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2021 ◽  
Vol 10 (23) ◽  
pp. 5668
Margaret Houser ◽  
David Barreto ◽  
Anita Mehta ◽  
Rachel F. Brem

Magnetic resonance imaging (MRI) is the most sensitive exam for detecting breast cancer. The American College of Radiology recommends women with 20% or greater lifetime risk of developing breast cancer be screened annually with MRI. However, other high-risk populations would also benefit. Hartmann et al. reported women with atypical hyperplasia have nearly a 30% incidence of breast cancer at 25-year follow-up. Women with dense breast tissue have up to a 4-fold increased risk of breast cancer when compared to average-risk women; their cancers are more likely to be mammographically occult. Because multiple cohorts of women are at high risk for developing breast cancer, there has been a movement to develop an abbreviated MRI (abMRI) protocol to expand the availability of MRI screening. Studies on abMRI effectiveness have been promising, with Weinstein et al. demonstrating a cancer detection rate of 27.4/1000 in women with dense breasts after a negative digital breast tomosynthesis. Breast MRI is also used to evaluate the extent of disease as part of preoperative assessment in women with newly diagnosed breast cancer, and to assess a patient’s response to neoadjuvant chemotherapy. This paper aims to explore the current uses of MRI and propose future indications and directions.

2021 ◽  
Vol 9 (11) ◽  
pp. 454-458
Reem Mohammed Alshiakh ◽  
Ahmad Omar Alghamdi ◽  
Suhad Ali Aljuhani ◽  
Hadeel Hamid Ahmad ◽  

Malignant neoplasms of the colon and rectum are often missed in patients younger than 45 years, the uncertainty of the diagnosis by the surgical team due to unavailability of clear screening guidelines in this population may be one of the reasons. The objective of this case report is to highlight the occurrence of colon cancer in a patient younger than 45 years to avoid the delay in management and the need for clear screening guidelines. Our patient, a 30 years old lady with an average risk of colon cancer demonstrated clinical symptoms and signs suggestive of partial bowel obstruction. After full radiological and laboratory investigations, she was initially diagnosed with inflammatory vs infectious cause of this obstruction. Colonoscopy showed a mass in the right hepatic flexure and sessile polyp in the transverse colon, Histopathology result showed moderately differentiated colon cancer. The patient was taken to the operation theater, right extended hemicolectomy was done, final histopathology result showed stage IIIc cancer, the patient was sent for oncology. In a conclusion, Colon cancer in patients younger than 45 years old requires a high index of suspicion by the surgeon and the managing team despite the unavailability of clear guidelines for screening at a young age.

Carlos Canelo-Aybar ◽  
Margarita Posso ◽  
Nadia Montero ◽  
Ivan Solà ◽  
Zuleika Saz-Parkinson ◽  

Abstract Background Although mammography screening is recommended in most European countries, the balance between the benefits and harms of different screening intervals is still a matter of debate. This review informed the European Commission Initiative on Breast Cancer (BC) recommendations. Methods We searched PubMed, EMBASE, and the Cochrane Library to identify RCTs, observational or modelling studies, comparing desirable (BC deaths averted, QALYs, BC stage, interval cancer) and undesirable (overdiagnosis, false positive related, radiation related) effects from annual, biennial, or triennial mammography screening in women of average risk for BC. We assessed the certainty of the evidence using the GRADE approach. Results We included one RCT, 13 observational, and 11 modelling studies. In women 50–69, annual compared to biennial screening may have small additional benefits but an important increase in false positive results; triennial compared to biennial screening may have smaller benefits while avoiding some harms. In younger women (aged 45–49), annual compared to biennial screening had a smaller gain in benefits and larger harms, showing a less favourable balance in this age group than in women 50–69. In women 70–74, there were fewer additional harms and similar benefits with shorter screening intervals. The overall certainty of the evidence for each of these comparisons was very low. Conclusions In women of average BC risk, screening intervals have different trade-offs for each age group. The balance probably favours biennial screening in women 50–69. In younger women, annual screening may have a less favourable balance, while in women aged 70–74 years longer screening intervals may be more favourable.

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2074
Masayuki Tsuneki ◽  
Fahdi Kanavati

Colorectal poorly differentiated adenocarcinoma (ADC) is known to have a poor prognosis as compared with well to moderately differentiated ADC. The frequency of poorly differentiated ADC is relatively low (usually less than 5% among colorectal carcinomas). Histopathological diagnosis based on endoscopic biopsy specimens is currently the most cost effective method to perform as part of colonoscopic screening in average risk patients, and it is an area that could benefit from AI-based tools to aid pathologists in their clinical workflows. In this study, we trained deep learning models to classify poorly differentiated colorectal ADC from Whole Slide Images (WSIs) using a simple transfer learning method. We evaluated the models on a combination of test sets obtained from five distinct sources, achieving receiver operating characteristic curve (ROC) area under the curves (AUCs) up to 0.95 on 1799 test cases.

2021 ◽  
Vol Publish Ahead of Print ◽  
Ryusaku Kusunoki ◽  
Hirofumi Fujishiro ◽  
Shinsuke Suemitsu ◽  
Masatoshi Kataoka ◽  
Aya Fujiwara ◽  

2021 ◽  
Kamarul Imran Musa ◽  
Che Muhammad Nur Hidayat Che Nawi ◽  
Mohd. Azahadi Omar ◽  
Thomas Keegan ◽  
Yong Poh Yu

Abstract Globorisk is a novel risk prediction model that predicts cardiovascular disease (CVD) in the national population of all world countries. Using Malaysia's risk factor levels and CVD event rates, we calculated the laboratory-based and office-based risk scores to predict the 10-year risk for fatal CVD and fatal plus non-fatal CVD for the Malaysian adult population. We analysed data from 8253 participants from the 2015 nationwide Malaysian National Health and Morbidity Survey (NHMS 2015). The average risk for the 10-year fatal and fatal plus non-fatal CVD was calculated, and participants were further grouped into four categories: Low Risk (<10% risk for CVD), High-Risk A (≥10%), High-Risk B (≥20%) and High-Risk C (≥30%). Results were reported for all participants and were then stratified by sex, race, region, and state. The average risks for laboratory-based fatal CVD, laboratory-based fatal plus non-fatal CVD and office-based fatal plus non-fatal CVD were 0.07 (SD = 0.10), 0.14 (SD = 0.12) and 0.11 (SD = 0.09), respectively. There were substantial differences in terms of the sex-, race- and state-specific Globorisk risk scores obtained.

Deborah A. Fisher ◽  
Nicole Princic ◽  
Lesley-Ann Miller-Wilson ◽  
Kathleen Wilson ◽  
Kathryn DeYoung ◽  

Abstract Purpose This study examined adherence to screening for fecal immunochemical test (FIT). Methods Adults (≥ 50–75) with a FIT between 1/1/2014 and 6/30/2019 in MarketScan administrative claims were selected (index = earliest FIT). Patients were followed for 10 years pre- and 3 years post-index. Patients at increased risk for CRC or with prior screening were excluded. Year over year adherence was measured post-index. Results Of 10,253 patients, the proportion adherent to repeat testing at year 2 was 23.4% and 10.6% at year 3. Of 76.6% not adherent in year 2, 5.4% were adherent in year 3. Conclusion Results suggest adherence to FIT tests is poor, minimizing potential benefits. Future studies are needed to consider alternative test options and whether more choice will improve long-term adherence.

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