ROLE OF MAMMOGRAPHY AND CORE BIOPSY IN THE DIAGNOSIS OF BREAST TUMOR

2017 ◽  
pp. 69-72
Author(s):  
Trong Hung Phan ◽  
Cong Thuan Dang ◽  
Thanh Thao Nguyen
Keyword(s):  
Breast Cancer ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Breast Tumor ◽  
Core Biopsy ◽  
Breast Tumors ◽  
Breast Disease ◽  
University Hospital ◽  
Sensitivity Specificity

Introduction: Breast tumor is a popular disease. Breast cancer is the most common cancer in women. Mammography is the chosen screening test and ultrasound-guided core-needle biopsy provides (US-CNB) the pathologic result for treatment. Objective: To study the role of mammography and core biopsy in diagnosis of breast tumors. Materials and methodology: Prospective and retrospective study of 33 breast tumors examined mammograms at Hue University Hospital and Hue Central Hospital from 7/2014 to 4/2017. Results: Mean age of breast cancer: 52 years old, of benign breast disease: 53 years old. 86% of all cases admitted to hospital due to self-detecting breast tumor. Locations: 0-3h 33.3%, 9-12h 27.2%. Sensitivity, specificity and accuracy of mammography were 76.9%, 28.6% and 66.7% respectively. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy value of US-CNB were 95.2%, 85.6%, 95.2%, 85.6% and 92.9%, respectively. The value of combined with mammograms and US-CNB has improved the specificity and positive predictive value to 100%, accuracy value to 95.2%. Moreover, this combination discovered 7.1% breast cancer more. Conclusion: US-CNB is a safe and less traumatic diagnostic tool with high pathologic efficiency. Combining mammography and US-CNB increases the diagnostic value. Key words: Breast tumor, breast cancer, mammograms

scholarly journals 3124 Early Electrographic Seizure Detection by Neuro ICU Nurses via Bedside Real-Time Quantitative EEG

2019 ◽  
Vol 3 (s1) ◽  
pp. 38-38
Author(s):  
Safa Kaleem ◽  
Christa B. Swisher
Keyword(s):  
Positive Predictive Value ◽  
Real Time ◽  
Predictive Value ◽  
Quantitative Eeg ◽  
University Hospital ◽  
Duke University ◽  
Study Population ◽  
Time To Detection ◽  
Sensitivity Specificity ◽  
Improve Patient

OBJECTIVES/SPECIFIC AIMS: 1. Determine positive predictive value, negative predictive value, sensitivity, and specificity of Neuro ICU nurse interpretation of real-time bedside qEEG. 2. Determine difference in time to detection of first seizure between Neuro ICU nurse qEEG interpretation and EEG fellow reads of cEEG. 3. Determine what qualities of seizures make detection by neuro ICU nurses more or less likely – e.g. duration of seizures, type of seizures, spatial extent of seizures. METHODS/STUDY POPULATION: Recruit neuro ICU nurses taking care of 150 patients admitted to the Neuro ICU at Duke University Hospital who are initiated on cEEG monitoring. Nurses will be consented for their participation in the study. Neuro ICU nurses will evaluate the qEE RESULTS/ANTICIPATED RESULTS: From literature estimates of a 20% seizure prevalence in critical care settings, we hope to have 30 patients with seizures and 120 without. Based on prior study in the Duke Neuro ICU, we hypothesize that Neuro ICU nurses will have sensitivity and DISCUSSION/SIGNIFICANCE OF IMPACT: This is the first prospective study of neuro ICU nurse interpretation of real-time bedside qEEG in patients with unknown NCSE/NCS presence. If nurse sensitivity, specificity, and positive predictive value are clinically useful, which we deem would be so at a sensitivity of 70% or greater, with acceptable false alarm rate, nurse readings of qEEG could significantly decrease the time to treatment of seizures in the Neuro ICU patient population, and perhaps could improve patient outcomes.

scholarly journals The role of Ghrelin Receptor Expression in the Diagnosis of breast cancer

2020 ◽  
Vol 11 (2) ◽  
pp. 1438-1446
Author(s):  
Abbas M. Ajeed ◽  
Alaa G. Hussein ◽  
Nazar Alwakeel ◽  
Omar F. Abdul-Rasheed
Keyword(s):  
Breast Cancer ◽  
Breast Tumor ◽  
Breast Tumors ◽  
Receptor Expression ◽  
Tissue Samples ◽  
Ghrelin Receptor ◽  
Female Patients ◽  
Benign Breast Tumor ◽  
Tumor Tissues

To determine the possible role of the assessment of Ghrelin receptor expression in breast tissues as a tool for the diagnosis of breast cancer and differentiate it from a benign breast tumor. A case-control study was done on 60 female patients with breast cancer and 60 female patients with benign breast tumors (Fibroadenoma) who were recruited from Al Imamain Al-Kadhemain Medical City and Oncology teaching Hospital, Baghdad, Iraq between May 2018 and December 2018. Immunohistochemical staining was done on the breast tissue samples obtained from patients and compared with the control group, which comprised 75 fibrocystic tissue samples obtained from age, BMI and sex-matched females. The degree of Ghrelin Receptor expression was determined immunohistochemically. The expression of Ghrelin receptors in breast malignant tumor tissues was higher than that in benign breast tumor tissues and controls, in addition to that, results obtained from all groups revealed that Ghrelin receptor intensity and its expression proportion were strongly and significantly associated with the type of tissues. The expression of the Ghrelin receptor can be considered as a highly significant immunohistochemical marker for the detection of breast tumors and for the differentiation between both types of tumors; benign and malignant.

The impact on case findings by transferring clinical breast examination skills to female community health volunteers in limited resources country like Nepal.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11094-e11094
Author(s):  
Sanjiv Kumar Hyoju
Keyword(s):  
Breast Cancer ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Clinical Breast Examination ◽  
Limited Resources ◽  
Breast Examination ◽  
Clinical Breast ◽  
Sensitivity Specificity ◽  
Kappa Agreement

e11094 Background: In limited resources countries, patients with breast cancer present to the hospital in the late stage because of lack of awareness, screening program. Clinical Breast Examination (CBE) may be the only means of detecting the breast cancer early in countries with limited resources since mammography is less likely to be cost effective approach and CBE by surgeons are also not possible because of limited health care facility. Hence CBE by FCHVs seems to be more feasible. This study was conducted to observe the skill transfer to FCHVs for detection of clinical abnormalities in breast by determining kappa agreement, sensitivity, specificity, positive predictive value and negative predictive value of CBE by FCHVs considering CBE by the Surgeon as gold standard. Methods: It is a cross-sectional study conducted in Eastern Nepal for period of one year from June 2008 to May 2009. Total 1238 women were examined by both a FCHV and the Surgeon. The results were analyzed to find out interobserver kappa agreement, sensitivity, specificity, positive predictive value and negative predictive value for detection of clinical abnormalities in breast following CBE by FCHVs considering CBE by the Surgeon as gold standard. Results: Total 1238 women received CBE by both a FCHV and the Surgeon. The interobserver kappa agreement for the detection of clinical abnormalities in breast was 67% indicating a good agreement exists between the FCHVs and the Surgeon’s CBE Sensitivity, specificity, positive predictive value and negative predictive values of “FCHVs’ CBE” to detect clinical abnormalities in breast in comparison to “the Surgeon’s CBE” as gold standard were 70%, 95%, 74% and 94% respectively. Conclusions: In view of good CBE skills transfer to FCHVs for detection of clinical abnormalities in breast, the effective training of FCHVs may diagnose and refer the women with clinical breast abnormalities to the hospital for further investigation and treatment.

Validation of BRCA mutation-carrier probability model, BRCAPRO, in Japanese.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12532-e12532
Author(s):  
Masahiro Ito ◽  
Yuri Yasuda ◽  
Akihiko Furuta ◽  
Noriaki Ohuchi
Keyword(s):  
Breast Cancer ◽  
Genetic Testing ◽  
Family History ◽  
Positive Predictive Value ◽  
Mutation Carrier ◽  
Predictive Value ◽  
Brca Mutation ◽  
Brca Mutation Carrier ◽  
Mutation Probability ◽  
Sensitivity Specificity

e12532 Background: Genetic testing has not been widely performed in Japan. It is not known whether BRCA mutation-carrier model is useful for selecting eligible person of genetic testing. We studied the validation of BRCAPRO in Japanese. Methods: Twenty-six hundred sixty-five people visited to our hospital between 2011 and 2012.They were surveyed family history as a risk factor of inheriting breast cancer according to NCCN guideline. Among them, those who have a number of family history of breast cancer, ovarian cancer, pancreatic cancer, prostate cancer were selected and in addition, genetic counselor constructed family tree. We also calculated BRCA1/2 mutation probability by BRCAPRO.Those who had more than 10% mutation probability and early onset breast cancer, triple negative breast cancer were received genetic counseling and genetic testing for applicants. We also calculated sensitivity, specificity and predictive value at 10% estimated probability. Results: One hundred five people (3.9%) were selected as a risk of inheriting breast cancer, of which sixty-three people (2.3%) were constructed family tree.The number of people who had more than 10% and 30% mutation probability by BRCAPRO was seven (0.26%) and three (0.11%).Nine people performed BRCA1/2 genetic testing (proband : eight, relative: one)Four people carried a deleterious BRCA mutation (BRCA1: three, BRCA2: one).In the cases which had more than 30% mutation probability, all of them carried a deleterious BRCA mutation. Most of their mutation site was L63X which was most frequent in Japan. Using a 10% cut-off, sensitivity was 75%, specificity was 80%,positive predictive value was 75%. When it comes to the cases which had more than 30% mutation probability, Sensitivity, specificity, positive predictive value were all 100%. Conclusions: Our findings suggest BRCAPRO is useful in Japanese, especially those who have more than 30% mutation probability.

scholarly journals Monofrequency electrical impedance mammography (EIM) diagnostic system in breast cancer screening

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Blanca Murillo-Ortiz ◽  
Abraham Hernández-Ramírez ◽  
Talia Rivera-Villanueva ◽  
David Suárez-García ◽  
Mario Murguía-Pérez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Electrical Impedance ◽  
Screening Method ◽  
Future Research ◽  
Predictive Values ◽  
Sensitivity Specificity

Abstract Background Some evidence has shown that malignant breast tumours have lower electrical impedance than surrounding normal tissues. Electrical impedance could be used as an indicator for breast cancer detection. The purpose of our study was to analyse the sensitivity and specificity of electrical impedance mammography (EIM) and its implementation for the differential diagnosis of pathological lesions of the breast, either alone or in combination with mammography/ultrasound, in 1200 women between 25 and 70 years old. Methods This study is a prospective, cross-sectional epidemiological observational study of serial screening. The women were invited to participate and signed a consent letter. Impedance imaging of the mammary gland was evaluated with the computerized mammography equipment of MEIK electroimpedance v.5.6. (0.5 mA, 50 kHz), developed and manufactured by PKF SIM-Technika®. The successful identification of breast cancer along with the sensitivity, specificity, and positive and negative predictive values of EIM were determined as follows: % sensitivity; % specificity; % positive predictive value (PPV); and % negative predictive value (NPV). Results EIM had a sensitivity of 85% and a specificity of 96%; the positive predictive value was 12%, and the negative predictive value was 99%. Seven cases were biopsy confirmed cancers. Significant correlations between the electrical conductivity index and body mass index (BMI) (p = 0.04) and patient age were observed (p = 0.01). We also observed that the average conductivity distribution increased according to age group (p = 0.001). We used the chi-squared test to assess the interactions between percent density and BMI (normal < 25 kg/m2 (n = 310), overweight 25–29.9 kg/m2 (n = 418) and obese ≥30 (n = 437)) (p <  0.05). The patients with a diagnosis of mammary carcinoma had a BMI of 35.51 kg/m2. Conclusions Our results demonstrate that the use of monofrequency electrical impedance mammography (EIM) in the detection of breast cancer had a sensitivity and specificity of 85 and 96%, respectively. These findings may support future research in the early detection of breast cancer. EIM is a non-radiation method that may also be used as a screening method for young women with dense breasts and a high risk of developing breast cancer.

scholarly journals The Role of Osteocalcin and Alkaline Phosphatase Immunohistochemistry in Osteosarcoma Diagnosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hasrayati Agustina ◽  
Ita Asyifa ◽  
Afiati Aziz ◽  
Bethy S. Hernowo
Keyword(s):  
Alkaline Phosphatase ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Bone Tumours ◽  
Small Specimen ◽  
Primary Bone ◽  
The Mean ◽  
Sensitivity Specificity ◽  
Primary Bone Tumours

Background. The diagnosis of Osteosarcoma (OSA) is not always straightforward. OSA may resemble Other Primary Bone Tumours (OPBT). The diagnosis of osteosarcoma is sometimes difficult especially in a very small specimen. Immunohistochemistry is one of ancillary testing types that can help the diagnosis of many tumours. The aim of this study was to evaluate the validity of Osteocalcin (OCN) and Alkaline Phosphatase (ALP) immunohistochemistry in discriminating OSA from OPBT. Method. This study included 50 selected human primary bone tumours, 25 cases of OSA and 25 cases of OPBT. Immunohistochemical evaluation of OCN and ALP was done for all cases. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Result. The mean age of OSA and OPBT patients was 19.6±13.6 and 40.0±16.3 years, respectively. Osteocalcin was positive in 17/25 (68%) cases of OSA and 16/25 (64%) cases of OPBT (p=0.061). Alkaline Phosphatase was positive in 24/25 (96%) cases of OSA and 5/25 (20%) cases of OPBT (p<0.001). The sensitivity of OCN in OSA diagnosis was 68%, with specificity, PPV, NPV, and overall accuracy being 36%, 52%, 53%, and 52%, respectively. The sensitivity of ALP in OSA diagnosis was 96%, with specificity, PPV, NPV, and overall accuracy being 80%, 82.7%, 95.2%, and 88%, respectively. Conclusion. ALP immunohistochemistry is useful in discriminating OSA from OPBT. ALP is superior to OCN in OSA diagnosis. OCN cannot be used to differentiate between OSA and OPBT.

scholarly journals EVALUATION OF ACUTE APPENDICITIS USING ULTRASOUND

2021 ◽  
Vol 9 (02) ◽  
pp. 315-321
Author(s):  
Abdullah Hamdan ◽  
◽  
Nasraldeen Alnaeem M. Alkhidir ◽  
Abdelmoneim Saeed ◽  
◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Clinical Diagnosis ◽  
Predictive Value ◽  
Sensitivity Specificity ◽  
Histopathological Report

The diagnosis of acute appendicitis is mainly clinical and to confirm the clinical diagnosis ultrasonography (USG) of the abdomen is being used to help in diagnosis of the disease. To find out the role of USG in the diagnosis of acute appendicitis in clinically equivocal cases and to correlate USG findings with histopathological reports (HPR) of removed appendix.Total numbers of 100 patients were included in the study from 12March 2019 to 5 December 2019. Findings on ultrasound were finally compared with histopathological report of appendices removed on surgery. Those cases with alternate diagnosis were followed up and proved with other means of investigation. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of ultrasound in diagnosis of acute appendicitis in our study were found to be 79 %, 84.20 %, 95.50%, 48.40% and 80% respectively.

Study of Role of Ultrasonography in Evaluation of Thyroid Nodules

2019 ◽  
Vol 9 (1) ◽  
pp. 2-6
Author(s):  
Merina Gyawali ◽  
Prakash Sharma
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Histological Analysis ◽  
Shape Sensitivity ◽  
Aspiration Cytology ◽  
Common Clinical Finding ◽  
Sensitivity Specificity ◽  
Pattern Sensitivity

Introduction: Thyroid nodules are a very common clinical finding which can be single ormultinodular and benign or malignant. Ultrasonography (USG) followed by USG guided fineneedle aspiration cytology (FNAC) is usually done in evaluating any thyroid nodule that ispalpable on physical examination. The purpose of this study was to study the role of USG in evaluating thyroid nodules and its correlation with findings of FNAC of thyroid. Methods: One hundred and twenty five patients with palpable thyroid referred for USG neckwere included in the study. Ultrasonography assessments of thyroid with different parameters were done. The findings were later compared with FNAC thyroid. Results: On FNAC and histological analysis, thyroid malignancy was observed in 14 out of 125 (11.21%) subjects. Malignant nodules on USG demonstrated hypoechoic pattern (sensitivity 82.3%, specificity 97.2%, and positive predictive value 82.3%), irregular margins (sensitivity 77.8%, specificity 96.3%, and accuracy 77.8%), central vascularity (sensitivity 82.3%, specificity 95.4%, and positive predictive value 73.7%) and taller-than-wider shape (sensitivity 82.3%, specificity 96.3%, and accuracy 77.8%). Sixteen cases with suspicion of malignant thyroid nodules demonstrated these 2 or more USG features. Sensitivity, specificity and positive predictive value of thyroid nodules for detecting malignancy increased to 87.5%, 98.2% and 87.5% respectively when two or more of these USG features were present. Conclusions: Thyroid USG demonstrating hypoechoic pattern, irregular margins, centralvascularity and taller-than-wider shape had potential of being malignant. Thyroid nodules were found to have more malignant potential when two or more of these USG features were present.

Defining cardiotoxicity of doxorubicin and trastuzumab.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23097-e23097
Author(s):  
Abir Khan ◽  
Omid Amidi ◽  
Kenneth R. Hess ◽  
Michael S. Ewer ◽  
Wamique Yusuf ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Clinical Heart Failure ◽  
Definition Of ◽  
Sensitivity Specificity

e23097 Background: Doxorubicin and trastuzumab have been described to cause clinical heart failure and asymptomatic declines in left ventricular ejection fraction (LVEF). Initial studies of doxorubicin in the 1970’s defined cardiotoxicity by the clinical syndrome of heart failure without imaging for LVEF determination. Trials with adjuvant trastuzumab used various LVEF cut-offs that were arbitrarily determined. This study aims to compare the predictive value of commonly used definitions of cardiotoxicity associated with chemotherapy for the development of clinical heart failure. Methods: A retrospective chart review was performed on an IRB approved cohort of 638 patients with breast cancer who received doxorubicin, trastuzumab, or both and who had baseline and follow up echocardiograms, collecting LVEF values for each echocardiogram. Clinical heart failure was determined by formal cardiology evaluations denoting clinical heart failure in patients. Four different definitions of cardiotoxicity were compared; American Society of Echocardiography (ASE), Cardiac Review and Evaluation Committee (CREC), Alexander et al, and Schwartz et al (Table). Results: Only 8 patients (1.25%) developed clinical heart failure. The sensitivity, specificity, positive predictive value, and negative predictive value of each definition of cardiotoxicity are listed in the table. Conclusions: Overall there is a low threshold for detection of clinical heart failure in breast cancer therapy. While the ASE definition has the highest combination of sensitivity, specificity, and positive predictive value, it has a sensitivity of only 62.5%. Thus, cardiologists and oncologists should collaborate to develop a definition of cardiotoxicity better correlated to clinical outcomes. [Table: see text]

scholarly journals The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation

2014 ◽  
Vol 28 (12) ◽  
pp. 1218-1224 ◽  
Author(s):  
Terry P Breisinger ◽  
Elizabeth R Skidmore ◽  
Christian Niyonkuru ◽  
Lauren Terhorst ◽  
Grace B Campbell
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Fall Risk ◽  
Stroke Rehabilitation ◽  
Assessment Tool ◽  
Area Under The Curve ◽  
University Hospital ◽  
Sensitivity Specificity ◽  
Stroke Assessment

Objective: To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Design and setting: Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Participants: Patients admitted for inpatient stroke rehabilitation ( N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Interventions: Not applicable. Main outcome measure(s): Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales’ classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. Results: A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen ( p < 0.001), with area under the curve of 0.73, positive predictive value of 0.29, and negative predictive value of 0.94. For the Fall Harm Risk Screen, area under the curve was 0.56, positive predictive value was 0.19, and negative predictive value was 0.86. Sensitivity and specificity of the SAFR (0.78 and 0.63, respectively) was higher than the Fall Harm Risk Screen (0.57 and 0.48, respectively). Conclusions: An evidence-derived, population-specific fall risk assessment may more accurately predict fallers than a general fall risk screen for stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted.

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