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In this study, we applied a cyclone tracking algorithm to multiple reanalyses and categorized the detected cyclones based on season, intensity, and sea ice state to provide an Arctic cyclone climatology with emphasis on cyclone‐sea ice interactions over the Arctic Ocean and adjacent waters. Our study period is from 1979 to 2015 and the reanalyses we are using are ERA‐Interim, ERA5, and CFSR. As for our intensity variable, we use Accumulated Cyclone Energy (ACE), which has commonly been used as an intensity metric in the tropics but has not been utilized for high latitudes before. ACE has the advantage that it relates the cyclone intensity to the kinetic energy of the cyclone and therefore better represents the cyclone impact/interaction with the surface. We performed comparisons with the other more commonly used intensity metrics to assess the use of the ACE metric in the Arctic. Our main findings include increased cyclone counts with higher trends toward the end of the study period. Cold season cyclone counts were also found to be related to decreased sea ice concentration throughout the year. We also show that there is a relationship between the cyclone intensity measured by ACE and the surface state. Less sea ice was shown to be related to higher cyclone intensities. Comparisons between the the three reanalysis data sets are also presented. Plain Language Summary: In this study, three cyclone data sets were compared over the Arctic Ocean and adjacent waters to have a better understanding of how Arctic storms interact with the sea ice. Our study period is from 1979 to 2015, and we assessed multiple different storm characteristics, such as the size and intensity of the storm, to study the storms' relationships with the sea ice. We found that in the cold season (December–May), less sea ice was related to more and stronger cyclones, and that the amount of sea ice present had an influence on the cyclone strength over the study region. Key Points: Less sea ice is related to higher cyclone track countsLess sea ice is related to stronger cyclonesThe new ERA5 reanalysis detects smaller cyclones than the ERA‐Interim or CFSR data sets [ABSTRACT FROM AUTHOR]

Radiomics focuses on extracting a large number of quantitative imaging features and testing both their correlation with clinical characteristics and their prognostic and predictive values. We propose a radiomic approach using magnetic resonance imaging (MRI) to decode the tumor phenotype and local recurrence in oropharyngeal squamous cell carcinoma (OPSCC). The contrast-enhanced T1-weighted sequences from baseline MRI examinations of OPSCC patients treated between 2008 and 2016 were retrospectively selected. Radiomic features were extracted using the IBEX software, and hiegrarchical clustering was applied to reduce features redundancy. The association of each radiomic feature with tumor grading and stage, HPV status, loco-regional recurrence within 2 years, considered as main endpoints, was assessed by univariate analysis and then corrected for multiple testing. Statistical analysis was performed with SAS/STAT® software. Thirty-two eligible cases were identified. For each patient, 1286 radiomic features were extracted, subsequently grouped into 16 clusters. Higher grading (G3 vs. G1/G2) was associated with lower values of GOH/65Percentile and GOH/85Percentile features (p=0.04 and 0.01, respectively). Positive HPV status was associated with higher values of GOH/10Percentile (p=0.03) and lower values of GOH/90Percentile (p=0.03). Loco-regional recurrence within 2 years was associated with higher values of GLCM3/4-7Correlation (p=0.04) and lower values of GLCM3/2-1InformationMeasureCorr1 (p=0.04). Results lost the statistical significance after correction for multiple testing. T stage was significantly correlated with 9 features, 4 of which (GLCM25/180-4InformationMeasureCorr2, Shape/MeanBreadth, GLCM25/90-1InverseDiffMomentNorm, and GLCM3/6-1InformationMeasureCorr1) retained statistical significance after False Discovery Rate correction. MRI-based radiomics is a feasible and promising approach for the prediction of tumor phenotype and local recurrence in OPSCC. Some radiomic features seem to be correlated with tumor characteristics and oncologic outcome however, larger collaborative studies are warranted in order to increase the statistical power and to obtain robust and validated results. [ABSTRACT FROM AUTHOR]

Background and Aims: A greater adherence to the Mediterranean diet has been associated with a reduced risk of major chronic diseases and cancer. The aim of the study was to assess the validity of a new short self-administered 15-item questionnaire (QueMD) to measure adherence to the Mediterranean diet in Italy.Methods and Results: Four-hundred and eighty three participants to cancer-screening programmes at the European Institute of Oncology, Milan (Italy) were invited to join this study. Those interested compiled the QueMD and a validated Food Frequency Questionnaire (FFQ) reporting their usual food consumption during the previous six months. We derived the alternate Mediterranean score (aMED) from both questionnaires with values ranging from 0 (minimal adherence) to 9 (maximal adherence). Complete dietary data were available for 343 individuals (participation rates 71.0%). Spearman correlation coefficient between the responses to the 15 questions of the QueMD and corresponding food intake derived from the FFQ ranged from 0.15 to 0.84. A moderate correlation was found between the aMED scores calculated from the QueMD and the FFQ (intraclass correlation coefficient 0.50; 95% CI, 0.42-0.58), while agreement between the two instruments was only poor to fair for 7 of the 9 single items composing the aMED score, with values ranging from 53.0% for wholegrain products to 79.5% for fruits.Conclusion: This new self-administered 15-item questionnaire could be a useful tool to assess adherence to the Mediterranean diet in the Italian population. [ABSTRACT FROM AUTHOR]

Background The SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial is an ongoing prospective randomized study comparing sentinel node biopsy vs. no axillary surgical staging in patients with small breast cancer and negative pre-operative ultra-sound of the axilla. Patients and methods The first 180 recruited patients were administered the Quick DASH (Disability Arm and Shoulder) questionnaire at different time points (before surgery, 1 week, 6 months and 1 year after surgery) to evaluate the physical function of the ipsilateral upper limb, The Quick DASH score ranges from 0 (no disability) to 100 (complete disability). Results 176 patients were available for analysis (94 in SNB arm and 82 in observation arm). The two groups were comparable with respect to age, tumor characteristics and treatments. Pre-surgery score values were 3.0% and 2.7% in the SNB arm and observation arm, respectively (P = 0.730). One week after surgery, the score increased to 24.0% in the SNB arm and 10.6% in the observation arm (P < 0.001). After 6 and 12 months, the score decreased in both arms to values similar to baseline values. The overall trend in time of the score was significantly different between the two arms (P < 0.001), even after the exclusion of five patients who received AD in the SNB arm (P < 0.001). Conclusions Patients who underwent SNB had a significantly higher rate of disability in the early post-operative period compared to patients who did not. The avoidance of SNB might translate into a considerable reduction of physical and emotional distress. [ABSTRACT FROM AUTHOR]

Breast metastasis from ovarian cancer is a rare event, with vary clinical and imaging presentations, depends on the form of dissemination of the disease and may mimic primary benign and malignant lesions.Confirmation of the diagnosis is of pivotal importance to choice an adequate therapeutic planning, allowing to avoid unnecessary surgeries and to provide appropriate systemic therapy. In this manuscript, we present a case of breast metastasis from ovarian cancer. The patient presented to our Institute with a localized, palpable mass in the upper outer quadrant of the right breast. Mammography and breast sonography showed a singular, round, and homogenous mass with regular borders. No suspicious axillary node was observed. Lesion biopsy revealed the presence of epithelial malignant tumor cells, compatible with a tube-ovarian serous histotype. So, although it could be rare, secondary malignant neoplasm should be considered in the differential diagnosis of breast lesions in patients with a personal history of ovarian cancer. Keywords: Breast metastasis, Intramammary metastasis, Ovarian cancer

We developed a synoptic climatology for Lake El'gygytgyn, Chukotka Russia, and explored modern climate trends affecting air temperatures there to aid in paleoclimate reconstructions of a 3.6 million-year-old sediment core taken from the lake. Our self-organized mapping (SOM) approach identified 35 synoptic weather patterns, based on sea level pressure, that span the range of synoptic patterns influencing the study domain over the 1961–2009 NCEP/NCAR analysis period. We found strong seasonality in modern weather patterns, with summer weather primarily characterized by weak low pressure systems over the Arctic Ocean or Siberia and winter weather primarily characterized by strong high pressure over the Arctic Ocean and strong low pressure in the Pacific Ocean. In general, the primary source of variation in air temperatures came from the dominant patterns in each season, which we identify in the text, and nearly all of the dominant weather patterns here have shown increasing temperatures. We found that nearly all of the warming in mean annual temperature over the past 50 yr (about 3 °C) occurred during sub-freezing conditions on either side of summer (that is, spring and fall). Here we found that the most summer-like weather patterns (low pressures to the north) in the shoulder seasons were responsible for much of the change. Finally, we compared the warmest 15 yr of the record (1995–2009) to the coolest (1961–1975) and found that changes in thermodynamics of weather were about 3 to 300 times more important than changes in frequency of weather patterns in controlling temperature variations during spring and fall, respectively. That is, in the modern record, general warming (local or advected) is more important by orders of magnitude than changes in storm tracks in controlling air temperature at Lake El'gygytgyn. We conclude with a discussion of how these results may be relevant to the paleoclimate reconstruction efforts and how this relevancy could be tested further. [ABSTRACT FROM AUTHOR]

We developed a synoptic climatology for Lake El'gygytgyn, Chukotka Russia, and explored modern climate trends affecting air temperatures there to aid in paleoclimate reconstructions of a 3.6 million year old sediment core taken from the lake. Our self-organized mapping (SOM) approach identified 35 synoptic weather patterns, based on sea level pressure, that span the range of synoptic patterns that influence the study domain over the 1961-2009 NCEP/NCAR reanalysis period. We found strong seasonality in modern weather patterns, with summer weather primarily characterized by weak low pressure systems over the Arctic Ocean or Siberia and winter weather primarily characterized by strong high pressures over the Arctic Ocean with strong low pressures in the Pacific Ocean. In general the primary source of variation in air temperatures came from the dominant patterns in each season, which we identify in the text, and nearly all of the dominant weather patterns here have shown increasing temperatures. We found that nearly all of the warming in mean annual temperature over the past 50 years (about 3 °C) occurred during sub-freezing conditions on either side of summer (that is, spring and fall). Here we found that the most summer-like weather patterns (low pressures to the North) in the shoulder seasons were responsible for much of the change. Finally we compared the warmest 15 years of the record (1995-2009) to the coolest (1961-1975) and found that changes in thermodynamics of weather were about 3 to 300 times more important than changes in frequency of weather patterns in controlling temperature variations during spring and fall, respectively. That is, in the modern record, general warming (local or imported) is more important by orders of magnitude than changes in storm tracks in controlling air temperature at Lake El'gygtgyn, and we conclude with a discussion of how these results may be relevant to the paleoclimate reconstruction efforts. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the efficacy of the rolled views taken in craniocaudal (CC) and mediolateral oblique (MLO) projections in solving equivocal mammography findings. Patients and Methods: The rolled views were taken by changing the positioning of the breast but not the obliquity of the X-ray beams. The breast was rolled medially or laterally in the rolled CC view, and inferiorly or superiorly in the rolled MLO view to separate overlapping structures from each other. Results: We evaluated equivocal findings in 87 asymptomatic women undergoing either CC (n = 48, 55%) or MLO (n = 39, 45%) rolled views between 2001 and 2008. The rolled views were helpful in solving equivocal mammographic findings and making proper decisions on management in 85 of the 87 (97.7%) women. This technique was used for breast asymmetries in 55 of the 87 (63.2%) women, and was sufficient to directly show summation artifacts in 59 of 79 (74.6%) women. The rolled views revealed 4 intramammary lymph nodes, 2 circumscribed masses out of 6 obscured masses, 7 summation artifacts, and 2 circumscribed masses out of 9 questionable masses. Conclusions: The rolled view is an effective method of differentiating summation artifacts from real lesions on mammography in both the CC and the MLO view. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

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bstract [ABSTRACT FROM AUTHOR]

Abstract Background This retrospective study aims to determine: 1) the sensitivity of preoperative mammography (Mx) and ultrasound (US), and re-reviewed Mx to detect multifocal multicentric breast carcinoma (MMBC), defined by pathology on surgical specimens, and 2) to analyze the characteristics of both detected and undetected foci on Mx and US. Methods Three experienced breast radiologists re-reviewed, independently, digital mammography of 97 women with MMBC pathologically diagnosed on surgical specimens. The radiologists were informed of all neoplastic foci, and blinded to the original mammograms and US reports. With regards to Mx, they considered the breast density, number of foci, the Mx characteristics of the lesions and their BI-RADS classification. For US, they considered size of the lesions, BI-RADS classification and US pattern and lesion characteristics. According to the histological size, the lesions were classified as: index cancer, 2nd lesion, 3rd lesion, and 4th lesion. Any pathologically identified malignant foci not previously described in the original imaging reports, were defined as undetected or missed lesions. Sensitivity was calculated for Mx, US and re-reviewed Mx for detecting the presence of the index cancer as well as additional satellite lesions. Results Pathological examination revealed 13 multifocal and 84 multicentric cancers with a total of 303 malignant foci (282 invasive and 21 non invasive). Original Mx and US reports had an overall sensitivity of 45.5% and 52.9%, respectively. Mx detected 83/97 index cancers with a sensitivity of 85.6%. The number of lesions undetected by original Mx was 165/303. The Mx pattern of breasts with undetected lesions were: fatty in 3 (1.8%); scattered fibroglandular density in 40 (24.3%), heterogeneously dense in 91 (55.1%) and dense in 31 (18.8%) cases. In breasts with an almost entirely fatty pattern, Mx sensitivity was 100%, while in fibroglandular or dense pattern it was reduced to 45.5%. Re-reviewed Mx detected only 3 additional lesions. The sensitivity of Mx was affected by the presence of dense breast tissue which obscured lesions or by an incorrect interpretation of suspicious findings. US detected 73/80 index cancers (sensitivity of 91.2%), US missed 117 malignant foci with a mean tumor diameter of 6.5 mm; the sensitivity was 52.9% Undetected lesions by US were those smallest in size and present in fatty breast or in the presence of microcalcifications without a visible mass. US sensitivity was affected by the presence of fatty tissue or by the extent of calcification. Conclusion Mx missed MMBC malignant foci more often in dense or fibroglandular breasts. US missed small lesions in mainly fatty breasts or when there were only microcalcifications. The combined sensitivity of both techniques to assess MMBC was 58%. We suggest larger studies on multimodality imaging.

Background Postmenopausal hormone replacement therapy (HRT) relieves menopausal symptoms and may decrease mortality in recently postmenopausal women, but increases breast cancer risk. Low-dose tamoxifen has shown retained activity in phase-II studies. Methods We conducted a phase-III trial in 1884 recently postmenopausal women on HRT who were randomly assigned to either tamoxifen, 5 mg/day, or placebo for 5 years. The primary end point was breast cancer incidence. Results After 6.2 ± 1.9 years mean follow-up, there were 24 breast cancers on placebo and 19 on tamoxifen (risk ratio, RR, 0.80; 95% CI 0.44–1.46). Tamoxifen showed favorable trends in luminal-A tumors (RR, 0.32; 95% CI 0.12–0.86), in HRT users <5 years (RR, 0.35; 95% CI 0.15–0.82) and in women completing at least 12 months of treatment (RR, 0.49; 95% CI 0.23–1.02). Serious adverse events did not differ between placebo and tamoxifen, including, respectively, coronary heart syndrome (6 versus 4), cerebrovascular events (2 versus 5), VTE (2 versus 5) and uterine cancers (3 versus 1). Vasomotor symptoms were 50% more frequent on tamoxifen. Conclusions The addition of low-dose tamoxifen to HRT did not significantly reduce breast cancer risk and increased climacteric symptoms in recently postmenopausal women. However, we noted beneficial trends in some subgroups which may deserve a larger study. [ABSTRACT FROM PUBLISHER]