and methods: </strong>This retrospective observer study included comprised 114 ABUS cases (40 normal, 35 benign, 39 malignant). Ten physicians from multiple institutions interpreted the anonymized coronal and transverse views independently. The observers scored their confidence in the lesion detection for each case using a continuous scale and recorded reading times for each coronal and transverse view interpretation. Free-response receiver operating characteristic analysis was employed to compare detection accuracies between views; a paired t-test was used to compare the average reading times.</p><p><strong>Results: </strong>Detection accuracy did not differ significantly between the coronal and transverse views (figure of merit=0.740 and 0.745, respectively; <i>p</i> = 0.72). However, the average reading time for the coronal view was significantly shorter than that for the transverse view (149.7 <i>vs.</i> 200.3 seconds per case, <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>The coronal view obtained with the ABUS was useful for interpretation and associated with significantly shorter reading times compared with the conventional transverse view while maintaining breast lesion detection accuracy.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Relationship Between Tamoxifen and Hereditary Angioedema.","authors":"Ana Raquel Pinto, Fabrícia Carolino","doi":"10.4274/ejbh.galenos.2023.2023-12-9","DOIUrl":"10.4274/ejbh.galenos.2023.2023-12-9","url":null,"abstract":"","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"71-72"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Granulomatous Mastitis With Steroids: Should the Decision to End the Treatment be Made Radiologically?","authors":"Kenan Çetin, Hasan Ediz Sıkar, Fatih Feratoğlu, Bağış Taşdoğan, Bahadır M Güllüoğlu","doi":"10.4274/ejbh.galenos.2023.2023-9-2","DOIUrl":"10.4274/ejbh.galenos.2023.2023-9-2","url":null,"abstract":"<p><strong>Objective: </strong>Idiopathic granulomatous mastitis (IGM) is a benign inflammatory breast disease of unknown etiology that affects women in their reproductive period. The most commonly preferred option as first-line treatment is steroids, but the lack of a standard treatment protocol and high recurrence rate after treatment constitutes a recurring challenge during its management. The aim of this study was to investigate whether the decision to end the treatment should be made radiologically or clinically.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included IGM patients who had complete clinical recovery with steroids and were followed for a minimum of 30 months. Patient demographics, disease severity and findings, treatment regimens and duration, and magnetic resonance imaging (MRI) findings at clinical recovery were assessed for their relation to recurrence.</p><p><strong>Results: </strong>Eighty-nine patients who were clinically completely healed after steroid treatment for IGM were included in the study. At the time of clinical healing, 51 (57.3%) patients had a complete radiological response and 38 (42.7%) had a partial radiological response (PRR) on MRI. Overall, recurrence developed in 22 (24.7%) patients after a median 38.6-month follow-up. Patients who experienced recurrence were significantly older and had PRR when their treatment was stopped upon clinical healing.</p><p><strong>Conclusion: </strong>During the process of clinical healing, the imaging findings revealed that the remaining disease seems to be a significant predictor for recurrence in IGM patients. In patients with PRR, extending the treatment with either prolonged steroid therapy or by surgical excision of the occult residual disease may prevent recurrences in IGM patients.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"20 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}