A case study of breast siliconoma

Background: Silicone or foreign materials injection is widely used for aesthetic breast augmentation and reconstructions in many countries. Once injected, it will stimulate a foreign body reaction between body tissues and silicone. This reaction can cause the formation of a granuloma known as siliconoma, which represent by the lumping at the breast. This symptom usually mimics breast cancer and sometimes be the origin of breast cancer. This paper is focused on the discussion on radiographic appearance of silicone and a case study of breast siliconoma. Case Study: A 66-year-old Chinese female with a family history of cancer presents with palpable painless lumps in her breasts. The lumps were present in both breasts without any mobility and other inflammatory processes. Mammographic examination demonstrated a dense bilateral mass towards the chest wall and asymmetrical rounded densities in both breasts. There are no breast cancer indications were reported. The pathology demonstrated a siliconoma.

Breast cancer screening during the adverse COVID-19 epidemiological situation

Purpose of the study. To evaluate the results of breast cancer screening (BC) in the conditions of an unfavorable epidemiological situation COVID‑19 based on the analysis of the BC screening project in the Kaluga Region.Patients and methods. Screening system: creation and implementation in practice of mobile mammography complexes (MMC); training of medical personnel in the method of conducting a standardized mammographic examination (ME); quality control of ME; "Cloud" storage and software development for archiving patients; an independent review of mammograms by certified specialists; expert review of images in case of discrepancies in diagnoses; referral of patients diagnosed with BI-RADS IV and V to the regional oncological dispensary for further examination and treatment. From 04.2018 to 12.2020 patients were examined on MMC according to the BC screening protocol. We examined 47367 patients over the age of 40 years. SD 57.66 ± 8.17 years (38-93). During the COVID‑19 pandemic, imaging of breast diseases must be carried out in compliance with all safety regulations for both personnel and patients. Balancing the need to avoid delays in diagnosing BC while preventing infection requires careful attention to personal protective equipment, handling of diagnostic equipment, diagnostic facilities, and physical distancing and vigilance to maintain these measures.Results. From 07.2020 to 11.2020: a total of 10736 studies have been carried out. In the context of new coronavirus infection, we noted an increased demand among patients wishing to undergo BC screening. The flow of patients over the same period of previous years was less, which indicates the demand and justification for screening mammography and the use of MMC in an unfavorable epidemiological situation. 174 patients received category BI-RADS IV-V and were referred for a follow-up examination and required treatment at an oncological dispensary. In 39 patients (22.4 %), BC was verified, and appropriate treatment was carried out. In 135 cases, benign processes were verified.Conclusion. BC screening should not be stopped against the backdrop of the COVID‑19 epidemic since a delay in BC diagnosis later threatens to reveal more voluminous processes with a worse prognosis for treatment and rehabilitation than timely detected changes in the mammary glands in the early preclinical stages of the disease.

Breast cancer in patients after augmentation with implants

Relevance. Currently, there is no definite answer to the question of the cause of breast cancer, since it is a systemic and multifactorial disease. Given that the number of aesthetic operations on the mammary glands using endoprostheses only increases every year, new cases of detection of malignant diseases do not decrease. Some researchers are beginning to speak out about the possible connection of augmentation mammoplasty in the anamnesis with the subsequent occurrence of breast cancer due to inadequate clinical and instrumental examination and ignoring some of its components (for example, the mammographic examination). Introduction. Taking into account the analysis of the literature and the presented clinical examples, the possible reasons for the connection of augmentation mammoplasty in the anamnesis with the subsequent detection of a malignant neoplasm are analyzed. Materials and methods. We analyzed domestic and foreign literature and described two clinical examples with authentic documentation based on the results of the examination and treatment. The article describes in detail the schemes of drug treatment and descriptions of the results of morphological examination of the surgical material. The types and results of surgical treatment with reliable photos are also presented. Results. Given the complexity of the diagnostic stage in patients with breast endoprosthesis in the described clinical examples, family history collected in sufficient detail, cytogenetic studies conducted, we should talk about the likely underdiagnosis during preventive examinations. Conclusion. The multifactorial and systematic nature of such a disease as breast cancer suggests that perhaps an intensive increase in the detectability of the above-mentioned against the background of previously performed aesthetic surgery would be the simplest solution to the problem. In this category of patients, anamnesis should be collected in more detail and carefully, and the entire complex of clinical and instrumental examinations, including mammography, magnetic resonance and ultrasound examinations, should be performed in order to fully diagnose and develop further patient management tactics.

Mammographic Breast Densities among 200 Nigerian Females in Sokoto, North Western Nigeria

Background: Breast density has been reported to be an independent predictor of breast cancer risk. Women with highest mammographic breast density may have four to six fold increased risk of developing cancer. Aim and Objective: This study is aimed at evaluating the various forms of breast densities following screening and diagnostic mammographic examination. Materials and Methods: From December 2010 and November 2012, 200 females had mammographic breast examination. Seventy-seven (77) females had routine screening mammography while 123 had diagnostic mammographic examination in the department with the General Electric (GE) Alpha-RT machine with model number MGF-101(manufactured 2010). All the subjects had to fill a mammographic form consisting of variables like age, sex, occupation, family history of breast cancer, tribe, contraception, parity, and caffeine consumption, history of surgical intervention (lumpectomy, biopsy and/or mastectomy), previous mammography and last child birth. MLO and CC views were done for the breast examination though additional views were occasionally employed. Results: Breast density decreases with increase in age of the female subjects and breast lesions are better detected following mammography on fatty or less dense breast.

Prediagnostic circulating metabolites in female breast cancer cases with low and high mammographic breast density

Mammographic breast density (MBD) is a strong independent risk factor for breast cancer (BC). We designed a matched case–case study in the EPIC Florence cohort, to evaluate possible associations between the pre-diagnostic metabolomic profile and the risk of BC in high- versus low-MBD women who developed BC during the follow-up. A case–case design with 100 low-MBD (MBD ≤ 25%) and 100 high-MDB BC cases (MBD > 50%) was performed. Matching variables included age, year and type of mammographic examination. 1H NMR metabolomic spectra were available for 87 complete case–case sets. The conditional logistic analyses showed an inverse association between serum levels of alanine, leucine, tyrosine, valine, lactic acid, pyruvic acid, triglycerides lipid main fraction and 11 VLDL lipid subfractions and high-MBD cases. Acetic acid was directly associated with high-MBD cases. In models adjusted for confounding variables, tyrosine remained inversely associated with high-MBD cases while 3 VLDL subfractions of free cholesterol emerged as directly associated with high-MBD cases. A pathway analysis showed that the “phenylalanine, tyrosine and tryptophan pathway” emerged and persisted after applying the FDR procedure. The supervised OPLS-DA analysis revealed a slight but significant separation between high- and low-MBD cases. This case–case study suggested a possible role for pre-diagnostic levels of tyrosine in modulating the risk of BC in high- versus low-MBD women. Moreover, some differences emerged in the pre-diagnostic concentration of other metabolites as well in the metabolomic fingerprints among the two groups of patients.

Breast-iRRISC: a novel model for predicting the individualised lifetime risk of radiation-induced breast cancer from a single screening event

Objectives: This work establishes the prototype of a new innovative risk model that aims to evaluate the total risk involved with screening mammography for each individual female. This has been specifically designed to accommodate any combination of lifetime screening regimes, using only the information gathered from a single mammographic examination. Methods: This model prototype was developed with the aid of a large dataset of images from the Cancer Institute New South Wales (CINSW) with over 30,000 images from over 7000 examinations. Each examination is derived from a separate female. Results: This prototype which we have called Breast Individualised Risk of Radiation-Induced Screening Cancer (Breast-iRRISC) is a novel tool for the assessment of the lifetime risk involved with screening mammography. The results demonstrate the applicability of this approach to the various screening regimes utilised around the globe, in addition to the personalised screening frequency patterns females have undergone and are likely to receive in the future. Conclusions: This unique tailored approach to risk assessment will further empower females and clinicians towards a more informed clinical decision process regarding future imaging pathways. It will also inform health policy decisions regarding alternate screening durations and intervals. Advances in knowledge: Breast-iRRISC is a novel tool that provides females, clinicians and health policymakers around the globe with the ability to quantify the lifetime risk of radiation-induced breast cancer from screening mammography on an individual level from a single exposure.

Mammographic Density Errors during Interpretation of Breast Examinations

Background: This article discusses errors that may occur when radiologists deal with mammographic density (MD) and present their performance analysis in Russia. Methods and Results: The authors of this report have analyzed 24,485 mammographic reports for 20,000 female patients (aged 29-85 years) that were made in various healthcare facilities in the Russian Federation. In 249(1.7%) mammographic exam reports, we observed a wrong MD interpretation. Conclusion: Diagnostic errors during mammographic examination occur because the radiologists lack theoretical knowledge about MD. This lack, in turn, results in a decrease in the quality of medical care provided for female patients and an increase in the number of diagnostic iatrogeny.

FORMALIZING THE STAGES OF MAMMOGRAPHIC EXAMINATIONS IN DESIGNING A MEDICAL DECISION SUPPORT SYSTEM

The paper considers the formalization of the stages and modeling of the mammographic examination procedure in the design of medical computer decision support systems. The mammographic examination process is presented in a generalized model, which consists of functional, structural, and mathematical models. The functional model (context diagram) is made using the functional modeling methodology. When analyzing the context diagram, four main functional blocks were identified: register a patient; perform registration and analysis of mammograms; carry out diagnostics; form a survey protocol. If there are standards for maintaining medical records and drawing up examination protocols, the first and last blocks are easily automated. The article focuses on the second and third blocks. At the mammogram analysis stage, the sub-stages “Perform preliminary processing” and “Perform morphological analysis” are essential. Preprocessing of mammograms (adaptive filtering, changing brightness or increasing contrast, etc.) is carried out using digital image processing methods to improve visualization quality. The result of morphological analysis is selecting structural elements and forming a set of diagnostic signs in the form of parameters of the found structural elements. Because some elements of mammograms (microcalcifications) have an irregular structure, specialized morphological analysis methods are used, based on taking into account the features of the images under consideration and their transformation methods in the form of the useful signal, in particular, fractal dimension models. The developed formalized models made it possible to reasonably design the decision support system’s structure during mammographic examinations, information, mathematical, software, and hardware to increase medical services’ efficiency and minimize the risks of medical errors.

Impact of Breast Density Awareness on Knowledge about Breast Cancer Risk Factors and the Self-Perceived Risk of Breast Cancer

Breast density (BD) reduces sensitivity of mammography, and is a strong risk factor for breast cancer (BC). Data about women’s awareness and knowledge of BD are limited. Our aim is to examine whether the BD information disclosure and BD awareness among women without BC are related to their knowledge about BC risk factors. We examined self-reported BC risk perception and its association to BD awareness and level of health literacy. A cross-sectional, single site study included 263 Croatian women without BC who had mammographic examination. Data were collected by interviews using questionnaires and a validated survey. Of the total, 77.1% had never heard of BD, and 22.9% were aware of their BD. Most participants who knew their BD (88.2%, p < 0.001) had higher levels of education. Majority of subjects (66.8%) had non-dense breasts and 33.2% had dense breasts. Subjects aware of their BD knew that post-menopausal hormone replacement therapy (p = 0.04) and higher BD (p = 0.03) are BC risk factors. They could more easily access information about health promotion (p = 0.03). High-BD informed women assessed their lifetime BC risk as significantly higher than all others (p = 0.03). Comprehension of BD awareness and knowledge is crucial for reinforcement of educational strategies and development of amendatory BC screening decisions.

Outcome of mammography examination among asymptomatic women.

e13558 Background: Early detection of breast cancer is important in reducing mortality, morbidity and high socio-economic burden associated with it. Mammography is currently the primary imaging modality used as a screening tool to detect early breast cancer in women experiencing no symptoms as they are most curable in the early stage. The aim of the study is to determine the mammographic outcome in asymptomatic women who presented for mammographic breast examination in Abuja,Nigeria. Methods: This descriptive cross-sectional study comprises of 113 asymptomatic women who presented for mammographic examination at the Radiology department of University of Abuja Teaching Hospital, Gwagwalada from March 2015 to December 2018. Two basic views (craniocaudal and mediolateral views) of the breast were obtained using EXR-650 machine.Additional views were obtained when necessary. Images of the breast were review by radiologist. Results: The mean age of study population was 40.72 ±10.45years with age range of 35 and 65 years. The mammographic outcome among asymptomatic women who had mammographic examination was negative in 69(61.1%) women and positive in 44(38.9%). The differences observed between the positive and negative mammographic outcome was statistically significant p = 0.01. The positive outcome noted in mammograms of women examined were: benign mass in 18(15.9%) women; 9(8.0%) had benign calcification; 7(6.2%) showed architectural distortion; 5(4.4%) was inconclusive; focal asymmetry in 3(2.6%); and suspicious mass in 2(1.8%). Conclusions: Mammogram is an important tool for screening and diagnoses of breast pathologies. In this study, screening of women reveals various benign and malignant breast changes which necessitate early interventions. Early detection of breast cancer save lives. [Table: see text]