Mean Glandular Dose Measurement in Three Mammography Centers in Kashan: An approach to Provide a Local DRL

Purpose: Mammography is the most important diagnostic modality for early detection of breast cancer, however, concerns related to the side effects induced by ionizing radiation are still present. In the current study, the Mean Glandular Dose (MGD) values for mammography examinations as well as a local Diagnostic Reference Level (DRL) were obtained for mammography centers in Kashan, Iran. Materials and Methods: Three mammography devices from three radiology centers were selected to obtain the MGD values of mammography examinations. To assess the MGD values, the technical parameters for patients’ imaging at these three radiology centers were extracted. Then, the incident air kerma (in mGy) value received by each patient was measured by a UNIDOS E electrometer (PTW, Germany) along with a SFD mammography ionization chamber (PTW, Germany). Finally, the incident air kerma values were converted to the MGD values by specific conversion factors. Based on the obtained MGD values, a local DRL was also established for mammography examinations. Results: Mean MGD values per exposure were obtained 2.39 ± 1.46 mGy for Right Craniocaudal (RCC), 2.64 ± 1.67 mGy for Left Craniocaudal (LCC), 2.82 ± 1.89 mGy for Right Mediolateral Oblique (RMLO), and 3.09 ± 1.90 mGy for left mediolateral oblique views. Moreover, a local DRL obtained from mammography examinations, which was established as the overall median of MGD value, was 1.72 mGy (1.91 mGy for digital and 1.32 mGy for analog mammography). Conclusion: The MGD values for different views obtained in this study are in the range of previously reported values. Considering the European guidelines for quality assurance in breast cancer screening and diagnosis, it can be mentioned that the obtained DRL was less than the recommended dose level (2.0 mGy).

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Change in body mass index in breast cancer patients in the first two years from diagnosis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e19020 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e19020-e19020

Author(s):

Maysa M. Abu-Khalaf ◽

Ayako Shimada ◽

Nikita Nikita ◽

Ida Micaily ◽

Hannah Hackbart ◽

...

Keyword(s):

Breast Cancer ◽

Race And Ethnicity ◽

Reference Group ◽

Reference Level ◽

Categorical Variables ◽

White Female ◽

Mixed Effect ◽

Significant Difference ◽

The Mean ◽

Race Ethnicity

e19020 Background: The rate of obesity in adults is 34% in the city of Philadelphia, with rates being highest among non-Hispanic blacks and Hispanics. We sought to evaluate how BMI varies by age and race/ethnicity at time of initial encounter for a breast cancer (BC) diagnosis (dx), and investigate factors predictive of BMI change in the first 2 years of dx. Methods: We identified 1,833 patients (pts) in our electronic medical record, (1/2015-present), who had a BC dx at their first hospital or ambulatory encounter using ICD-10 code C50.X, and had BMI recorded at baseline (BL) (6 mo pre-and up to 3 mo post), at 1 yr +/- 3 mo and 2 yr +/- 6 mo. We summarized demographic data (age, gender, marital status, race/ethnicity) with mean and standard deviation for continuous variables and with count and percentage for categorical variables. Descriptive statistics were summarized by 3-level BMI categories: underweight/normal (≤ 24.9), overweight (25 to 29.9), and obese (>30) and compared with ANOVA test, Chi-square-test or Fisher’s exact test as appropriate. Mixed effect regression analysis was conducted to adjust for the effects of time (i.e., BL, 1 yr, 2 yr), gender, race/ethnicity and the interaction of time and race and ethnicity in estimating mean BMI. We calculated the mean change of BMI between the BL and later time points by race/ethnicity. The significance level of all tests was set a priori to the 0.05 level. Results: 99.4% of pts were female; mean age was 63 yrs; White (60 %), Black/AA (27 %). By BMI category, we did not observe a substantial difference in the mean age of dx and gender (p = 0.18 for age and p = 0.55 for gender). We observed a substantial difference in race/ethnicity among BMI categories (p < .0001); the highest percentage of obese pts were Black/AA. In the mixed effect model, the reference level was set as a white female with an average (avg) systolic blood pressure of 137.8. The estimated avg BL BMI of this reference group was 28.8. We observed that among Asian/Pacific Islander (API) pts the avg BL BMI is lower by 3.5 ( p < .0001) and among female Black/AA pts the avg BL BMI is higher by 2.6 ( p < .0001) compared to reference group. No significant change was noted in mean BMI between BL and 1 yr for any race and ethnicity group, and only the Hispanic/Latino group had a declining trend for change in BMI between BL and 2 yr (estimate: -1.9; 95% CI: -5.9, 2.1). Conclusions: In our cohort, Black/AA pts likely have higher BL BMI and API pts likely have lower BL BMI compared to White pts. We found no significant difference in change of BMI by race and ethnicity group during the first 2 years from an initial encounter for a BC dx.

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INTRAORAL DENTAL X-RAY RADIOGRAPHY IN BOSNIA AND HERZEGOVINA: STUDY FOR REVISING DIAGNOSTIC REFERENCE LEVEL VALUE

Radiation Protection Dosimetry ◽

10.1093/rpd/ncaa081 ◽

2020 ◽

Vol 190 (1) ◽

pp. 90-99

Author(s):

Jovica Praskalo ◽

Adnan Beganović ◽

Jovana Milanović ◽

Koviljka Stanković

Keyword(s):

Bosnia And Herzegovina ◽

Digital Image ◽

Reference Level ◽

Diagnostic Reference Level ◽

X Ray ◽

The Third ◽

Air Kerma ◽

Dental Procedures ◽

Maxilla And Mandible ◽

Area Product

Abstract This paper presents the study that would allow a revision of the currently valid diagnostic reference level in intraoral dental X-ray radiography in Bosnia and Herzegovina. The study was conducted for six procedures that are used to capture incisor, premolar and molar teeth, of both maxilla and mandible, in adults. Measurements were performed on 41 intraoral X-ray devices, 20 of which were systems with digital image receptor and 21 film-based X-ray systems. In this study, incident air kerma (Ki) and air kerma-area product (PKA) were used as patient dose descriptors. The third quartile (Q3) of the measured incident air-kerma values was used to compare with the current national diagnostic reference level (DRL) for intraoral dental procedures. The obtained results of Q3 for both types of devices, with film-based and digital image receptors, have shown that the third quartile values are lower (3.5 and 1.2 mGy, respectively) than the current national DRL (7.0 mGy). Hence, new data can be used to re-establish the diagnostic reference levels in intraoral dental X-ray examinations in Bosnia and Herzegovina.

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An Australian local diagnostic reference level for paediatric whole-body 18F-FDG PET/CT

British Journal of Radiology ◽

10.1259/bjr.20180879 ◽

2019 ◽

Vol 92 (1096) ◽

pp. 20180879

Author(s):

Essam Mohammed Alkhybari ◽

Mark F. McEntee ◽

Kathy P. Willowson ◽

Patrick C. Brennan ◽

Theo Kitsos ◽

...

Keyword(s):

Fdg Pet ◽

Whole Body ◽

Reference Level ◽

Diagnostic Reference Level ◽

Weight Category ◽

Pet Ct ◽

The Mean ◽

Fdg Pet Ct ◽

Administered Activity ◽

Age Category

Objective: The aim of this study is to report a local diagnostic reference level (DRL) for paediatric whole-body (WB) fludeoxyglucose (18F-FDG) positron emission tomography (PET) CT examinations. Methods: The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) national DRL (NDRL) age category (0–4 years and 5–14 years), the International Commission on Radiological Protection age category (ICRP age) (<1, >1–5, >5–10, and >10–15 years), and European guideline weight category ( EG weight) (<5, 5–<15, 15–<30, 30–<50, and 50–<80 kg) were used to determine a local DRL for WB 18F FDG PET/CT studies. Two-structured questionnaires were designed to collect dose data, patient demographics, equipment details, and acquisition protocols for WB 18F-FDG PET/CT procedures. The local DRL was based on the median 18F-FDG administered activity (MBq), dose–length product (DLP), and the CT dose index volume (CTDIvol), values. The effective dose (E) was also calculated and reported. Results: The local DRLs for 18F-FDG administered activity, CTDIvol and DLP values based on ARPANSA age and ICRP age were increased from lower to higher age categories. For the EG weight category, the local DRL for 18F-FDG administered activity, CTDIvol and DLP values were increased from the low EG weight category to the high EG weight category. The mean administered activity in our study based on ICRP age category >1–5, >5–10, and >10–15 years is 79.97, 119.40, and 176.04 MBq, which is lower than the mean administered activity reported in the North American Consensus guideline published in 2010 (99, 166, and 286 MBq) and European Association of Nuclear Medicine and Dosage Card (version 1.5.2008) (120, 189, and 302 MBq). However, the mean administered activity in our study based on ICRP age category <1 year was 55 MBq compared to the EANM Dosage card (version 1.5.2008) (70 MBq) and the NACG 2010 (51 MBq). Our study shows that the finding for ICRP age category <1 year was similar to the NACG 2010 value. Conclusion: The determined local DRL values for the radiation doses associated with WB 18F FDG PET/CT examinations are differed considerably between the ARPANSA and ICRP age category and EG weight category. Although, the determined 18F-FDG value for ICRP < 1 year is in good agreement with available publish data, it is preferable to optimise the 18F-FDG administered activity while preserving the diagnostic image quality. Advances in knowledge: The local DRL value determined from WB 18F-FDG PET/CT examinations may help to establish the ARPANSA NDRL for WB FDG 18F-PET/CT examinations.

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Harmonic scalpel versus traditional ligation in axillary dissection for breast cancer: a retrospective multivariate analysis

Perspectives in Surgery ◽

10.33699/pis.2020.99.11.502-508 ◽

2020 ◽

Vol 99 (11) ◽

Keyword(s):

Breast Cancer ◽

Axillary Dissection ◽

Harmonic Scalpel ◽

Breast Conserving Surgery ◽

Seroma Formation ◽

Nodal Involvement ◽

Single Centre ◽

Absorbable Material ◽

Drain Removal ◽

The Mean

Introduction: The aim of this pilot retrospective study is to evaluate the complication rate in patients after axillary dissection comparing preparation with harmonic scalpel vs traditional ligation technique, and to analyse risk factors for complications occurrence. Methods: 144 patients with 148 axillary dissections operated in a single centre between January 2014 and 2019 were included into the study. Axillary dissection was performed using harmonic scalpel in 73 and absorbable ligations in 70 cases. Results: Seroma formation was observed in 41 patients (56.2%) in the harmonic scalpel group and in 21 patients (30.0%) in the ligations group (p=0.003). The mean period from the surgery to drain removal was 4.0 days in the harmonic scalpel group and 3.0 days in the ligations group (p<0.001). The mean amount of the drained fluid after mastectomy was 300.9 ml in the harmonic scalpel group and 168.7 ml in the ligations group (p=0.005); after breast conserving surgery, it was 241.9 ml and 107.4 ml, respectively (p =0.023). Conclusion: In comparison with traditional ligations with absorbable material, axillary dissection using harmonic scalpel significantly increases the risk of postoperative seroma formation, prolongs the time from the surgery to drain removal, and increases the amount of drained fluid.ut any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.

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The Expression of Dopamine Receptors Gene and their Potential Role in Targeting Breast Cancer Cells with Selective Agonist and Antagonist Drugs. Could it be the Novel Insight to Therapy?

Current Drug Discovery Technologies ◽

10.2174/1570163815666180130101421 ◽

2019 ◽

Vol 16 (2) ◽

pp. 184-197 ◽

Cited By ~ 2

Author(s):

Hossein Bakhtou ◽

Asiie Olfatbakhsh ◽

Abdolkhaegh Deezagi ◽

Ghasem Ahangari

Keyword(s):

Breast Cancer ◽

Gene Expression ◽

Cancer Cells ◽

Dopamine Receptors ◽

Breast Cancer Cells ◽

D2 Receptors ◽

Healthy Individuals ◽

Agonist And Antagonist ◽

The Mean ◽

Mcf 7

Background:Breast cancer is one of the common causes of mortality for women in Iran and other parts of the world. The substantial increasing rate of breast cancer in both developed and developing countries warns the scientists to provide more preventive steps and therapeutic measures. This study is conducted to investigate the impact of neurotransmitters (e.g., Dopamine) through their receptors and the importance of cancers via damaging immune system. It also evaluates dopamine receptors gene expression in the women with breast cancer at stages II or III and dopamine receptor D2 (DRD2) related agonist and antagonist drug effects on human breast cancer cells, including MCF-7 and SKBR-3.Methods:The patients were categorized into two groups: 30 native patients who were diagnosed with breast cancer at stages II and III, with the mean age of 44.6 years and they were reported to have the experience of a chronic stress or unpleasant life event. The second group included 30 individuals with the mean age of 39 years as the control group. In order to determine the RNA concentration in all samples, the RNA samples were extracted and cDNA was synthesized. The MCF-7 cells and SKBR-3 cells were treated with dopamine receptors agonists and antagonists. The MTT test was conducted to identify oxidative and reductive enzymes and to specify appropriate dosage at four concentrations of dopamine and Cabergoline on MCF-7 and SKBR-3 cells. Immunofluorescence staining was done by the use of a mixed dye containing acridine orange and ethidiume bromide on account of differentiating between apoptotic and necrotic cells. Flow cytometry assay was an applied method to differentiate necrotic from apoptotic cells.Results:Sixty seven and thirty three percent of the patients were related to stages II and III, respectively. About sixty three percent of the patients expressed ER, while fifty seven percent expressed PR. Thirty seven percent of the patients were identified as HER-2 positive. All types of D2-receptors were expressed in PBMC of patients with breast cancer and healthy individuals. The expression of the whole dopamine receptor subtypes (DRD2-DRD4) was carried out on MCF-7 cell line. The results of RT-PCR confirmed the expression of DRD2 on SKBR-3 cells, whereas the other types of D2- receptors did not have an expression. The remarkable differences in gene expression rates between patients and healthy individuals were revealed in the result of the Real-time PCR analysis. The over expression in DRD2 and DRD4 genes of PBMCs was observed in the patients with breast cancer at stages II and III. The great amount of apoptosis and necrosis occurred after the treatment of MCF-7 cells by Cabergoline from 25 to 100 µmolL-1 concentrations.Conclusion:This study revealed the features of dopamine receptors associated with apoptosis induction in breast cancer cells. Moreover, the use of D2-agonist based on dopamine receptors expression in various breast tumoral cells could be promising as a new insight of complementary therapy in breast cancer.

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Correlation of AGR2 expression with the incidence of metastasis in luminal breast cancer

Breast Disease ◽

10.3233/bd-219015 ◽

2021 ◽

pp. 1-5

Author(s):

David Samuel Kereh ◽

John Pieter ◽

William Hamdani ◽

Haryasena Haryasena ◽

Daniel Sampepajung ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Mean Value ◽

Rank Test ◽

Luminal Breast Cancer ◽

P Value ◽

Strong Positive Correlation ◽

Breast Cancer Patients ◽

The Mean ◽

Spearman Test

BACKGROUND: AGR2 expression is associated with luminal breast cancer. Overexpression of AGR2 is a predictor of poor prognosis. Several studies have found correlations between AGR2 in disseminated tumor cells (DTCs) in breast cancer patients. OBJECTIVE: This study aims to determine the correlation between anterior Gradient2 (AGR2) expression with the incidence of distant metastases in luminal breast cancer. METHODS: This study was an observational study using a cross-sectional method and was conducted at Wahidin Sudirohusodo Hospital and the network. ELISA methods examine AGR2 expression from blood serum of breast cancer patients. To compare the AGR2 expression in metastatic patients and the non-metastatic patient was tested with Mann Whitney test. The correlation of AGR2 expression and metastasis was tested with the Rank Spearman test. RESULTS: The mean value of AGR2 antibody expression on ELISA in this study was 2.90 ± 1.82 ng/dl, and its cut-off point was 2.1 ng/dl. Based on this cut-off point value, 14 subjects (66.7%) had overexpression of AGR2 serum ELISA, and 7 subjects (33.3%) had not. The mean value AGR2 was significantly higher in metastatic than not metastatic, 3.77 versus 1.76 (p < 0.01). The Spearman rank test obtained a p-value for the 2 tail test of 0.003 (p < 0.05), which showed a significant correlation of both, while the correlation coefficient of 0.612 showed a strong positive correlation of AGR2 overexpression and metastasis. CONCLUSIONS: AGR2 expression is correlated with metastasis in Luminal breast cancer.

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Comparison of metabolic changes after neoadjuvant endocrine and chemotherapy in ER-positive, HER2-negative breast cancer

Scientific Reports ◽

10.1038/s41598-021-89651-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ho Hyun Ryu ◽

Sei Hyun Ahn ◽

Seon Ok Kim ◽

Jeong Eun Kim ◽

Ji sun Kim ◽

...

Keyword(s):

Breast Cancer ◽

Metabolic Profile ◽

Fasting Glucose ◽

Medical Center ◽

Mean Value ◽

Metabolic Changes ◽

Phase Iii ◽

Breast Cancer Patients ◽

Neoadjuvant Endocrine Therapy ◽

The Mean

AbstractSurvival of breast cancer patients has improved, and treatment-related changes regarding metabolic profile deterioration after neoadjuvant systemic treatment (NST) become important issues in cancer survivors. We sought to compare metabolic profile changes and the neutrophil-to-lymphocyte ratio (NLR) between patients undergoing neoadjuvant chemotherapy (NCT) and neoadjuvant endocrine therapy (NET) 3 years after the treatment. In a prospective, randomized, phase III trial which compared 24 weeks of NCT with adriamycin and cyclophosphamide followed by docetaxel and NET with goserelin and tamoxifen (NEST), 123 patients in the Asan Medical Center were retrospectively reviewed to evaluate metabolic changes, such as body mass index (BMI), blood pressure (BP), total cholesterol (TC), fasting glucose, and the NLR. The mean age of patients was 42 years. The changes in BMI, serum glucose, and TC during NST and after 3 years were significantly different between NCT and NET. The proportion of overweight + obese group and the mean BMI were significantly increased during NCT (26.6% to 37.5%, 22.84 kg/m2 to 23.87 kg/m2, p < 0.05), and these attributes found to have normalized at the 3-year follow-up. In the NET group, BMI changes were not observed (p > 0.05, all). There were no differences in changes over time among in the Hypertension group during NCT and NET (p = 0.96). The mean value of serum TC and fasting glucose significantly increased (< 0.05, both) during NCT and decreased 3 years after NCT (p < 0.05); however, no significant changes were observed in the NET group. The NLR was increased from 1.83 to 3.18 after NCT (p < 0.05) and decreased from 1.98 to 1.43 (p < 0.05) after NET. Compared with minimal metabolic effect of NET, NCT worsens metabolic profiles, which were recovered over 3 years. The NLR was increased after NCT but decreased after NET.

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Patterns of Sequelae in Women with a History of Localized Breast Cancer: Results from the French VICAN Survey

Cancers ◽

10.3390/cancers13051161 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1161

Author(s):

Lidia Delrieu ◽

Liacine Bouaoun ◽

Douae El Fatouhi ◽

Elise Dumas ◽

Anne-Deborah Bouhnik ◽

...

Keyword(s):

Breast Cancer ◽

Latent Class ◽

Early Stage ◽

Current Analysis ◽

Functional Pain ◽

Cognitive Sequelae ◽

History Of ◽

The Mean ◽

Study Participants ◽

Changes Over Time

Breast cancer (BC) remains complex for women both physically and psychologically. The objectives of this study were to (1) assess the evolution of the main sequelae and treatment two and five years after diagnosis in women with early-stage breast cancer, (2) explore patterns of sequelae associated with given sociodemographic, clinical, and lifestyle factors. The current analysis was based on 654 localized BC patients enrolled in the French nationwide longitudinal survey “vie après cancer” VICAN (January–June 2010). Information about study participants was collected at enrollment, two and five years after diagnosis. Changes over time of the main sequelae were analyzed and latent class analysis was performed to identify patterns of sequelae related to BC five years after diagnosis. The mean age (±SD) of study participants at inclusion was 49.7 (±10.5) years old. Six main classes of sequelae were identified two years and five years post-diagnosis (functional, pain, esthetic, fatigue, psychological, and gynecological). A significant decrease was observed for fatigue (p = 0.03) and an increase in cognitive sequelae was reported (p = 0.03). Two latent classes were identified—functional and esthetic patterns. Substantial sequelae remain up to five years after BC diagnosis. Changes in patient care pathways are needed to identify BC patients at a high risk.

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Lesion-Based Bone Metastasis Detection in Chest Bone Scintigraphy Images of Prostate Cancer Patients Using Pre-Train, Negative Mining, and Deep Learning

Diagnostics ◽

10.3390/diagnostics11030518 ◽

2021 ◽

Vol 11 (3) ◽

pp. 518

Author(s):

Da-Chuan Cheng ◽

Te-Chun Hsieh ◽

Kuo-Yang Yen ◽

Chia-Hung Kao

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Deep Learning ◽

Bone Metastasis ◽

Cancer Patients ◽

Bone Scintigraphy ◽

Breast Cancer Patients ◽

Location Detection ◽

The Mean ◽

Mean Sensitivity

This study aimed to explore efficient ways to diagnose bone metastasis early using bone scintigraphy images through negative mining, pre-training, the convolutional neural network, and deep learning. We studied 205 prostate cancer patients and 371 breast cancer patients and used bone scintigraphy data from breast cancer patients to pre-train a YOLO v4 with a false-positive reduction strategy. With the pre-trained model, transferred learning was applied to prostate cancer patients to build a model to detect and identify metastasis locations using bone scintigraphy. Ten-fold cross validation was conducted. The mean sensitivity and precision rates for bone metastasis location detection and classification (lesion-based) in the chests of prostate patients were 0.72 ± 0.04 and 0.90 ± 0.04, respectively. The mean sensitivity and specificity rates for bone metastasis classification (patient-based) in the chests of prostate patients were 0.94 ± 0.09 and 0.92 ± 0.09, respectively. The developed system has the potential to provide pre-diagnostic reports to aid in physicians’ final decisions.

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Annual hazard rates of recurrence for breast cancer after primary therapy.

Journal of Clinical Oncology ◽

10.1200/jco.1996.14.10.2738 ◽

1996 ◽

Vol 14 (10) ◽

pp. 2738-2746 ◽

Cited By ~ 592

Author(s):

T Saphner ◽

D C Tormey ◽

R Gray

Keyword(s):

Breast Cancer ◽

Eastern Cooperative Oncology Group ◽

Entire Group ◽

Hazard Rates ◽

Primary Therapy ◽

Time Intervals ◽

Differentiating Agents ◽

The Mean ◽

Lower Hazard

PURPOSE To determine if the long-term increase of recurrence for breast cancer is stable or slowly decreasing, or if it ever reaches zero; and to determine the effect of prognostic factors on the hazard of recurrence. METHODS All patients entered onto the seven completed and unblinded Eastern Cooperative Oncology Group (ECOG) coordinated studies of postoperative adjuvant therapy for breast cancer were analyzed in terms of annual hazard of recurrence of breast cancer. RESULTS For the entire group, the peak hazard of recurrence occurred in the interval of 1 to 2 years. The hazard decreased consistently in the interval of 2 to 5 years. Beyond 5 years, the hazard of recurrence decreased very, very slowly through year 12. The average hazard of recurrence between years 5 and 12 for the entire population was 4.3% per year. The pattern of a peak hazard of recurrence during the first 5 years with a slowly decreasing hazard of recurrence beyond 5 years was also observed to varying degrees in most subsets. Higher risk subsets such as patients with more than three nodes positive had a higher hazard of recurrence at all time intervals, while lower risk subsets such as patients with negative nodes had a lower hazard of recurrence in all time periods. CONCLUSION Patients 5 years postsurgery for breast cancer appear to have a very slowly decreasing hazard of recurrence. The mean hazard of recurrence between years 5 to 12 postsurgery is 4.3% per year. This group of patients may be well suited for trials evaluating cytostatic drugs or differentiating agents.

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