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The aim of this study was to examine past mammography use and mode of detection among breast cancer (BC) patients in Estonia, a country that has low screening coverage and high BC mortality. Women newly diagnosed with primary BC in Estonia in 2008–2010 were interviewed. Determinants of past mammography use and the detection of BC by mammography were studied using multivariate logistic regression. Among 977 participants, almost half reported no mammograms prior to the detection of BC. Overall, 22% of the cases were detected by mammography (16% by screening mammography). Detection by mammography was strongly related to age, past mammography use, and obesity. Among cases detected by mammography, 10% were stage III/IV at diagnosis (32% among cases detected by other modes). This study showed low mammography utilization and high rate of self-detection of BC in Estonia. Increased detection by mammography would help diagnose the disease at an earlier stage and consequently avoid premature BC deaths. Efforts should be undertaken to increase participation in screening and improve the availability of mammography among older and high-risk women. The results are likely to be relevant for other countries and population groups with low screening coverage. [ABSTRACT FROM PUBLISHER]

Background. Survival from breast cancer (BC) in Estonia has been consistently among the lowest in Europe. The aim of this study was to examine most recent trends in BC survival in Estonia by age and stage. The trends in overall BC incidence and mortality are also shown in the paper. Material and methods. Estonian Cancer Registry data on all cases of BC, diagnosed in women in Estonia during 1995-2007 (n = 7424) and followed up for vital status through 2009, were used to estimate relative survival ratios (RSR). Period hybrid approach was used to obtain the most recent estimates (2005-2009). Stage was classified as localized, local/regional spread or distant. Results. BC incidence continued to rise throughout the study period, but mortality has been in steady decline since 2000. The distribution of patients shifted towards older age and earlier stage at diagnosis. Overall age-standardized five-year RSR increased from 63% in 1995-1999 to 74% in 2005-2009. Younger age groups experienced a more rapid improvement compared to women over 60. Significant survival increase was observed for both localized and locally/regionally spread BC with five-year RSRs reaching 96% and 70% in 2005-2009, respectively; the latest five-year RSR for distant BC was 11%. Survival for T4 tumors was poor and large age difference was seen for locally/regionally spread BC. Conclusions. Considerable improvement in BC survival was observed over the study period. Women under 60 benefited most from both earlier diagnosis and treatment advances of locally/regionally spread cancers. However, the survival gap with more developed countries persists. Further increase in survival, but also decline in BC mortality in Estonia could be achieved by facilitating early diagnosis in all age groups, but particularly among women over 60. Investigations should continue to clarify the underlying mechanisms of the stage-specific survival deficit in Estonia. [ABSTRACT FROM AUTHOR]

We aimed to determine the relationships between the results of routine AI laboratory tests and flow cytometric analysis (FCM) of the quality of frozen-thawed (FT) bovine spermatozoa. The results were compared to the field fertility data. Forty five ejaculates from fifteen (14 to 86 Mo age) Estonian Holstein (EHF) dairy bulls were examined for motility (subjectively by light microscope and objectively using a computer assisted motility analyzer (CMA)), hypo-osmotic swelling tests (HOS-1, HOS-2, HOS-3), membrane lipid architecture status (Merocyanine 540 staining) and mitochondrial membrane potential (Mitotracker Deep Reed 633 staining). Stained spermatozoa were assessed by FCM. Significant positive correlations were observed between subjectively assessed motility variables (SubMot), general motile (GMot) and progressively motile (PMot) spermatozoa and sperm with stable membrane (LSM) (P<0.001). Strong positive correlations with non-return rates (NRR) were obtained for HOS-2, HOS-3, SubMot, PMot, GMot and curve line velocity (VCL) (PO.01). The best predictive model PNRR (predictive non-return rates), according to the results of routine laboratory tests and FCM analysis, included seven parameters (R²=0.91). The strongest positive correlation was found between PNRR and NRR on bull level (r=0.96; P<.001) compared to that of batch level. Combinations of common AI laboratory tests (motility analysis, HOS) and FCM assays can be used for the prediction of the FT bull semen fertility. [ABSTRACT FROM AUTHOR]

The aim of the current study was to investigate relationships between the grade of Holstein genes and sperm motility, membrane integrity, membrane lipid architecture status and mitochondrial membrane potential in frozen- thawed (FT) semen, collected from Estonian Holstein (EHF) dairy bulls. Nineteen ejaculates from seven young (age from 14 to 22 MO) EHF bulls were examined for motility using a computer assisted motility analyzer (CMA), hypo-osmotic swelling (HOS). Membrane lipid architecture status (Merocyanine 540 staining) and mitochondrial membrane potential (Mitotracker Deep Reed 633 staining) was assessed by flow cytometry (FCM). Fertility results were available as 60 days non-return rates (NRR). The results showed that there was a significant difference in the incidence of general motile (GMot) and progressively motile spermatozoa (PMot), viable sperms with stable membrane (LSM) and high mitochondrial activity (MTDR-H) between the bull groups with the different grade of Holstein genes at batch level. The positive correlation between PMot, LSM, MTDR-H and NRR was recorded at batch level (P<0.05). The strongest correlation was obtained between the curve line velocity (VCL) and NRR at bull level (P<0.01). A strong positive correlation was found between predicted non-return rates (PNRR) and NRR (P<0.001). [ABSTRACT FROM AUTHOR]

Although hereditary breast cancer screening and management are well accepted and established in clinical settings, these efforts result in the detection of only a fraction of genetic predisposition at the population level. Here, we describe our experience from a national pilot study (2018-2021) in which 180 female participants of Estonian biobank (of >150,000 participants in total) were re-contacted to discuss personalized clinical prevention measures based on their genetic predisposition defined by 11 breast cancer-related genes. Our results show that genetic risk variants are relatively common in the average-risk Estonian population. Seventy-five percent of breast cancer cases in at-risk subjects occurred before the age of 50 years. Only one-third of subjects would have been eligible for clinical screening according to the current criteria. The participants perceived the receipt of genetic risk information as valuable. Fluent cooperation of project teams supported by state-of-art data management, quality control, and secure transfer can enable the integration of research results to everyday medical practice in a highly efficient, timely, and well-accepted manner. The positive experience in this genotype-first breast cancer study confirms the value of using existing basic genomic data from population biobanks for precise prevention., Competing Interests: PP was employed by the company Antegenes The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Jürgens, Roht, Leitsalu, Nõukas, Palover, Nikopensius, Reigo, Kals, Kallak, Kütner, Budrikas, Kuusk, Valvere, Laidre, Toome, Rekker, Tooming, Ülle Murumets, Kahre, Kruuv-Käo, Õunap, Padrik, Metspalu, Esko, Fischer and Tõnisson.)