Dietary Acid Load, Serum Polychlorinated Biphenyl Levels, and Mortality Following Breast Cancer in the Long Island Breast Cancer Study Project

Dietary acid load (DAL) may be associated with all-cause mortality (ACM) and breast cancer-specific mortality (BCM), and these associations may be modified by serum polychlorinated biphenyl (PCB) levels. Participants included 519 women diagnosed with first primary in situ or invasive breast cancer in 1996/1997 with available lipid-corrected PCB data. After a median of 17 years, there were 217 deaths (73 BCM). Potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores calculated from a baseline food frequency questionnaire estimated DAL. Cox regression estimated covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between PRAL and NEAP with mortality. We evaluated effect measure modification by total serum PCB levels (>median vs. ≤median). PRAL quartile 4 versus quartile 1 was associated with an ACM HR of 1.31 (95%CI = 0.90–1.92). In the upper median of PCBs, ACM HRs were 1.43 (95%CI = 0.96–2.11) and 1.40 (95%CI = 0.94–2.07) for PRAL and NEAP upper medians, respectively. In the lower median of PCBs, the upper median of NEAP was inversely associated with BCM (HR = 0.40, 95%CI = 0.19–0.85). DAL may be associated with increased risk of all-cause mortality following breast cancer among women with high total serum PCB levels, but inversely associated with breast cancer mortality among women with low PCB levels.

Women’s conceptual knowledge about breast cancer screening and overdiagnosis in Norway: a cross-sectional study

ObjectiveTo investigate conceptual knowledge about mammographic screening among Norwegian women.DesignWe administered a cross-sectional, web-based survey. We used multiple-choice questions and a grading rubric published by a research group from Australia.SettingOur Norwegian-language survey was open from April to June 2020 and targeted women aged 45–74 years.Participants2033 women completed our questionnaire. We excluded 13 women outside the target age range and 128 women with incomplete data. Responses from 1892 women were included in the final study sample.Primary and secondary outcome measuresThe questionnaire focused on women’s knowledge about the breast cancer mortality reduction, false positive results and overdiagnosis associated with mammographic screening. The primary outcome was the mean number of marks assigned in each of the three themes and overall. There were three potential marks for questions about breast cancer mortality, one for false positives and six for overdiagnosis.ResultsMost women (91.7%) correctly reported that screened women are less likely to die of breast cancer than non-screened women. 39.7% of women reported having heard of a ‘false positive screening result’ and 86.2% identified the term’s definition; 51.3% of women had heard of ‘overdiagnosis’ and 14.8% identified the term’s definition. The mean score was 2.59 of 3 for questions about breast cancer mortality benefit and 0.93 of 1 for the question about false positive screening results. It was 2.23 of 6 for questions about overdiagnosis.ConclusionsMost participants correctly answered questions about the breast cancer mortality benefit and false positive results associated with screening. The proportion of correct responses to questions about overdiagnosis was modest, indicating that conceptual knowledge about overdiagnosis was lower. Qualitative studies that can obtain in-depth information about women’s understanding of overdiagnosis may help improve Norwegian-language information about this challenging topic.

Trends in Breast Cancer Mortality Between 2001 and 2017: An Observational Study in the European Union and the United Kingdom

PURPOSE Breast cancer is the most common cancer in women worldwide, representing 25.4% of the newly diagnosed cases in 2018. The past two decades have seen advancements in screening technologies, guidelines, and newer modalities of treatment. Our study reports and compares trends in breast cancer mortality in the European Union and the United Kingdom. MATERIALS AND METHODS We used the WHO Mortality Database. We extracted breast cancer mortality data from 2001 to 2017 on the basis of the International Classification of Diseases, 10th revision system. Crude mortality rates were dichotomized by sex and reported by year. We computed age-standardized death rates (ASDRs) per 100,000 population using the world standard population. Breast cancer mortality trends were compared using joinpoint regression analysis. RESULTS We analyzed data from 24 EU countries, including the United Kingdom. For women, breast cancer mortality was observed to be downtrending in all countries except Croatia, France, and Poland. For the most recent female data, the highest ASDR for breast cancer was identified in Croatia (19.29 per 100,000), and the lowest ASDR was noted in Spain (12.8 per 100,000). Denmark had the highest change in ASDR and the highest estimated annual percentage change of −3.2%. For men, breast cancer mortality decreased in 18 countries, with the largest relative reduction observed in Denmark with an estimated annual percentage change of −27.5%. For the most recent male data, the highest ASDR for breast cancer was identified in Latvia (0.54 per 100,000). CONCLUSION Breast cancer mortality rates have down trended in most EU countries between 2001 and 2017 for both men and women. Given the observational nature of this study, causality to the observed trends cannot be reliably ascribed. However, possible contributing factors should be considered and subject to further study.

Brest Cancer Screening and Mobile Web App Intervention: Perceptions, Knowledge, and Needs among Native Women

American Indian (AI) women have the highest breast cancer mortality and lowest breast cancer screening rates in the U.S. The present study, in collaboration with the Yankton Sioux Tribe (YST) in South Dakota, sought to (1) identify the general public/professionals’ knowledge, attitudes, and needs for a mobile web app for breast cancer screening (wMammogram) intervention, and (2) inform development of the wMammogram intervention to improve Breast Cancer screening among YST women. Following a community-based participatory research approach, two focus groups were conducted in October 2020 with a total of 22 YST women aged 40-70 years, including 17 elderly women. Each group consisted of 11 community leaders, members, healthcare professionals. Qualitative analysis was conducted using grounded theory. Participants in both groups were generally favorable toward the wMammogram intervention, and noted a potential health benefit, particularly for women in their 50s to 60s. Key areas identified by participants for intervention include: (1) needs for better knowledge of breast cancer, screening, and prevention/early detection, (2) culturally tailored educational materials rooted in AI cultural values and beliefs (e.g., holistic wellness approach, Native lifestyles), (3) barriers (e.g., fear), (4) motivators (e.g., reminders), and (5) suggestions for acceptability (e.g., content and structure of messages). These results suggest that the wMammogram intervention, which is culturally tailored and addresses the community’s concerns, can be a feasible, acceptable, and effective tool to promote breast cancer screening among YST women. The results informed the development of an innovative health intervention to help reduce health disparities experienced in Indian Country.

Do automated breast ultrasound and tomosynthesis have an effective role in dense breast evaluation?

Background Mammography plays a great role in reducing breast cancer mortality as it is the standard method of breast imaging and screening. But the accuracy of mammography performance reduces in cancer detection in women with dense breast due to the summation of images and overlapping of breast tissue. ABUS and tomosynthesis both recently help to detect breast cancer in dense breasted women. This prospective study was done in the female imaging unit and approved by its research and ethical committee; all the patients did an informed consent during the period from October 2018 to March 2019. The study was conducted on 38 patients with 38 lesions subjected to digital mammography, tomosynthesis and automated breast ultrasound (ABUS), who all had dense breast in mammography. Results Automated breast ultrasound (ABUS) showed 100% in all sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) as well as accuracy, while the digital mammography tomosynthesis showed 100% in specificity, 87.5% in sensitivity, 100% in PPV, 82.4% in NPV and 92.1% accuracy. Conclusion Automated breast ultrasound (ABUS) together with tomosynthesis makes a revolution in breast screening and detecting cancer in women with dense breasts.

Breast Cancer Mortality in the Primorsky Region: Data Analysis and Modeling

Introduction: In the Primorsky Region, there is a steady upward trend in breast cancer morbidity and mortality. Lifestyle, material wellbeing, availability and timeliness of receiving medical care, along with genetic predisposition, have a significant impact on life expectancy and mortality of cancer patients, which is of great importance for public health, especially when developing a strategy to improve the quality of life and health status of the population. Objective: The study aimed to analyze the situation and to develop a model for mortality prediction based on breast cancer prevalence rates and socio-economic indicators of the population of the Primorsky Region. Materials and methods: The study was carried out based on data from the Federal State Statistics Service and the Medical Information Analytical Center of the Primorsky Region for 1994–2019. Correlation analysis was used to analyze statistical data and the prediction model was developed using artificial neural networks. Results: In 2000–2019, there was a rise in breast cancer mortality by 39.13 % in the region. The statistical analysis of the relationship between socio-economic indicators and the mortality rate showed significant correlations, which were further used for the development of a neural network model. We observed that predictions were most influenced by parameters of material well-being and health care quality. Conclusion: The established relationships prove the necessity of considering them when designing management decisions aimed to increase life expectancy and improve the quality of life in breast cancer patients.