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Breast cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sarah J Vinnicombe, Alexandra Athanasiou
Recommendations on the frequency of surveillance mammography vary. The Royal College of Radiologists and the National Institute for Clinical Excellence (NICE) in the UK recommend annual mammography from 1 year post-completion of treatment until 50 years of age, but there is no clear consensus on surveillance for women over 50 (206). In the US, the American Society of Clinical Oncology (ASCO) recommends indefinite annual mammography. The UK phase III randomized controlled trial, Mammo-50, comparing annual and biennial DM for women treated with BCS, will provide important information on optimal frequency, cost-effectiveness, and quality of life (207). Most guidelines do not support the use of whole-breast ultrasound in surveillance even if the index lesion was mammographically occult. Continued screening with breast MRI is recommended for those at high risk, e.g. BRCA carriers. MRI is highly sensitive in women with a personal history and has detection rates similar to those of women with a genetic or family history, but cost-effectiveness is not established (208).
Breast imaging
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Breast ultrasound imaging is performed with high-frequency transducers to produce dynamic examinations of all types of breast tissues. It is used as the preferred imaging modality in younger women (<40 years old) in the triple assessment of breast symptoms alongside clinical palpation and pathological assessment[23; 24]. In the older woman it is used as an adjuvant to other imaging modalities, especially mammography. Ultrasound can assess the size, shape and echotexture of lesions.
Breast cancer
Published in Ruijiang Li, Lei Xing, Sandy Napel, Daniel L. Rubin, Radiomics and Radiogenomics, 2019
Ultrasound imaging (sonography) of the breast uses sound waves to produce pictures of the internal structures of the breast. Breast ultrasound is primarily used for working up suspicious lesions that may have been found during a physical exam, from screening mammograms, or other imaging modalities. Thus, ultrasound is typically used to characterize a suspicious lesion (6).
Increasing importance of breast cancer in Nepal
Published in Hospital Practice, 2022
Ruqaiyyah Siddiqui, Ajnish Ghimire, Jibran Sualeh Muhammad, Naveed Ahmed Khan
Most of the tertiary hospitals in Nepal offer mammography facilities. However, only when mammography detects the lesion of breast cancer, high-resolution ultrasound is performed for detection and differentiation [74]. With only one private cancer hospital in Far-western Nepal as shown in Figure 1, most patients travel to India (Shimla, Delhi, Lucknow) and Bagmati Province (Kathmandu, Lalitpur, Bhaktapur) of Nepal [11]. This suggests that perhaps the patients in those regions do not get a proper diagnosis and early detection of breast cancer due to the lack of facilities. A study revealed that early detection of breast cancer by automated whole breast ultrasound improved the detection mechanism compared to a mammogram [75]. As modern technology for detection is on the rise, the American Cancer Society (ACS) recommends the use of magnetic resonance imaging (MRI) for the detection of breast cancer for those women who are at high risk of breast cancer. Unfortunately, in Nepal, there are only 25 MRI devices in the whole country [76]. Breast self-examination can be one of the most critical ways to aware people of rural, suburbs as well as city areas. It is therefore recommended for health agencies, governmental bodies, and Non-governmental Organizations (NGOs) to perform various screening awareness campaigns.
A novel mutation in ATM gene in a Saudi female with ataxia telangiectasia
Published in International Journal of Neuroscience, 2021
Hussein Algahtani, Bader Shirah, Raghad Algahtani, Mohammad H. Al-Qahtani, Angham Abdulrahman Abdulkareem, Muhammad Imran Naseer
Individuals with ataxia telangiectasia have approximately a 100-fold increased risk of developing malignancy compared to the general population. Malignancy is considered the second cause of death in ataxia telangiectasia patients following pulmonary disease [18]. The most common malignancies include lymphoma, leukemia, tumors of the gastrointestinal tract, and breast cancer. Extensive information about ataxia telangiectasia showed that homozygous patients affected with this syndrome have both very high cancer rate and exquisite tendency to ionizing radiation. In at least two studies, it has been shown that the relative risk of breast cancer in ataxia telangiectasia heterozygotes was 3.9% with ataxia telangiectasia carriers representing 3.8% of all cases. Epidemiologic studies of ataxia telangiectasia families have reported a four-fold increase in breast cancer among female relatives presumed to be carriers [19]. Our patient is under close monitoring using annual breast ultrasound with no radiation exposure allowed without the permission of the primary care consultant. This includes different forms of radiological investigations such as X-ray and CT.
Benefit–risk profile of black cohosh (isopropanolic Cimicifuga racemosa extract) with and without St John’s wort in breast cancer patients
Published in Climacteric, 2019
X. Ruan, A. O. Mueck, A.-M. Beer, B. Naser, S. Pickartz
Mammographic breast density (visually assessed) and proliferation of breast epithelial cells (fine-needle aspiration biopsies) did not increase after 6 months of treatment with iCR (n = 74)28. Digitized assessment of the mammograms confirmed these findings29. Breast ultrasound did not reveal changes after 6 months of iCR treatment (n = 54)11,30. Three to 6-month treatment with iCR (1–3 tablets b.i.d.) did not significantly change estradiol, follicle stimulating hormone, luteinizing hormone, prolactin, sex hormone-binding globulin, or testosterone levels (n = 523)10,11,13,20,23,30–36. Ultrasound did not reveal any increase in endometrial thickness after 3 to 6-month iCR use (n = 451)10,11,13,14,28,30,32,34,35. Two case–control studies found that taking iCR/iCR + HP was associated with a reduced risk for breast cancer37,38. The larger study (6646 controls with 320 iCR/iCR + HP users; 3257 breast cancer cases with 112 iCR/iCR + HP users) demonstrated that lifestyle factors, tumor histology, and receptor status did not influence the results37. Treatment duration was positively associated with risk reduction.