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Published in Guillaume Madelin, X-Nuclei Magnetic Resonance Imaging, 2022
Treatments for breast cancer such as prophylactic mastectomy or chemoprevention are more effective when the disease is detected at an early stage. Mammography is the standard method for breast cancer screening [123] with high specificity (>90%) but has a very variable sensitivity (30–60%) due to difficult lesion detection in dense breast tissue [124–126]. Ultrasound (US) is a supplemental method for women with high-risk and dense breast tissue that can increase screening sensitivity, but can also lead to higher false-positive rates [127]. Standard proton MRI has a higher sensitivity (75–90%) and is less affected by the breast tissue density, but has lower specificity (70–90%) [124, 127]. False-positive diagnoses from these screening methods result in increased patient anxiety, overdiagnosis and unnecessary biopsy, or overtreatment [128]. Dynamic contrast-enhanced MRI (DCE-MRI) is the most sensitive MRI method to detect breast cancer and assess tumor size, with a good specificity, and can provide to some extent functional information about tumor perfusion and vascularity. Other 1H MR techniques such as DWI, PWI and MRS can also be added to the scan protocol to provide more specific information about the hallmarks of cancer as a multiparametric MRI method [129], and improve sensitivity and specificity of breast cancer detection and therapy assessment.
Mammographic Screening and Breast Cancer Management – Part 1
Published in Sandeep Reddy, Artificial Intelligence, 2020
Breast density is associated with higher risk of breast cancer, although the degree of relative risk increase varies across the literature. Assessment of density is variable across computational methods, human radiologist assessment, and its correlation with breast cancer (Destounis et al., 2017). Screening programs may or may not notify women with high density, with 38 states in the USA recently legislating mandatory notification (Keating & Pace, 2019). Density is thought to confer increased risk via two mechanisms: Dense breast tissue can have the effect of masking cancerous lesions.Women with dense breasts have relatively more tissue from which cancer can generate (Kerlikowske & Vachon, 2016).
Imaging of the Breast with Photon-Counting Detectors
Published in Katsuyuki Taguchi, Ira Blevis, Krzysztof Iniewski, Spectral, Photon Counting Computed Tomography, 2020
Stephen J. Glick, Bahaa Ghammraoui
It is known that women with radiographically dense breast tissue are at increased risk of developing breast cancer.26,47 Breast density is typically assessed using the BI-RADS breast density rating scale that places patients into one of four categories, namely; fatty, scattered density, heterogeneously dense, and extremely dense. However, the assignment of BI-RADS scores is a subjective process, and inter-rate agreement is generally low. Some studies have suggested a Cohen's kappa coefficient to assess breast radiologist agreement of between 0.44 and 0.54.29,30 One approach to reducing this observer variability is the use of quantitative algorithms that can estimate area-based or volume-based breast density.48–51 Another idea involves using dual-energy mammography to estimate breast density52,53; however, this approach is limited in that it typically requires two scans at two different time points, and the delay between scans can result in motion artifacts.
Investigating the effectiveness of supplemental breast cancer screening tests considering radiologists’ bias
Published in IISE Transactions on Healthcare Systems Engineering, 2023
Mahboubeh Madadi, Sevda Molani, Donna L. Williams
Breast density is associated with increased progression of tumor-associated collagen signatures which provides a link between density and carcinoma progression (Provenzano et al., 2008). In addition, there is evidence to support positive association between high breast density and tumor size (Nazari & Mukherjee, 2018; Shawky et al., 2019). Previous studies have shown that the relative risk of breast cancer associated with breast density is substantially higher than other risk factors such as breast cancer family history and menstrual and reproductive risk factors (Keefer, 2012). The reported odds ratio for developing breast cancer for the most dense compared with the least dense breast tissue categories ranges from 1.46 (Duffy et al., 2018) to 6.0 (Harvey, 2004). Additionally, higher breast density can significantly reduce the mass detection rate since the normal tissues in dense breasts appear as bright areas in mammography. Due to the lower sensitivity of screening mammography in women with dense breasts, the cancer is more likely to remain undetected. Breast density is a dynamic risk factor and typically decreases as a patient becomes older (Lokate et al., 2013; Vachon et al., 2007; Work et al., 2014). Younger women (especially those in pre-menopausal status) are more likely to have dense breasts (Aiello et al., 2005). According to Mandelblatt et al. (2016), 58.8% of women aged 40–49 have highly dense breasts, while this percentage decreases to 42.7% and 31.1% for women aged 50–64 and 65–74, respectively.
Air pollution and molecular changes in age-related diseases
Published in International Journal of Environmental Health Research, 2022
B. Hermanova, P. Riedlova, A. Dalecka, V. Jirik, V. Janout, R. J. Sram
Breast cancer is the most frequently diagnosed cancer in the majority of European women. Certain factors are known to increase the risk of this cancer, including hormonal, nutritional and environmental factors, as well as genetic factors (the most important genes BRCA1/BRCA2). One risk factor already mentioned above is the environment in which we live and its associated polluted air. This is a mixture of chemicals containing carcinogenic compounds and substances with endocrine-disrupting properties. It may also result in the development of gene sequence variants (Homaei Shandiz and Hadizadeh Talasaz 2017). Fine particles in the air can promote inflammation or densify breast tissue, and for these reasons exposed women may be more susceptible developing tumours. Women with dense breast tissue are several times more likely to develop some form of breast cancer (Villeneuve et al. 2018). Studies conducted in Canada, Denmark and the USA, for instance, have found that women living in urban areas with high levels of air pollution have as much as a 30% higher risk of developing breast cancer than women living in rural areas. A positive link was also found between premenopausal breast cancer and PM2.5 exposure and a postmenopausal breast cancer and exposure to NO2 (Meijer et al. 2012; Homaei Shandiz and Hadizadeh Talasaz 2017; Schmidt 2018; Villeneuve et al. 2018; White et al. 2018). But Spanish cohort Sister Study found no association between ambient air pollution and breast cancer risk (Reding et al. 2015).