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Background. We compared the clinico-radio-pathological characteristics of breast cancer detected through mammogram (MMG) and ultrasound (USG) and discuss the implication of the choice of imaging as the future direction of our recently launched local screening program. Methods. Retrospective study of 14613 Hong Kong Chinese female patients with histologically confirmed breast cancer registered in the Hong Kong Breast Cancer Registry between January 2006 and February 2020. Patients were classified into four groups based on the mode of breast cancer detection (detectable by both mammogram and ultrasound (MMG+/USG+), mammogram only (MMG+/USG−), ultrasound only (MMG−/USG+), or not detectable by either (MMG−/USG−). Characteristics of breast cancer detected were compared, including patient demographics, breast density on MMG, mode of presentation, tumour size, histological type, and staging. Types of mammographic abnormalities were also evaluated for MMG+ subgroups. Results. 85% of the cancers were detectable by MMG, while USG detected an additional 9%. MMG+/USG+ cancers were larger, more advanced in stage, often of symptomatic presentation, and commonly manifested as mammographic mass. MMG+/USG− cancers were more likely of asymptomatic presentation, manifested as microcalcifications, and of earlier stage and to be ductal carcinoma in situ. MMG−/USG+ cancers were more likely seen in young patients and those with denser breasts and more likely of symptomatic presentation. MMG−/USG− cancers were often smaller and found in denser breasts. Conclusion. Mammogram has a good detection rate of cancers in our local population. It has superiority in detecting early cancers by detecting microcalcifications. Our current study agrees that ultrasound is one of the key adjunct tools of breast cancer detection. [ABSTRACT FROM AUTHOR]

Background: The distinct trajectories of psychological distress over the first year of the diagnosis with breast cancer (BC) and its determinants have not been explored. Methods: 285 of 405 Chinese women receiving surgery for BC were assessed at 5-day, 1-month, 4-month, and 8-month post-surgery on measures of psychological distress, optimism, treatment decision-making (TDM) difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, and physical symptom distress. Latent growth mixture modelling identified trajectories of psychological response to BC. Multinominal logistic regression compared TDM difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, optimism, and physical symptom distress, by distress pattern adjusted for age, education, employment status, and stage of disease. Results: Four distinct trajectories of distress were identified, namely, resilience (66%), chronic distress (15%), recovered (12%), and delayed-recovery (7%). TDM difficulties, optimism, satisfaction with consultation, and physical symptom distress predicted distress trajectories. Psychologically resilient women had less physical symptom distress at early post-surgery compared with women with other distress patterns. Compared with the resilient group, women in the recovered or chronic distress groups experienced greater TDM difficulties, whereas women in the delayed-recovery group reported greater dissatisfaction with the initial medical consultation. Women in the chronic distress group reported greater pessimistic outlook. Conclusion: Optimism and better early post-operative treatment outcomes predicted resilience to distress. Pre-operative interventions helping women to establish a realistic expectation of treatment outcome may minimize disappointment with treatment outcome and resultant distress, whereas post-operative rehabilitation should focus on symptom management. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: The patterns and determinants of longer-term psychological morbidity in women following breast cancer surgery have not been described for Chinese populations. Methods: Chinese women were assessed at 3-days, 4-months and 8-months following breast surgery, on treatment decision-making difficulty (TDMD), satisfaction with treatment outcome (E-OI), self efficacy (GSeS), optimism (C-LOT-R), consultation satisfaction (C-MISS-R), physical symptom distress (PSD) and psychological morbidity (CHQ-12) and compared using polynomial logistic models. Results: Of 303/405 women providing complete data, 33% received chemotherapy and 26% radiotherapy. GSeS, CLOTR and TDMD scores were moderate. Though the proportion of women meeting psychological morbidity case-criteria declined from 78% (95% Confidence Interval 73–83%) at Baseline to 64% (59–69%) at 8-months, almost 50% (44–54%) of women remained distressed over the 8-month period. After adjustment for demographic and clinical factors, severity of psychological morbidity at 4-months was predicted by PSD, disappointment and higher Baseline CHQ12, and among moderate/severe cases only, greater TDMD and pessimistic outlook. At 8-months, CHQ12 scores were predicted by PSD, Baseline CHQ-12, and difficulties with TDM. Conclusion: TDM difficulties, early post-surgical psychological and physical symptom distress indicate risk for prolonged distress in Chinese women following breast cancer surgery. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]