scholarly journals Towards a Personalized Organized Screening in Breast Cancer : Practical Determination of Thresholds of Risk in Women at Average-Risk

2021 ◽  
Author(s):  
Emmanuel Bonnet ◽  
Jean Pierre Daures ◽  
Paul Landais
Keyword(s):  
Breast Cancer ◽  
Age At Menarche ◽  
High Threshold ◽  
Average Risk ◽  
New Strategy ◽  
History Of ◽  
Low Threshold ◽  
Set Up ◽  
Level Of Risk

Abstract In France, more than 10 million women at ”average” risk of breast cancer (BC), are included in the organized BC screening. Existing predictive models of BC risk are not adapted to the French population. Thus, we set up a new score in the French Hérault region and looked for a graded level of risk in women at "average" risk. We recruited a retrospective cohort of women, aged 50 to 60, who underwent the organized BC screening, and included 2241 non-cancer women and 527 who developed a BC during a 12-year follow-up period (2006-2018). The risk factors identified were high breast density (ACR BI-RADS grading)(B vs A: HR 1.41, 95%CI [1.05; 1.9], p=0.023; C vs A: HR=1.65 [1.2; 2.27], p=0.02 ; D vs A: HR=2.11 [1.25;3.58],p=0.006), a history of maternal breast cancer (HR=1.61 [1.24; 2.09], p < 0.001), and socioeconomic difficulties (HR 1.23 [1.09; 1.55], p=0.003). While early menopause (HR=0.36 [0.13; 0.99], p=0.003) and an age at menarche after 12 years (HR=0.77 [0.63; 0.95], p=0.047) were protective factors. We identified 3 groups at risk: lower, average, and higher, respectively. A low threshold was characterized at 1.9% of risk and a high threshold at 4.5%. Mean risks in the 3 groups of risk were 1.37%, 2.68%, and 5.84%, respectively. Thus, 12% of women presented a level of risk different from the average risk group, corresponding to 600,000 women involved in the French organized BC screening, enabling to propose a new strategy for performing an organized and personalized national BC screening.

scholarly journals Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Emmanuel Bonnet ◽  
Jean-Pierre Daures ◽  
Paul Landais
Keyword(s):  
Breast Cancer ◽  
Screening Program ◽  
Age At Menarche ◽  
High Threshold ◽  
Average Risk ◽  
Organized Screening Program ◽  
New Strategy ◽  
History Of ◽  
Set Up ◽  
Level Of Risk

AbstractIn France, more than 10 million women at ”average” risk of breast cancer (BC), are included in the organized BC screening. Existing predictive models of BC risk are not adapted to the French population. Thus, we set up a new score in the French Hérault region and looked for subgroups at a graded level of risk in women at ”average” risk. We recruited a retrospective cohort of women, aged 50 to 60, who underwent the organized BC screening, and included 2241 non-cancer women and 527 who developed a BC during a 12-year follow-up period (2006-2018). The risk factors identified were high breast density (ACR BI-RADS grading)(B vs A: HR = 1.41, 95%CI [1.05; 1.9], p = 0.023; C vs A: HR = 1.65 [1.2; 2.27], p = 0.02 ; D vs A: HR = 2.11 [1.25;3.58], p = 0.006), a history of maternal breast cancer (HR = 1.61 [1.24; 2.09], p < 0.001), and socioeconomic difficulties (HR 1.23 [1.09; 1.55], p = 0.003). While early menopause (HR = 0.36 [0.13; 0.99], p = 0.003) and an age at menarche after 12 years (HR = 0.77 [0.63; 0.95], p = 0.047) were protective factors. We identified 3 groups at risk: lower, average, and higher, respectively. A low threshold was characterized at 1.9% of 12-year risk and a high threshold at 4.5% 12-year risk. Mean 12-year risks in the 3 groups of risk were 1.37%, 2.68%, and 5.84%, respectively. Thus, 12% of women presented a level of risk different from the average risk group, corresponding to 600,000 women involved in the French organized BC screening, enabling to propose a new strategy to personalize the national BC screening. On one hand, for women at lower risk, we proposed to reduce the frequency of mammograms and on the other hand, for women at higher risk, we suggested intensifying surveillance.

scholarly journals Effect of immunoadjuvants on the disease course in patients with operable breast cancer

2019 ◽  
Vol 14 (4) ◽  
pp. 20-23
Author(s):  
M. M. Vasilyeva ◽  
I. P. Moshurov ◽  
L. Yu. Grivtsova ◽  
N. N. Tupitsyn ◽  
N. A. Kozlov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Tissue ◽  
Radical Mastectomy ◽  
Control Group ◽  
Cancer Management ◽  
New Strategy ◽  
Breast Cancer Management ◽  
Grade Ii ◽  
And Control

Background. A new strategy of breast cancer management is required for effective disease prevention and control. Immunotherapy is one of promising options.Objective: to evaluate the effect of immunoadjuvant polyoxidonium on pathmorphological changes in breast tumors.Materials and methods. The study was performed in 75 patients with breast cancer: 50 patients received polyoxidonium in a neoadjuvant regimen (main group), 25 patients did not receive polyoxidonium (control group). Polyoxidonium at a dose of 12 mg was administered intramuscularly 1 time per day on the days 1, 2, 3, 5 and 7 before surgery; on the day 8, radical mastectomy was performed in patients of both groups, followed by histological examination and determination of the grade of therapeutic pathomorphosis of the tumor.Results. The proportion of cases with grade I therapeutic pathomorphosis was 58 %, grade II therapeutic pathomorphosis – 6 %. Pathomorphosis in metastatic lymph nodes was observed in 22.7 % of cases.Conclusion. The anti-tumor effect of polyoxidonium was confirmed on the basis of the induction of pathomorphosis of the tumor tissue of breast cancer.

Pattern of breast diseases in Kuwait Cancer Control Center, Kuwait

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10754-10754 ◽  
Author(s):  
S. A. Alawadi ◽  
M. D. Delvadiya
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement ◽  
Case Series ◽  
Breast Diseases ◽  
Age At Menarche ◽  
Female Breast ◽  
N2 Disease ◽  
Case Series Study ◽  
History Of ◽  
Second Degree

10754 Background: The aim of this case series study is to evaluate the outline and pattern of female breast cancers in Kuwait. Methods: Our study consisted of data from 300 cases of female breast cancer seen in our outpatient department. Data on profile of their disease at presentation and known risk factors was retrieved. The analysis indented to examine the pattern of the disease and risk factor profile of the patients. Results: Out of 300 patients, 52% were Kuwaiti citizens, 24% were Arabs from other countries, 23% were of Asian origin and 1% was of other nationality. Their median age ± SD (Standard Deviation) was 50 ± 9.7 years. Most patients were younger than 55 years (77.4%) and were predominantly premenopausals (63%). Only 18% had stage I disease at presentation, whilst 54 %, 24 %, and 4% had stage II, III and IV disease, respectively. Among patients with known axillary nodal status (298 patients) 44.3% were node-negative whilst 39.6% and 16.8% had N1 and N2 disease, respectively. History of benign breast disease was positive in 9% and only 1% had breast biopsy done before the biopsy which diagnosed cancer. In 20.7% there was family history of breast cancer. Among them 11.7% had first degree relative with breast cancer, 3.3%, 7.3% and 1% patients had either mother, sister or both with history of breast cancer. Whilst 12% patients had second degree relatives with breast cancer, 3% patients out of them had both first and second degree relatives with breast cancer. History of alcohol ingestion was rare, only 0.7% patients were taking alcohol. 9.7% patients were nulliparous, while 10.7% patients had their first child after the age of 30 years. Breast feeding was common, 80 % patients breast fed their children and 43.3 % did that for more than 6 months. Age at menarche was 12 years or less in 34 % patients and age at menopause was more than 55 years in only 6.3% patients. Oral contraceptives were used by 38.7% patients, 12%, 9.3% and 17.3% patients used them for 2 or less, 2 to 5 or more than 5 years, respectively. Only 3% patients took hormone replacement therapy, 7 of them took that fore more than 2 years. Only 6 % patients gave history of smoking and only half of them were currently smoking. Conclusions: This data analysis suggested that pattern of breast cancer in Kuwait is similar to other countries in this region. No significant financial relationships to disclose.

MRI screening of women at average risk of breast cancer.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 21-21 ◽  
Author(s):  
Simone Schrading ◽  
Christiane K. Kuhl
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Pulse Sequence ◽  
Mammographic Breast Density ◽  
Average Risk ◽  
High Grade ◽  
Entire Cohort ◽  
History Of ◽  
Mean Size ◽  
Screening Mammograms

21 Background: In asymptomatic women at average risk, mammography alone, possibly amended by the US, is recommended for screening. MRI is established for screening women at high risk, but there are no data available to support its use in women at average risk. Methods: Between Jan 2005 and Dec 2012, 1,387 women at average risk, i.e. without personal or family history of breast or ovarian cancer or tissue diagnosis of atypias underwent 1,705 annual MRI screening studies. Mean/median age was 55/56, range 40-79. All women had normal CBE and normal double-read 2-view digital screening mammograms. In women with breast densities, additional US had been performed and women were included if also US was normal. Patients underwent bilateral DCE MRI at 1.5T using a 2D GE pulse sequence. Results: A total of 54 MRIs were rated positive (MR-BI-RADS 4/5) (54/1705; 3.2%). Biopsies performed in these women were positive for breast cancer or DCIS in 18, and revealed high risk lesions in 8 patients, yielding an additional cancer yield of 11/1,000. In 28 women, biopsy revealed benign changes only. This translates into a PPV of 33% (18/54), or 48% (26/54) if high risk lesions are included. Of the 18 cancers, 11 (61%) were invasive and 7 (39%) DCIS. Mean size of invasive cancers was 11 mm (median 10, range 4 -22). Invasive cancers were intermediate or high grade in 9/11, DCIS in 6/7. All invasive cancers were staged pN0, M0. Minimal cancer rate was 13/18 (72%). Distribution of mammographic breast densities in women with MRI-diagnosed cancer was as follows: ACR I in 2 (11%), ACR II in 3 (17%), ACR III in 8 (44%), ACR IV in 5 (28%). This was equivalent to the distribution of breast densities in the entire cohort. Conclusions: In this cohort of heavily pre-screened women at average risk, the additional cancer yield achieved through MRI was high (11/1,000). Although the biologic profile of MRI-only detected additional cancers was indicative of prognostically relevant disease, with a high proportion of high-grade cancers, stage distribution of cancers was favorable. Mammographic breast density did not predict the likelihood with which additional cancers were identified through MRI. In women with dense breasts who underwent screening US in addition to mammography, there is still a significant reservoir of undetected cancers.

scholarly journals The Clinical Significance of PR, ER, NF-κB, and TNF-αin Breast Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Xian-Long Zhou ◽  
Wei Fan ◽  
Gui Yang ◽  
Ming-Xia Yu
Keyword(s):  
Breast Cancer ◽  
Progesterone Receptors ◽  
Tumor Grade ◽  
Age At Menarche ◽  
Human Breast ◽  
Positive Expression ◽  
History Of ◽  
Expression Rate ◽  
Status Number ◽  
Necrosis Factor

Objectives. To investigate the expression of estrogen (ER), progesterone receptors (PR), nuclear factor-κB (NF-κB), and tumor necrosis factor-α(TNF-α) in human breast cancer (BC), and the correlation of these four parameters with clinicopathological features of BC.Methods and Results. We performed an immunohistochemical SABC method for the identification of ER, PR, NF-κB, and TNF-αexpression in 112 patients with primary BC. The total positive expression rate of ER, PR, NF-κB, and TNF-αwas 67%, 76%, 84%, and 94%, respectively. The expressions of ER and PR were correlated with tumor grade, TNM stage, and lymph node metastasis (P<0.01, resp.), but not with age, tumor size, histological subtype, age at menarche, menopause status, number of pregnancies, number of deliveries, and family history of cancer. Expressions of ER and PR were both correlated with NF-κB and TNF-αexpression (P<0.05, resp.). Moreover, there was significant correlation between ER and PR(P<0.0001)as well as between NF-κB and TNF-αexpression(P<0.05).Conclusion. PR and ER are highly expressed, with significant correlation with NF-κB and TNF-αexpression in breast cancer. The important roles of ER and PR in invasion and metastasis of breast cancer are probably associated with NF-κB and TNF-αexpression.

‘Dynamic Differentiation’: The Principles of CBDR-RC, Progression and Highest Possible Ambition in the Paris Agreement

2016 ◽  
Vol 5 (2) ◽  
pp. 285-303 ◽  
Author(s):  
Christina Voigt ◽  
Felipe Ferreira
Keyword(s):  
Collective Learning ◽  
Paris Agreement ◽  
Duty Of Care ◽  
Due Diligence ◽  
Common But Differentiated Responsibilities ◽  
Climate Action ◽  
History Of ◽  
Nationally Determined Contributions ◽  
Set Up

AbstractThe Paris Agreement has struck a careful balance between the need for ambitious and effective climate action and for fair effort sharing among parties based on differentiation. This article provides an overview of the negotiation history of differentiation and analyzes the ‘dynamic differentiation’ as built into the architecture of the Agreement. While being set against the normative background of the United Nations Framework Convention on Climate Change (UNFCCC), the Paris Agreement adopts a more diversified way of differential treatment among parties, approaching it in three complementary ways: firstly, on a principled basis, reflecting common but differentiated responsibilities and respective capabilities (CBDR-RC), in the light of different national circumstances; secondly, in the content of its articles, in particular on mitigation, finance and transparency; and thirdly, on the basis of the principles of progression and highest possible ambition, which represent new and dynamic aspects of differentiation. The authors argue that ‘highest possible ambition’ is reflective of a duty of care that states now need to exercise. It implies a due diligence standard, which requires each government to act in proportion to the risk at stake and to take all appropriate and adequate climate measures according to its responsibility and its best capabilities. By expecting parties to apply this standard at each successive preparation of nationally determined contributions (NDCs), and to progress beyond previous ones, the Paris Agreement has set up reiterative processes, an ‘international normative pull’ and a collective learning environment. This, in turn, creates a reflexive approach to parties’ determination of effort, promoting the evolution of voluntary cooperative behaviour.

Accurate Method for Comparison of Scorching Qualities of Accelerators

1929 ◽  
Vol 2 (1) ◽  
pp. 68-80
Author(s):  
H. R. Thies
Keyword(s):  
Critical Point ◽  
Accurate Method ◽  
Index Number ◽  
Value Stocks ◽  
History Of ◽  
Milling Temperature ◽  
Set Up ◽  
And Control ◽  
Complete History

Abstract The determination of critical point curves for accelerators is of value in ascertaining their scorching tendencies. Also, the index number, defined as that increment of time at which the set-up crosses the 140 mm. “height of column” ordinate, is of value in comparing the scorching qualities of various accelerators. For accurate work the cures on the accelerators compared should be balanced at the temperature of use, and control obscuration readings should be fairly close together in their value. Stocks should be milled in as nearly the same manner as possible. For the complete history of an accelerator's behavior, critical point determinations should be made at at least two and perhaps three, temperatures, one corresponding to the milling temperature, another to the warm storing temperature of stock after it has left the mill or calender, and a third to room temperature, although the experimental results on the last named are not complete at this time. If these determinations are made, the scorching tendencies of an accelerator under actual factory use can be predicted with accuracy.

scholarly journals Family History, Reproductive, and Lifestyle Risk Factors for Fibroadenoma and Breast Cancer

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Jingmei Li ◽  
Keith Humphreys ◽  
Peh Joo Ho ◽  
Mikael Eriksson ◽  
Eva Darai-Ramqvist ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Family History ◽  
Age At Menarche ◽  
Protective Effects ◽  
Lifestyle Risk Factors ◽  
Hazard Ratios ◽  
History Of ◽  
Participant Characteristics ◽  
Lifestyle Risk

Abstract Background To understand which breast cancer (BC) risk factors also increase the risk of fibroadenoma and investigate whether these factors have the same effect in BC patients with previous fibroadenoma. Methods Using multistate survival analysis on a large dataset (n = 58 322), we examined the effects of BC risk factors on transitions between three states: event-free, biopsy-confirmed fibroadenoma, and BC. Hazard ratios and corresponding 95% confidence intervals associated with covariate effects were estimated. Median follow-up time was 25.3 years. Results The mean ages at diagnosis of fibroadenoma and BC were 42.6 and 48.3 years, respectively. Participant characteristics known to increase the risk of BC were found to increase the risk of fibroadenoma (family history of BC and higher education). Participant characteristics known to confer protective effects for BC (older age at menarche, more children, and larger childhood body size) were found to reduce fibroadenoma risk. The effect sizes associated with the direct transitions from event-free to fibroadenoma and BC were generally not different for the covariates tested. Age at fibroadenoma diagnosis was associated with the transition from fibroadenoma to BC (hazard ratioper year increase = 1.07 [95% confidence interval = 1.03 to 1.12]). Conclusion We showed that biopsy-confirmed fibroadenomas shared many risk factors with BC. More work is needed to understand the relationships between fibroadenoma and BC to identify women who are at high risk of developing BC after a fibroadenoma diagnosis.

scholarly journals Prevalence of risk factors for breast cancer in women aged 30 years and above in Mumbai

2018 ◽  
Vol 5 (2) ◽  
pp. 647
Author(s):  
Padmavathi V. Dyavarishetty ◽  
Shobha S. Kowli
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Risk Factor ◽  
Population Based ◽  
Individual Risk ◽  
Age At Menarche ◽  
Cross Sectional ◽  
Cancer History ◽  
Increasing Trend ◽  
History Of

Background: Even though there is an increasing trend of breast cancer, women still do not perceive themselves at risk. Poor awareness about the disease and its risk factors and the absence of population based screening contribute to delayed diagnosis. The objective of the study was to assess the prevalence of various risk factors for breast cancer in women aged 30 years and above. Methods: The cross-sectional study using convenience sampling of all women aged 30 years and above was conducted in Mumbai. Of the 2430 women enumerated in the study area, 1158 women participated in the study. Risk factors for breast cancer assessed included age at menarche; age at first child birth; breastfeeding; use of oral contraceptive pills, age of menopause, first degree relatives with history of breast cancer, history of current and past breast cancer; history of any previous breast related abnormalities. Results: 15.5% of the women had atleast one risk factor for breast cancer. The prevalence of individual risk factors was below 6%. Conclusions: Prevalence of the risk factors for breast cancer is not very high, but never the less, the increasing trend of breast cancer in the country makes it imperative to introduce population based screening for all women with or without risk factor. 

scholarly journals Risk Factors for Premenopausal Breast Cancer in Bangladesh

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Javaid Iqbal ◽  
Tahmina Ferdousy ◽  
Rahela Dipi ◽  
Reza Salim ◽  
Wei Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Premenopausal Women ◽  
Breast Cancer Diagnosis ◽  
Age At Menarche ◽  
Premenopausal Breast Cancer ◽  
Factors Associated ◽  
History Of

Background. The incidence of premenopausal breast cancer is rising throughout South Asia. Our objective was to determine the role of risk factors associated with Westernization for premenopausal breast cancer in Bangladesh.Methods. We conducted a matched case-control study between January 1, 2007, and December 31, 2010, at four hospitals in Bangladesh. Cases were premenopausal women diagnosed with invasive breast cancer. Controls were premenopausal women with no personal history of breast cancer. Logistic regression was used to calculate the odds ratios (OR) for breast cancer.Results. We identified 129 age-matched pairs. The mean age of breast cancer diagnosis was 37.5 years. Each year decrease in the age of menarche significantly increased the risk of breast cancer (OR = 1.67, 95% CI 1.09–2.56,P=0.02). The risk was also increased with a current body mass index of ≥25 kg/m2(OR = 5.24, 95% CI 1.10–24.9,P=0.04). Age at first childbirth, parity, and breastfeeding were not significantly associated with premenopausal breast cancer risk (P>0.05).Conclusions. Age at menarche and adult weight gain were associated with premenopausal breast cancer risk. Other factors associated with Westernization may not be relevant to premenopausal breast cancer risk in Bangladesh.

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