Search

Objective. To evaluate the clinical therapeutic efficacy and safety of modified Erzhi granules (MEG) in patients with menopause-related vulvovaginal atrophy (VVA). Methods. This randomized, double-blind, placebo-controlled study comprised two groups, including the treatment and control groups. Patients receive MEG and placebo for 12 weeks, respectively. Vaginal health score (VHS), vaginitis score, vaginal maturation index (VMI), female sexual function index (FSFI), and modified Kupperman Index (modified KI) were used as efficacy endpoints and assessed at baseline, 4, 8, and 12 weeks during administration, and 4 weeks after drug withdrawal. At baseline and 12 weeks, serum estradiol (E2), follicle stimulating hormone (FSH), pelvic ultrasound, breast ultrasound, and other safety parameters were measured, recording adverse events. Results. At 12 weeks, VHS, percentage of superficial cells in the vaginal epithelium and FSFI were significantly increased, while vaginitis score, percentage of basal cells in the vaginal epithelium, and modified KI were significantly decreased in comparison with baseline and control group (all P<0.05); these differences persisted for up to 4 weeks after drug withdrawal. The placebo group showed no significant change during treatment compared with baseline values (p>0.05). Serum E2 and FSH levels, endometrial thickness, and breast thickness in all patients were within the normal ranges before and after treatment, with no serious adverse reactions observed. Conclusion. MEG significantly alleviates menopause-related vulvovaginal atrophy, with no overt adverse effects on the endometrium, breast, hepatic, and renal functions. [ABSTRACT FROM AUTHOR]

Abstract: High breast density is associated with an increased risk of breast cancer development. Little is known concerning ethnic variations in breast density and its relevant contributing factors. We aimed to study breast density among Ethiopian immigrants to Israel in comparison with Israeli‐born women and to determine any effect on breast density of the length of residency in the immigrant population. Mammographic breast density using the BI‐RADS system was estimated and compared between 77 women of Ethiopian origin who live in Israel and 177 Israeli‐born controls. Logistic regression analysis was performed to estimate the odds ratios (OR) for high density (BI‐RADS score ≥ 3) vs low density (BI‐RADS score < 3) cases, comparing the 2 origin groups. Ethiopian‐born women had a crude OR of 0.15 (95% CI: 0.08‐0.26) for high breast density compared with Israeli‐born women. Adjustments for various cofounders did not affect the results. Time since immigration to Israel seemed to modify the relationship, with a stronger association for women who immigrated within 2 years prior to mammography (OR:0.07, 95% CI: 0.03‐0.17) as opposed to women with a longer residency stay in Israel (OR:0.23, 95% CI:0.10‐0.50). Adjustments of various confounders did not alter these findings. Breast density in Ethiopian immigrants to Israel is significantly lower than that of Israeli‐born controls. Our study suggests a positive association between time since immigration and breast density. Future studies are required to define the possible effects of dietary change on mammographic density following immigration. [ABSTRACT FROM AUTHOR]

Abstract: Expected postoperative enhancement on breast MRI can appear similar to enhancement seen in recurrent or residual malignancy. Our aim was to assess the time course and patterns of enhancement at the surgical site, thereby helping to distinguish between benign and malignant postoperative enhancement. In 200 MRI scans performed in 153 patients after breast conservation treatment, 43 after surgical excision of atypia, and 4 patients after benign excisional biopsy were categorized by postoperative time interval. We defined 4 patterns of morphologic enhancement on MRI: cavity wall/seroma (Pattern I); thin linear (Pattern II); mass (Pattern III); and fat necrosis (Pattern IV). Of 200 MRI scans, 66 (33%) demonstrated enhancement at the surgical site. Enhancement typically decreased through the postoperative follow‐up period. Enhancement was observed in 41% (28/68) of cases beyond the 18‐month interval but was uncommon after 5 years. Pattern III enhancement was the morphologic pattern seen most commonly with malignancy (5/19 cases, 26%). When associated with delayed washout kinetics, it was even more strongly predictive of malignancy (4/5 cases, 80%). In patients with a history of excisional biopsy and no prior radiation treatment, the percentage of MRI scans showing enhancement was significantly lower than (21% vs 49% with P‐value .0027) in patients who had undergone radiation. Enhancement at the surgical site occurred in one‐third of cases up to 5 years after surgery, particularly in patients who underwent both radiation and surgery. Mass enhancement, particularly in conjunction with delayed washout kinetics, is most predictive of malignancy and should prompt biopsy or re‐excision. [ABSTRACT FROM AUTHOR]

This article examines how non-fiction children’s television programmes portray bodily changes and sexuality at puberty. Engaging with the body and the sexuality of children in the broadcast media raises cultural and social challenges. Public concern about social morality and the ‘sexualisation of children’, sexual objectification and pornography, together with the construction of childhood as a naïve pre-sexual stage of life, have silenced children’s television when it comes to the subject of children’s sexuality. However, a few programmes have offered an alternative to this taboo. Based on a study of 30 non-fiction programmes submitted between 1964 and 2016 to Prix Jeunesse international festival for children’s media, this paper describes and analyses how these programmes present unique, thought-provoking and innovative ways of engaging with the culturally controversial issue of the body and sexuality on children’s television. [ABSTRACT FROM AUTHOR]

Objective: A comprehensive survey was conducted to evaluate the shortcomings of clinical care in patients with Turner syndrome (TS) in Turkey. Methods: A structured questionnaire prepared by the Turner study group in Turkey, which covered relevant aspects of patient care in TS was sent to 44 pediatric endocrinology centers. Results: Eighteen centers (41%) responded to the questionnaire. In the majority of the centers, diagnostic genetic testing, screening for Y chromosomal material, protocols regarding the timing and posology of growth hormone (GH) and estrogen, thrombophilia screening, fertility information and screening for glucose intolerance, thyroid, and coeliac diseases in patients with TS were in line with the current consensus. Thirteen centers (72.2%) performed GH stimulation tests. Only four centers (22.2%) used oxandrolone in patients with TS with very short stature. The majority of the centers relied on bone age and breast development to assess estrogen adequacy, though together with variable combinations of oestrogen surrogates. Two centers (11.1%) reported performing serum estradiol measurements. Eight centers (44.4%) routinely conducted cardiac/thoracic aorta magnetic resonance imaging. Screening for hearing, dental and ophthalmologic problems were performed by thirteen (72.2%), six (33.3%) and ten (55.6%) centers, respectively. Psychiatric assessments were made by four centers (22.2%) at diagnosis, with only one center (5.6%) requiring annual reassessments. Conclusion: Although we found some conformity between the current consensus and practice of the participating centers in Turkey regarding TS, further improvements are mandatory in the multi-disciplinary approach to address co-morbidities, which if unrecognized, may be associated with reduced quality of life and even mortality. [ABSTRACT FROM AUTHOR]

Mathematical simulation of heat-exchange processes in a breast with a malignant tumor was carried out taking into account thermophysical properties of internal tissues. The results of calculation of the physical temperature in the breast and the brightness temperature for four antennas used in breast care are presented. The obtained results can be used in developing new medical antennas and radiometers with improved characteristics. [ABSTRACT FROM AUTHOR]

Background: Use of preoperative breast magnetic resonance imaging (MRI) among women with a new breast cancer has increased over the past decade. MRI use is more frequent in younger women and those with lobular carcinoma, but associations with breast density and family history of breast cancer are unknown. Materials and Methods: Data for 3075 women ages >65 years with stage 0-III breast cancer who underwent breast conserving surgery or mastectomy from 2005 to 2010 in the Breast Cancer Surveillance Consortium were linked to administrative claims data to assess associations of preoperative MRI use with mammographic breast density and first-degree family history of breast cancer. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the association of MRI use with breast density and family history, adjusting for woman and tumor characteristics. Results: Overall, preoperative MRI use was 16.4%. The proportion of women receiving breast MRI was similar by breast density (17.6% dense, 16.9% nondense) and family history (17.1% with family history, 16.5% without family history). After adjusting for potential confounders, we found no difference in preoperative MRI use by breast density (OR = 0.95 for dense vs. nondense, 95% CI: 0.73–1.22) or family history (OR = 0.99 for family history vs. none, 95% CI: 0.73–1.32). Conclusions: Among women aged >65 years with breast cancer, having dense breasts or a first-degree relative with breast cancer was not associated with greater preoperative MRI use. This utilization is in keeping with lack of evidence that MRI has higher yield of malignancy in these subgroups. [ABSTRACT FROM AUTHOR]

Background Pediatric breast masses can be a diagnostic challenge. Nearly all are benign, but there is no consensus on which should be removed. We hypothesized that children with asymptomatic breast lesions can be safely managed nonoperatively. Methods We performed a single-institution retrospective review of children (≤18 y) who underwent breast mass excision from 2008 to 2016. Male patients with gynecomastia and those who had needle biopsy without formal excision were excluded. Pearson correlation was used to compare ultrasound and pathologic size. Kruskal–Wallis test was used to compare size and final diagnosis. Results One hundred ninety-six patients were included (96% female). Mean age was 15 ± 3 y. Most patients (71%) presented with a painless mass. Preoperative ultrasound was obtained in 70%. Pathology included fibroadenoma (81.5%), tubular adenoma (5%), benign phyllodes tumor (3%), benign fibroepithelial neoplasm (0.5%), and other benign lesions (10%). There were no malignant lesions. Ultrasound size had a Pearson correlation of 0.84 with pathologic size ( P < 0.0001). There was no association between the size and final diagnosis. Conclusions Over 9 y, all pediatric breast masses removed at a single center were benign, most commonly fibroadenoma. Ultrasound was an accurate predictor of size, but large lesions did not necessarily confer a high malignancy risk. Observation is appropriate for asymptomatic breast masses in children. Decision for surgery should be individualized and not based on size alone. [ABSTRACT FROM AUTHOR]

Key Clinical Message: In patients with autoimmune disease, gynecomastia should not be considered as 1 of the first signs of hyperthyroidism, rather it is a breast pathology that can be present even when euthyroidism restoration is achieved. It is unknown whether the autoimmune nature of thyroid disorders or simply the hyperthyroidism effects breast changes. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the association of alcohol intake with mammographic breast density in postmenopausal women by their hormone therapy (HT) status.Methods: This study included 2,100 cancer-free postmenopausal women within the Nurses' Health Study and Nurses' Health Study II cohorts. Percent breast density (PD), absolute dense (DA), and non-dense areas (NDA) were measured from digitized film mammograms using a computer-assisted thresholding technique; all measures were square root transformed. Alcohol consumption was assessed with a food frequency questionnaire (0, < 5, and ≥ 5 g/day). Information regarding breast cancer risk factors was obtained from baseline or biennial questionnaires closest to the mammogram date. We used generalized linear regression to examine associations between alcohol and breast density measures in women with no HT history, current, and past HT users.Results: In multivariable analyses, we found no associations of alcohol consumption with PD (p trend = 0.32) and DA (p trend = 0.53) and an inverse association with NDA (β = - 0.41, 95% CI - 0.73, - 0.09 for ≥ 5 g/day, p trend < 0.01). In the stratified analysis by HT status, alcohol was not associated with PD in any of the strata. We found a significant inverse association of alcohol with NDA among past HT users (β = - 0.79, 95% CI - 1.51, - 0.07 for ≥ 5 g/day, p trend = 0.02). There were no significant interactions between alcohol and HT in relation to PD, DA, and NDA (p interaction = 0.19, 0.42, and 0.43, respectively).Conclusions: Our findings suggest that associations of alcohol with breast density do not vary by HT status. [ABSTRACT FROM AUTHOR]

Mammographic breast density (MBD) is the most commonly used method to assess the volume of fibroglandular tissue (FGT). However, MRI could provide a clinically feasible and more accurate alternative. There were three aims in this study: (1) to evaluate a clinically feasible method to quantify FGT with MRI, (2) to assess the inter-rater agreement of MRI-based volumetric measurements and (3) to compare them to measurements acquired using digital mammography and 3D tomosynthesis. This retrospective study examined 72 women (mean age 52.4 ± 12.3 years) with 105 disease-free breasts undergoing diagnostic 3.0-T breast MRI and either digital mammography or tomosynthesis. Two observers analyzed MRI images for breast and FGT volumes and FGT-% from T1-weighted images (0.7-, 2.0-, and 4.0-mm-thick slices) using K-means clustering, data from histogram, and active contour algorithms. Reference values were obtained with Quantra software. Inter-rater agreement for MRI measurements made with 2-mm-thick slices was excellent: for FGT-%, r = 0.994 (95% CI 0.990-0.997); for breast volume, r = 0.985 (95% CI 0.934-0.994); and for FGT volume, r = 0.979 (95% CI 0.958-0.989). MRI-based FGT-% correlated strongly with MBD in mammography (r = 0.819-0.904, P < 0.001) and moderately to high with MBD in tomosynthesis (r = 0.630-0.738, P < 0.001). K-means clustering-based assessments of the proportion of the fibroglandular tissue in the breast at MRI are highly reproducible. In the future, quantitative assessment of FGT-% to complement visual estimation of FGT should be performed on a more regular basis as it provides a component which can be incorporated into the individual’s breast cancer risk stratification. [ABSTRACT FROM AUTHOR]

Mammographic breast density has been established as an independent risk marker for developing breast cancer. Breast density assessment is a routine clinical need in breast cancer screening and current standard is using the Breast Imaging and Reporting Data System (BI-RADS) criteria including four qualitative categories (i.e., fatty, scattered density, heterogeneously dense, or extremely dense). In each mammogram examination, a breast is typically imaged with two different views, i.e., the mediolateral oblique (MLO) view and cranial caudal (CC) view. The BI-RADS-based breast density assessment is a qualitative process made by visual observation of both the MLO and CC views by radiologists, where there is a notable inter- and intra-reader variability. In order to maintain consistency and accuracy in BI-RADS-based breast density assessment, gaining understanding on radiologists’ reading behaviors will be educational. In this study, we proposed to leverage the newly emerged deep learning approach to investigate how the MLO and CC view images of a mammogram examination may have been clinically used by radiologists in coming up with a BI-RADS density category. We implemented a convolutional neural network (CNN)-based deep learning model, aimed at distinguishing the breast density categories using a large (15,415 images) set of real-world clinical mammogram images. Our results showed that the classification of density categories (in terms of area under the receiver operating characteristic curve) using MLO view images is significantly higher than that using the CC view. This indicates that most likely it is the MLO view that the radiologists have predominately used to determine the breast density BI-RADS categories. Our study holds a potential to further interpret radiologists’ reading characteristics, enhance personalized clinical training to radiologists, and ultimately reduce reader variations in breast density assessment. [ABSTRACT FROM AUTHOR]

PURPOSE: The primary aim of this study was to determine the feasibility of conducting a randomised controlled trial (RCT) to evaluate the effectiveness of kinesiology tape (KT) and usual care versus usual care alone in the treatment of breast lymphoedema (BLE). METHODS: Fourteen participants with BLE were randomly assigned to either the KT and usual care group or usual care alone group. Both groups received three sessions of manual lymphatic drainage (MLD) once per week for three weeks, with the KT group additionally wearing the KT for two seven-day periods in between MLD sessions. Safety and acceptability of the KT were assessed by recording adverse events, skin changes and compliance with KT. Outcomes included were: ease of recruitment, attrition and acceptability of KT, percentage breast tissue water, patient-reported breast heaviness/fullness, breast discomfort and breast redness. RESULTS: Recruitment for this study was an average of 2.8 participants per month. There were no dropouts from either group. No adverse events or major skin side effects were recorded in either group. Minor skin redness was the most common dermal change (n = 5). Compliance with KT was excellent. Percentage tissue water in the worst affected breast quadrant reduced, on average, by 15.14% and 10.43% in both the KT group and the usual care group respectively. CONCLUSION: This feasibility RCT into the use of KT in BLE has shown that recruitment to a larger scale RCT is feasible. It has been demonstrated that KT is a safe and acceptable intervention with no adverse events and minor dermal changes. A large, multi-centred RCT is now necessary to accurately assess the effect of KT in BLE. [ABSTRACT FROM AUTHOR]

Breast cancer is the main cause of female malignancy worldwide. Effective early detection by imaging studies remains critical to decrease mortality rates, particularly in women at high risk for developing breast cancer. Breast Magnetic Resonance Imaging (MRI) is a common diagnostic tool in the management of breast diseases, especially for high-risk women. However, during this examination, both normal and abnormal breast tissues enhance after contrast material administration. Specifically, the normal breast tissue enhancement is known as background parenchymal enhancement: it may represent breast activity and depends on several factors, varying in degree and distribution in different patients as well as in the same patient over time. While a light degree of normal breast tissue enhancement generally causes no interpretative difficulties, a higher degree may cause difficulty to detect and classify breast lesions at Magnetic Resonance Imaging even for experienced radiologists. In this work, we intend to investigate the exploitation of some statistical measurements to automatically characterize the enhancement trend of the whole breast area in both normal and abnormal tissues independently from the presence of a background parenchymal enhancement thus to provide a diagnostic support tool for radiologists in the MRI analysis. [ABSTRACT FROM AUTHOR]

Background: Dense breasts on mammography independently increases breast cancer risk and decreases mammography sensitivity. Thirty-two states have adopted notification laws to raise awareness among women with dense breasts about supplemental screening. Little is known about these policies' impact on clinical practice among primary care providers (PCPs). Materials andMethods: This study explores PCP attitudes, knowledge, and the impact of the Massachusetts dense breast notification legislation on clinical practice after its enactment in 2015. An anonymous, online survey at two urban safety-net hospitals was administered in 2015–2016. Practicing MDs and nurse practitioners in primary care were invited to participate. Results: All 145 PCPs in general internal medicine at the two sites were e-mailed a survey link and 80 (55%) were completed. While 64 of 80 PCPs surveyed (80%) had some familiarity with the legislation, none identified the 8 required components of notifications contained in the Massachusetts legislation. Forty-nine percent (39/80) did not feel prepared to respond to patient questions about dense breasts. Forty-one percent (33/80) correctly identified that no current guidelines recommend the use of supplemental screening tests solely based on breast density and 85% (68/80) indicated interest in further training. Female and less experienced providers were more likely to be in favor of the legislation (49% vs. 11% by gender; 76% <5 years vs. 9%> 20 years). Women practitioners (55%) who were more likely than men (17%, p = 0.01) to agree with the policy changed their discussions of mammography results with patients. Conclusions: PCPs feel underprepared to counsel women about breast density identified on mammography and its implications. [ABSTRACT FROM AUTHOR]

Abstract: Mammography is the only method presently considered appropriate for mass screening of breast cancer. However, higher breast density was strongly associated with lower mammographic sensitivity. Breast density is also identified as independent and strongest risk factors for breast cancer. Studies have shown women with high breast density have four to six times increased risk of breast cancer as compare to women with fatty breast. It varies between different age group it generally decreases with increasing age in postmenopausal women and it can be different in different ethnic groups and people from different geographical areas. This study evaluates the breast density in Indian population and its relationship with the age. We reviewed of all screening mammography examinations performed from May 2012 to January 2015 at our institute PGIMER, Chandigarh, INDIA. Descriptive analyses were used to examine the association between age and breast density. A total of 6132 screening mammograms were performed. Each subgroup categorized by decade of age. There was a significant inverse relationship between age and breast density (P < .001). Twenty‐two percent of patients between 40 and 49 years old had dense breasts. This percentage decreased to 9% of women in their 50s. Only 7% of women in their 60s and 8% of women in their 70s had dense breasts. This data has been compared with the Western study done in New York University (NYU) shows there is significant difference (P value <.05) in the breast density in Indian and Western population with more Indians having ACR Grade 1 and 2 and Western population having 2 and 3. We found an inverse relationship between patient age and mammographic breast density. However, there were a large proportion of young women who had lower grades of mammographic density which could potentially benefit from the use of routine screening mammography in this subgroup of patients. Moreover, the breast density of Indian population is less when compared to the Western population. This might suggest that mammography is a good modality of choice for screening Indian population. [ABSTRACT FROM AUTHOR]

Abstract: Breast MRI plays a critical role in the diagnosis and management of breast cancer. The purpose of this study is to evaluate the effect of preoperative breast MRI on the management of a large cohort of breast cancer patients at our institution. This study is a retrospective chart review of all newly diagnosed breast cancer patients who underwent preoperative breast MRI at our institution between January 1, 2004 and December 31, 2009. 1352 patients comprised the study population. 241 (17.8%) patients underwent a change in surgical management as a result of preoperative MRI. Patients with tumors in the lower inner quadrant and the central breast and those with pathology of invasive lobular carcinoma were significantly more likely to have their management changed by preoperative MRI. There was also a significant trend for larger tumors to be associated with a change in surgical management. No statistically significant association was found between breast density and change in management. This study supports the recommendation for the use of preoperative breast MRI in the majority of newly diagnosed breast cancer patients, especially those with larger tumors, pathology of invasive lobular carcinoma, and tumors in the lower inner quadrant. Preoperative breast MRI is a useful tool for the evaluation of additional disease that led to a change in the surgical management of 17.8% of patients. [ABSTRACT FROM AUTHOR]

Abstract: We compared the performance characteristics of 297 629 full field digital (FFDM) and 416 791 screen film mammograms (SFM). Sensitivity increased with age, decreased with breast density, and was lower for more aggressive and lobular tumors. While sensitivity did not differ significantly by modality, specificity was generally 1%‐2% points higher for FFDM than for SFM across age and breast density categories. The lower recall rate for FFDM vs SFM in our study may partially explain performance differences by modality. In this large health care organization, modest gains in performance were achieved with the introduction of FFDM as a replacement for SFM. [ABSTRACT FROM AUTHOR]

Abstract: Data on ethnic variations in breast density are limited and often not inclusive of underrepresented minorities. As breast density is associated with elevated breast cancer risk, investigating racial and ethnic difference may elucidate the observed differences in breast cancer risk among different populations. We reviewed breast density from initial screening of women from the Capital Breast Care Center and Georgetown University Hospital from 2010 to 2014. Patient demographics including race, age at screening, education, menopausal status, and body mass index were abstracted. We recorded the BI‐RADS density categories: (1) “fatty,” (2) “scattered fibroglandular densities,” (3) “heterogeneously dense,” and (4) “extremely dense.” Multivariable unconditional logistic regression was used to identify predictors of breast density. Density categorization was recorded for 2146 women over the 5‐year period, comprising Blacks (n = 940), Hispanics (n = 893), and Whites (n = 314). Analysis of subject characteristics by breast density showed that high category is observed in younger, Hispanic, nulliparous, premenopausal, and nonobese women (t‐test or chi‐square test, P‐values <.0001). Obese women are 70% less likely to have high density. Being Hispanic, premenopausal, and nonobese were predictive of high density on logistic regression. In this analysis of density distribution in a diverse sample, Hispanic women have the highest breast density, followed by Blacks and Whites. Unique in our findings is women who identify as Hispanic have the highest breast density and lower rates of obesity. Further investigation of the impact of obesity on breast density, especially in the understudied Hispanic group is needed. [ABSTRACT FROM AUTHOR]

Background Breast Cancer is the most frequent cancer among women. Early detection of breast cancer can effectively reduce the subsequent mortality and morbidity. Breast Self Examination (BSE) is an important tool for screening as well as mass awareness. Objective To assess the awareness among female students of the local degree college about breast cancer and BSE and the effectiveness of a breast cancer awareness programme in terms of increase in knowledge among the participants about breast cancer and BSE. Methods 177 female students studying in a local degree college were included in the study after obtaining written consent. A pre- intervention questionnaire consisting of 20 questions related to demographic data, awareness and knowledge on breast cancer and BSE was administered. Teaching program that consisted of power point presentation regarding basic anatomy and physiology of the breast, risk factors for breast cancer and steps of BSE was introduced. Post intervention test was done by administering the same questionnaire after the teaching program. Results were analysed using descriptive statistics. Results Among the 177 students, 80.8%(143) students had never heard/ watched on BSE. 97.7%(173) had never performed BSE. After the intervention, there was statistically significant increase in correct answers for 10 among the 20 questions which included questions on anatomy and physiology of breast, transmission of breast cancer, age group affecting breast cancer, approach towards physician and methodology of BSE. Conclusion The awareness program showed significant rise in knowledge on breast cancer and BSE. This effectiveness of the teaching program further implies the need of intensification of such awareness programs among the college going and older age groups as well. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the effect of supplementation with 50,000 IU/monthly vitamin D for 1 yr on breast density in Iranian women. Methods: This double-blind, placebo-controlled, single center clinical trial was conducted among 400 women aged 40 yr and older. Participants were allocated to 2 groups. Group 1 received vitamin D (Cholecalciferol) 50,000 IU in tablet form, monthly, for 1 yr. Group 2 received vitamin E 400 IU in tablet form, monthly, for the same period of time. Participants had follow-up clinic visits every 6 mo and received an annual mammogram. Results: Final data were evaluated based on 216 and 194 women in the vitamin D and control groups. The mean decrease in mammographic density was −5.01%(95% CI, −9.9% to −0.01%) and −2.34 %(95% CI, −6.84% to −2.15%) in the vitamin D and control groups, respectively. There was no significant association between vitamin D consumption and breast density after 1 yr (OR = 0.7, 95% CI, 0.46 to 1.06; P = 0.1).Similar results were observed when multivariate model of logistic regression analysis was performed. Conclusions: This study showed that monthly consumption of 50,000 IU of vitamin D supplementation for 1 yr did not affect breast density. [ABSTRACT FROM AUTHOR]

Purpose: Heavy metals and other elements may act as breast carcinogens due to estrogenic activity. We investigated associations between urine concentrations of a panel of elements and breast density. Methods: Mammographic density categories were abstracted from radiology reports of 725 women aged 40-65 yr in the Avon Army of Women. A panel of 27 elements was quantified in urine using high resolution magnetic sector inductively coupled plasma mass spectrometry. We applied LASSO (least absolute shrinkage and selection operator) logistic regression to the 27 elements and calculated odds ratios (OR) and 95% confidence intervals (CI) for dense vs. nondense breasts, adjusting for potential confounders. Results: Of the 27 elements, only magnesium (Mg) was selected into the optimal regression model. The odds ratio for dense breasts associated with doubling the Mg concentration was 1.24 (95% CI 1.03-1.49). Doubling the calcium-to-magnesium ratio was inversely associated with dense breasts (OR 0.83, 95% CI 0.70-0.98). Conclusions: Our cross-sectional study found that higher levels of urinary magnesium were associated with greater breast density. Prospective studies are needed to confirm whether magnesium as evaluated in urine is prospectively associated with breast density and, more importantly, breast cancer. [ABSTRACT FROM AUTHOR]

Background: Despite the high incidence of breast cancer worldwide, methods for early non‐invasive diagnosis and sensitive and specific prognostic evaluation remain difficult. In this study, we investigated microwave parameters as a potential non‐invasive approach to detect breast cancer. Methods: Samples of freshly excised breast tissues (n = 509) from 98 patients were identified as normal, benign tumor, or malignant cancer via histology. Further samples were prepared and the microwave effective dielectric permittivity and effective conductivity were measured every 0.0375 GHz from 0.5 GHz to 8 GHz. These parameters were compared among the breast tissue types. Results: The effective relative permittivity and effective conductivity at each frequency was significantly higher in breast cancer tissues compared with benign tumors, which in turn was significantly higher than in normal breast tissue. The standard deviation of each parameter was narrowest at ~2.5 GHz in both normal and malignant breast tissues. Conclusions: The effective dielectric permittivity and effective conductivity, measured via microwave technology, could differentiate breast cancer from normal and benign tumor tissues. [ABSTRACT FROM AUTHOR]

Screening mammography introduces low doses of radiation per examination and in regular intervals over decades for women who have annual screening. Further, advanced breast imaging modalities and follow-up imaging methods contribute to additional radiation exposure in radiosensitive breast tissue. This article reviews the effects of radiation on the breasts, summarizes dose measurements and estimates for breast imaging modalities, and discusses efforts to optimize dose in breast imaging. [ABSTRACT FROM AUTHOR]

Objectives: This preliminary study aimed to 1) determine changes in the salivary oxytocin (OT) level during breast stimulation for promoting the spontaneous onset of labor in low-risk term pregnancies, and 2) clarify the feasibility of the breast stimulation intervention protocol in terms of practicality and acceptability. Methods: We used a single arm trial design. Sixteen low-risk pregnant women between 38 and 40 weeks of gestation with cephalic presentation participated. They performed breast stimulation for 3 days with an attendant midwife in a single maternity hospital. Each breast was stimulated for 15 minutes for a total of 1 hour per day. Saliva was collected 10 minutes before the intervention and 15, 30, 60, 75, and 90 minutes after the intervention, yielding 18 samples per woman. Results: Among a total of 282 saliva samples from the 16 participants, OT level was measured in 142 samples (missing rate: 49.6%). The median OT level showed the highest values on day 3 of the breast stimulation, with a marked increase 30 min after the intervention. In the mixed models after multiple imputation for missing data, the OT level on the first day of intervention was significantly lower than that on the third day of intervention. Fatigue from breast stimulation decreased on subsequent days, and most of the women (75%) felt no discomfort with the protocol. Uterine hyperstimulation was not observed. Conclusion: Following a 3-day breast stimulation protocol for spontaneous onset of labor, the mean OT level showed the highest values on day 3. The breast stimulation intervention protocol showed good feasibility in terms of practicality and acceptability among the pregnant women. Additional large-scale studies are warranted to confirm the protocol’s effectiveness. [ABSTRACT FROM AUTHOR]

This research aimed at determining and comparing the fatty acid lipid and amino acid profiles of protein from breast muscles of 17-week-old geese native to northern Poland - Kartuska (KA) and Suwalska (SU) as well as native to southern Poland - Lubelska (LU) and Kielecka (KI). There were 18 birds from each genotype (n = 18). During the experimental period, geese were fed ad libitum on the same complete feed. Genotype affected the fatty acid lipid and amino acid profiles of protein. The data indicated that protein nutritional value of KA and SU breast muscles was lower than LU and KI because they contained lower levels of tryptophan according to the standard protein (FAO/WHO, 1991). Research conducted on Polish, domestic varieties of geese suggest that muscles of the birds from the same region of Poland are characterised by similar amino acid profiles. The KI geese were shown to have the least nutritional value of lipid, because of their low PUFA share and high level of n-6/n-3 ratio. The n-6/n-3 ratios in muscles of all analysed geese were higher (7.56-9.65) than recommended, but at the same time, they were lower than in the so-called contemporary western diet. [ABSTRACT FROM AUTHOR]

Previous models to predict breast movement whilst performing physical activities have, erroneously, assumed uniform elasticity within the breast. Consequently, the predicted displacements have not yet been satisfactorily validated. In this study, real time motion capture of the natural vibrations of a breast that followed, after raising and allowing it to fall freely, revealed an obvious difference in the vibration characteristics above and below the static equilibrium position. This implied that the elastic and viscous damping properties of a breast could vary under extension or compression. Therefore, a new piecewise mass-spring-damper model of a breast was developed with theoretical equations to derive values for its spring constants and damping coefficients from free-falling breast experiments. The effective breast mass was estimated from the breast volume extracted from a 3D body scanned image. The derived spring constant (k a  = 73.5 N m −1 ) above the static equilibrium position was significantly smaller than that below it (k b  = 658 N m −1 ), whereas the respective damping coefficients were similar (c a  = 1.83 N s m −1 , c b  = 2.07 N s m −1 ). These values were used to predict the nipple displacement during bare-breasted running for validation. The predicted and experimental results had a 2.6% or less root-mean-square-error of the theoretical and experimental amplitudes, so the piecewise mass-spring-damper model and equations were considered to have been successfully validated. This provides a theoretical basis for further research into the dynamic, nonlinear viscoelastic properties of different breasts and the prediction of external forces for the necessary breast support during different sports activities. [ABSTRACT FROM AUTHOR]

Introduction. Data examining mammographic breast density (MBD) among patients in Sub-Saharan Africa are sparse. We evaluated how MBD relates to breast cancer characteristics in Kenyan women undergoing diagnostic mammography. Methods. This cross-sectional study included women with pathologically confirmed breast cancers (n=123). Pretreatment mammograms of the unaffected breast were assessed to estimate absolute dense area (cm2), nondense area (cm2), and percent density (PD). Relationships between density measurements and clinical characteristics were evaluated using analysis of covariance. Results. Median PD and dense area were 24.9% and 85.3 cm2. Higher PD and dense area were observed in younger women (P<0.01). Higher dense and nondense areas were observed in obese women (P-trend < 0.01). Estrogen receptor (ER) positive patients (73%) had higher PD and dense area than ER-negative patients (P≤0.02). Triple negative breast cancer (TNBC) patients (17%) had lower PD and dense area (P≤0.01) compared with non-TNBCs. No associations were observed between MBD and tumor size and grade. Conclusions. Our findings show discordant relationships between MBD and molecular tumor subtypes to those previously observed in Western populations. The relatively low breast density observed at diagnosis may have important implications for cancer prevention initiatives in Kenya. Subsequent larger studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Background Mammographic density has been shown to be a strong independent predictor of breast cancer and a causative factor in reducing the sensitivity of mammography. There remain questions as to the use of mammographic density information in the context of screening and risk management, and of the association with cancer in populations known to be at increased risk of breast cancer. Aim To assess the association of breast density with presence of cancer by measuring mammographic density visually as a percentage, and with two automated volumetric methods, Quantra™ and VolparaDensity™. Methods The TOMosynthesis with digital MammographY (TOMMY) study of digital breast tomosynthesis in the Breast Screening Programme of the National Health Service (NHS) of the United Kingdom (UK) included 6020 breast screening assessment cases (of whom 1158 had breast cancer) and 1040 screened women with a family history of breast cancer (of whom two had breast cancer). We assessed the association of each measure with breast cancer risk in these populations at enhanced risk, using logistic regression adjusted for age and total breast volume as a surrogate for body mass index (BMI). Results All density measures showed a positive association with presence of cancer and all declined with age. The strongest effect was seen with Volpara absolute density, with a significant 3% (95% CI 1–5%) increase in risk per 10 cm 3 of dense tissue. The effect of Volpara volumetric density on risk was stronger for large and grade 3 tumours. Conclusions Automated absolute breast density is a predictor of breast cancer risk in populations at enhanced risk due to either positive mammographic findings or family history. In the screening context, density could be a trigger for more intensive imaging. [ABSTRACT FROM AUTHOR]

Abstract: Radiation dose during screening mammography is a concern among women. The purpose of this study was to evaluate the relative contribution of breast density to the radiation dose from screening mammography. This IRB approved retrospective study involved collecting patient age, weight, height, compressed breast thickness, and average glandular dose for each exposure for 434 sequential patients undergoing screening mammography at our institution. Automated volumetric density software was used to quantify breast density. The relationship of predictors was evaluated by univariate and multivariate analysis. Median patient age was 58 years and median body mass index (BMI) was 26.8. Median volumetric breast density was 5.8% (range 1.7‐30.5%). Median compressed breast thickness was 63.4 mm (range 24.5‐111.5 mm). Univariate analysis showed positive associations between radiation dose and both breast thickness and BMI, an inverse association with age, and no association with density. Multivariate regression analysis demonstrated a significant association between dose and age (P=.021), laterality (P<.001), BMI (P=.038), density (P<.001), and breast thickness (P<.001). Decomposition of the multivariate regression model coefficient of determination showed that breast thickness was the primary determinant of dose, accounting for 76% of the 58% of the dose variability, followed by density (8%), laterality (4%), age (<1%), and BMI (<1%). Compressed breast thickness had the greatest effect on average glandular dose. Breast density has a minor impact, while BMI and age have minimal impact on dose. [ABSTRACT FROM AUTHOR]

Background Women with large breasts frequently experience upper torso pain secondary to their breast size. Evidence is lacking on the underlying causes of this pain. This study investigated whether upper torso pain and musculoskeletal structure and function differed between women with large breasts and women with small breasts. Methods A linear regression, adjusting for body mass, compared the upper torso pain, thoracic flexion torque due to breast mass, thoracic kyphosis, shoulder active range-of-motion, and scapular retraction muscle strength of 27 women with large breasts (bilateral breast volume > 1200 ml, age 45.9 y SD 9.9 y, BMI 29.0 kg/m 2 SD 3.8 kg/m 2 ) and 26 women with small breasts (bilateral breast volume < 800 ml, age 43.8 y SD10.9 y, BMI 23.3 kg/m 2 SD 2.9 kg/m 2 ). Findings Women with large breasts reported a higher upper torso pain score (46.6, 95%CI 33.3–58.0 versus 24.1, 95%CI 12.5–37.8), accompanied by a larger flexion torque (5.9 Nm, 95%CI 4.5–5.8 Nm versus 0.9 Nm, 95%CI 0.8–2.4 Nm), greater thoracic kyphosis (34°, 95%CI 31–38° versus 27°, 95% CI 24–31°), decreased shoulder elevation range-of-motion (160°, 95%CI 158–163° versus 169°, 95%CI 166–172°), and decreased scapular retraction endurance-strength (511.4 s, 95%CI 362.2–691.3 s versus 875.8 s, 95%CI 691.5–1028.4 s) compared to the women with small breasts. Interpretation Differences in the upper torso posture, range-of-motion, and muscle strength of women with large breasts provides insight into underlying causes of their musculoskeletal pain. This information can be used to develop evidence-based assessment and treatment strategies to relieve and prevent symptom progression. [ABSTRACT FROM AUTHOR]

Background Prior research shows between-race differences in women's knowledge and emotions related to having dense breasts, thus suggesting that between-race differences in behavioral decision-making following receipt of breast density (BD) notifications are likely. Guided by the theory of planned behavior, this study examined differences in emotion-related responses (i.e., anxiety, worry, confusion) and behavioral cognition (e.g., intentions, behavioral attitudes) following receipt of BD notifications among African American (AA) and European American (EA) women. This study also examined whether race-related perceptions (i.e., discrimination, group-based medical mistrust), relevant knowledge and socioeconomic status (SES) explained the between race differences. Method Michigan women ( N = 457) who presented for routine screening mammogram and had dense breasts, no prior breast cancer diagnoses, and had screen-negative mammograms were recruited from July, 2015 to March 2016. MANOVA was used to examine between race differences in psychological responses (i.e., emotional responses and behavioral cognition), and a multi-group structural regression model was used to examine whether race-related constructs, knowledge and SES mediated the effect of race on emotional responses and behavioral cognition. Prior awareness of BD was accounted for in all analyses. Results AA women generally reported more negative psychological responses to receiving BD notifications regardless of prior BD awareness. AA women had more favorable perceptions related to talking to their physicians about the BD notifications. Generally, race-related perceptions, SES, and related knowledge partially accounted for the effect of race on psychological response. Race-related perceptions and SES partially accounted for the differences in behavioral intentions. Between-race differences in emotional responses to BD notifications did not explain differences in women's intentions to discuss BD notifications with their physicians. Conclusions Future examinations are warranted to examine whether there are between-race differences in actual post-BD notification behaviors and whether similar race-related variables account for differences. [ABSTRACT FROM AUTHOR]

Much research has been devoted to why women choose not to be reconstructed following mastectomy. The effect of breast size has not been well explored. The authors aimed to assess the relationship between breast size and reconstructive choices. A single-center retrospective review of women undergoing mastectomy between 2011 and 2014 was performed. Demographics, surgical variables, and reconstruction decisions were analyzed using t tests, Mann-Whitney U tests, and chi-squared tests. Significant ( P < .05) variables were included in a multivariable logistic regression model. About 610 patients were analyzed. The median mastectomy specimen weight was 572 g (62-5230 g), which did not correlate with BMI ( P = .44). Women who underwent reconstruction had lighter mastectomy specimens, averaging 643 vs 848 g ( P < .0001). A regression controlling for ethnicity, insurance status, number of comorbidities, age at mastectomy, cancer stage, BMI, specimen weight, and mastectomy laterality was constructed. Lower specimen weight ( P = .005), lower cancer stage ( P = .008), bilateral mastectomy ( P = .042), and younger age at mastectomy ( P < .0001) were significantly associated with reconstruction. Women with larger breasts were less likely to be reconstructed regardless of their BMI and comorbidities. Larger breasted women may be considered worse prosthetic reconstruction candidates due to increased complications and suboptimal aesthetic outcomes but may find the increased invasiveness and recovery of autologous reconstruction an unattractive alternative. Furthermore, it is possible that surgeons may be less supportive of breast reconstruction for larger breasted women if there are concerns about safety or the aesthetic quality of the result. In the future, qualitative research must be done to determine why more larger breasted women choose not to be reconstructed as well as develop better ways to increase their reconstructive options. [ABSTRACT FROM AUTHOR]

Previous studies have linked reductions in mammographic density after a breast cancer diagnosis to an improved prognosis. These studies focused on short-term change, using a 2-stage process, treating estimated change as a fixed covariate in a survival model. We propose the use of a joint longitudinal-survival model. This enables us to model long-term trends in density while accounting for dropout as well as for measurement error. We studied the change in mammographic density after a breast cancer diagnosis and its association with prognosis (measured by cause-specific mortality), overall and with respect to hormone replacement therapy and tamoxifen treatment. We included 1,740 women aged 50-74 years, diagnosed with breast cancer in Sweden during 1993-1995, with follow-up until 2008. They had a total of 6,317 mammographic density measures available from the first 5 years of follow-up, including baseline measures. We found that the impact of the withdrawal of hormone replacement therapy on density reduction was larger than that of tamoxifen treatment. Unlike previous studies, we found that there was an association between density reduction and survival, both for tamoxifen-treated women and women who were not treated with tamoxifen. [ABSTRACT FROM AUTHOR]

Female breasts change throughout a woman's life in response to fluctuating hormonal influences. Individuals managing active women and those modeling female breasts must understand these structural and functional changes across a female's lifespan because these changes affect breast injuries sustained by women. We initially review female breast structure and function and then describe how breast structure changes across a woman's lifespan. Key studies about direct contact and frictional breast injuries are then summarized. Limitations of current breast injury research, gaps in knowledge about breast injuries incurred by specific populations, and the lack of breast injury models are also highlighted. With minimal anatomical protection, it is unsurprising that breast injuries occur. Although research about breast injuries is scant, direct contact during blunt force trauma to the anterior chest wall and frictional breast injuries have been reported. There is a lack, however, of research documenting the incidence and severity of breast injuries incurred in occupational settings and in women's sports. Therefore, to design effective breast protective equipment, we recommend research to model and investigate the mechanisms and forces involved in breast injuries, particularly injuries sustained during sport. This unique review summarizes how female breasts change over a woman's life span, with implications for breast injuries sustained by females. Knowledge gaps about female breast injuries are highlighted. We conclude by recommending research required to develop evidence-based strategies to improve how we classify, prevent, and clinically manage breast injuries sustained by females. We review changes to the breast across a woman's lifespan, highlighting implications for managing and modeling female breast injuries. • We review how breast structure and function change across a woman's lifespan. • We review key studies and highlight knowledge gaps on female breast injuries. • We recommend research to improve how we classify and manage female breast injuries. [ABSTRACT FROM AUTHOR]

The article focuses on the new federal mammogram standards set by the Food and Drug Administration to provide better information to women with dense breasts. Topics include informing women and their healthcare providers about the challenges of detecting tumors in dense breast tissue and the higher risk of breast cancer; and the importance of follow-up testing and introducing clearer wording in the notices sent to women by enabling earlier detection of breast cancer.

Background/Aims: Transforming growth factor-β1 (TGF-β1) plays a crucial role in chronic inflammation in various tissues and is related to inflammation-caused organ fibrogenesis associated with the epithelial-mesenchymal transition (EMT) and the deposition of the extracellular matrix (ECM). However, the effect of TGF-β1 on bovine mammary epithelial cells (BMECs) with mastitis and its mechanism, remain unknown. Methods: We analyzed the level of TGF-β1 in inflamed mammary tissues and cells using western blotting. BMECs were treated with TGF-β1 and EMT-related gene and protein expression changes were evaluated using quantitative real-time polymerase chain reaction (qPCR), western blotting and immunofluorescence. We also inhibited the TGF/Smad signaling pathway using a receptor inhibitor and analyzed EMT-related protein expression by western blotting. In addition, we injected TGF-β1 into mice mammary glands to investigate whether it can cause mammary fibrosis in vivo. Results: The TGF-β1 level was up-regulated in mammary tissues with mastitis and in inducible inflammatory BMECs. TGF-β1 treatment activated the TGF/ Smad signaling pathway in BMECs during their transition to the EMT phenotype, as indicated by morphological changes from a cobblestone-like shape to a spindle-like one. TGF-β1 treatment also up-regulated the expression of α-smooth muscle actin, vimentin and collagen I, albumin and down-regulated the expression of E-cadherin both in mRNA level and protein level. Furthermore, TGF-β1 enhanced the gene expressions of MMP2, MMP7 and fibronectin in BMECs. TGF-β1 injection induced mice mammary infection and fibrosis. Conclusion: These findings suggested that aberrant up-regulation of TGF-β1 in bovine mastitic mammary glands might play an important role in bovine mammary fibrosis caused by unresolved inflammation. [ABSTRACT FROM AUTHOR]

The article discusses the value of sonography as supplement imaging modality to mammography as screening and diagnostic techniques for breast pathologies. Topics discussed include correlations of mammographic and sonographic images of the breast, and how common breast diseases appear on these imaging modalities. Also mentioned are limitations of mammography and sonography in diagnosing breast conditions.

Background: Mammographic breast density is a well-established, strong breast cancer risk factor but the biology underlying this association remains unclear. Breast density may reflect underlying alterations in the size and activity of the breast stem cell pool. We examined, for the first time, associations of CD44, CD24, and aldehyde dehydrogenase family 1 member A1 (ALDH1A1) breast stem cell markers with breast density.Methods: We included in this study 64 asymptomatic healthy women who previously volunteered for a unique biopsy study of normal breast tissue at the Mayo Clinic (2006-2008). Mammographically identified dense and non-dense areas were confirmed/localized by ultrasound and biopsied. Immunohistochemical analysis of the markers was performed according to a standard protocol and the staining was assessed by a single blinded pathologist. In core biopsy samples retrieved from areas of high vs. low density within the same woman, we compared staining extent and an expression score (the product of staining intensity and extent), using the signed rank test. All tests of statistical significance were two-sided.Results: A total of 64, 28, and 10 women were available for CD44, CD24, and ALDH1A1 staining, respectively. For all three markers, we found higher levels of staining extent in dense as compared to non-dense tissue, though for CD24 and ALDH1A1 the difference did not reach statistical significance (CD44, 6.3% vs. 2.0%, p < 0.001; CD24, 8.0% vs. 5.6%, p = 0.10; and ALDH1A1, 0.5% vs. 0.3%, p = 0.12). The expression score for CD44 was significantly greater in dense as compared to non-dense tissue (9.8 vs.3.0, p < 0.001).Conclusions: Our findings suggest an increased presence and/or activity of stem cells in dense as compared to non-dense breast tissue. [ABSTRACT FROM AUTHOR]

Purpose. To study the distribution of breast mammogram density in Lebanese women and correlate it with breast cancer (BC) incidence. Methods. Data from 1,049 women who had screening or diagnostic mammography were retrospectively reviewed. Age, menopausal status, contraceptives or hormonal replacement therapy (HRT), parity, breastfeeding, history of BC, breast mammogram density, and final BI-RADS assessment were collected. Breast density was analyzed in each age category and compared according to factors that could influence breast density and BC incidence. Results. 120 (11.4%) patients had BC personal history with radiation and/or chemotherapy; 66 patients were postmenopausal under HRT. Mean age was 52.58±11.90 years. 76.4% of the patients (30–39 years) had dense breasts. Parity, age, and menopausal status were correlated to breast density whereas breastfeeding and personal/family history of BC and HRT were not. In multivariate analysis, it was shown that the risk of breast cancer significantly increases 3.3% with age (P=0.005), 2.5 times in case of menopause (P=0.004), and 1.4 times when breast density increases (P=0.014). Conclusion. Breast density distribution in Lebanon is similar to the western society. Similarly to other studies, it was shown that high breast density was statistically related to breast cancer, especially in older and menopausal women. [ABSTRACT FROM AUTHOR]

Early detection of breast cancer risk by screening tools such as mammography can reduces the cost of treatment management and the prognosis of the disease. The level of breast density of in mammogram is one of the potential cofounder factor for breast cancer risk. The development of mammary epithelial cells is determined by the genetic factor. Transforming growth factor-beta (TGF-β) gene involves in the regulation of cell proliferation and cell division. This study aimed to assess the association of TGF-β1 polymorphisms with breast density among women who underwent breast screening using mammogram. The detection of genotypes for three polymorphisms of TGF-β1 assigned as rs1800469, rs1800470 and rs4803455 were performed using PCR-RFLP technique. The allele and genotype frequencies were calculated for control group that consists of BIRADS 1 and BIRADS 2 class whilst case group consisted of BIRADS 3 and BIRADS 4 class. Two polymorphisms (rs1800469 and rs1800470) yielded a significant association with breast density with p value of 0.004 and 0.003, respectively. However, the third polymorphism, rs4803455 did not yield a significant association (p value=0.090). Haplotype association analysis might suggest the haplotype GAA conferred susceptibility (p value= 0.02, OR=2.21[1.07-4.55]) rather than haplotype AAC predispose a protective effect (p value=0.004, OR=0.40[0.21-0.77]) to breast density development. This preliminary data on single and haplotype association might reveal the association of polymorphisms of TGF-β1 with breast density and give an insight on the role of polymorphism in predisposing to breast density development. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate how breast density interacted with demographic, reproductive, and lifestyle features among Vietnamese women. Mammographic density and established risk factors for breast cancer were collected from 1651 women (345 cancer cases and 1306 normal cases) in Vietnam. The association of breast density categories with potential risk factors was investigated using Spearman’s test for continuous variables and χ2 tests for categorical variables. Independent factors associated with high breast density and breast cancer in specific density groupings were assessed using logistic regression. Results showed that high breast density was significantly associated with young age, low body mass index, low number of children, early age at having the last child, premenopausal status, and increased vegetable consumption. Reproductive factors were key agents associated with breast cancer for women with high breast density, which was not so evident for women with low breast density. [ABSTRACT FROM AUTHOR]

Males sometimes experience the swelling and enlargement of an area around their nipples. The occurrence of gynecomastia is more common than generally known and affects boys’ and young adolescent males’ lives emotionally and socially as well as physically. Understanding the causes of “female breasts” in males is important in order to help boys receive the correct information about their condition and the proper treatment for it. [ABSTRACT FROM AUTHOR]

Breasts, including the nipple and areola, have two functions: lactation and as an erogenous area. Male breasts are much less studied that those of women. In men, breasts have only an erotic function. Because there is dense and very well organized innervation of the nipple-areola complex in men, nipple erection occurs frequently and via different mechanisms from penile erection. Although it seems to be less important for men than for women and it is poorly studied, the erotic value of breast stimulation is notable. Consequently, there is a need to include this aspect in sexological and andrological studies and to preserve breasts and their innervation or to reconstruct them in cases of surgical intervention. [ABSTRACT FROM AUTHOR]

Objective: To find out the diagnostic role of kisspeptin and neurokinin B in idiopathic central precocious puberty (ICPP) and premature thelarche (PT). Methods: The girls who presented with early breast development before the age of 8 years were evaluated. Patients with intracranial pathologies were excluded. Basal and stimulated follicle-stimulating hormone/luteinizing hormone (LH) levels and basal neurokinin B/kisspeptin levels were measured. Patients who had peak value of LH >5 mIU/mL and a bone age (BA)/chronological age (CA) ratio >1.1 were diagnosed as central precocious puberty (CPP), while cases who did not meet these criteria were diagnosed as PT. Healthy agematched prepubertal girls were included as the control group. Results: The study group contained 25 girls with ICPP (7±0.8 years), 35 girls with PT (6.8±0.7 years), and 30 controls (6.7±0.7 years). Basal serum kisspeptin and neurokinin B levels were 2.36±0.47 ng/mL and 2.61±0.32 ng/mL, respectively in the ICPP group, 2.23±0.43 ng/mL and 2.24±0.23 ng/mL, respectively in the PT group, and 1.92±0.33 ng/mL and 2.03±0.24 ng/mL, respectively in the controls. Both kisspeptin and neurokinin B levels were higher in the ICPP and PT groups compared to controls (p<0.05). Moreover, basal neurokinin B level was different between ICPP and PT groups (p<0.01). A serum neurokinin B level of 2.42 ng/mL provided the most appropriate level to differentiate ICPP from PT, with a sensitivity of 84% and specificity of 77.1%. Conclusion: Differentiation of CPP from PT is sometime difficult, and there is a need for a simple method for the differential diagnosis. Our results suggest that basal serum neurokinin B level can be used as an adjunctive parameter to differentiate ICCP from PT. [ABSTRACT FROM AUTHOR]

Background. Omitting the placement of clips inside tumour bed during breast cancer surgery poses a challenge for delineation of lumpectomy cavity clinical target volume (CTVLC). We aimed to quantify inter-observer variation and accuracy for CT- and MRI-based segmentation of CTVLC in patients without clips. Patients and methods. CT- and MRI-simulator images of 12 breast cancer patients, treated by breast conserving surgery and radiotherapy, were included in this study. Five radiation oncologists recorded the cavity visualization score (CVS) and delineated CTVLC on both modalities. Expert-consensus (EC) contours were delineated by a senior radiation oncologist, respecting opinions of all observers. Inter-observer volumetric variation and generalized conformity index (CIgen) were calculated. Deviations from EC contour were quantified by the accuracy index (AI) and inter-delineation distances (IDD). Results. Mean CVS was 3.88 +/- 0.99 and 3.05 +/- 1.07 for MRI and CT, respectively (p = 0.001). Mean volumes of CTVLC were similar: 154 +/- 26 cm³ on CT and 152 +/- 19 cm3 on MRI. Mean CIgen and AI were superior for MRI when compared with CT (CIgen: 0.74 +/- 0.07 vs. 0.67 +/- 0.12, p = 0.007; AI: 0.81 +/- 0.04 vs. 0.76 +/- 0.07; p = 0.004). CIgen and AI increased with increasing CVS. Mean IDD was 3 mm +/- 1.5 mm and 3.6 mm +/- 2.3 mm for MRI and CT, respectively (p = 0.017). Conclusions. When compared with CT, MRI improved visualization of post-lumpectomy changes, reduced interobserver variation and improved the accuracy of CTVLC contouring in patients without clips in the tumour bed. Further studies with bigger sample sizes are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Background: Estrogen is known to affect both mammographic breast density and bone mineral density (BMD), but there are inconsistent results about the association of these density measurements in postmenopausal women. Furthermore, there are scarce data on the relationship between breast density and BMD in never users of postmenopausal hormone therapy. Aim: In this study, we examined the relationship between mammographic breast density and BMD in postmenopausal women who were never hormone replacement therapy users. Methods: A total of 293 postmenopausal women were enrolled in this cross-sectional study. Mammograms and BMD measurements for screening purposes were obtained. Assessment of mammographic breast density was performed by using breast imaging reporting and data system classification. The BMD was measured using dual-energy X-ray absorptiometry of the lumbar spine and femoral neck. Results: Grade 1 breast density was observed in 64 women (21.8 %), grade 2 in 113 women (38.6 %) and grades 3 and 4 in 116 (39.6 %) women. Breast density decreased with increasing age and body mass index (BMI). Meanwhile, no significant differences were detected in BMD measures of the hip ( p = 0.14) and lumbar spine ( p = 0.29) among the breast density categories. After adjusting for age and BMI, the differences in the mean BMD at the hip and lumbar spine across the breast density categories remained insignificant ( p = 0.26 and 0.11, respectively). Conclusion: There is no evidence of a relationship between mammographic breast density and BMD in postmenopausal women who had never used hormone replacement therapy. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To identify previously unstudied factors predicting re excision following breast-conserving surgery (BCS) and to assess the feasibility of obtaining data about breast density for predictive modeling. Design: Retrospective secondary data analysis. Setting: Data were obtained from the cancer registry and electronic health records (EHRs) at Texas Health Harris Methodist Hospital, a large, urban, private, nonprofit hospital in North Texas. Sample: 244 patients choosing BCS from 2011'2012. Methods: Data were subjected to univariate analyses (chi square) followed by logistic regression. Main Research Variables: The primary dependent variable was re-excision following BCS. Predictors of interest included lifestyle factors, time from diagnosis to surgery, surgical approach, patient age, and breast density, and controlled for covariates, such as assay results. Findings: Three factors predicted re-excision with 87% accuracy: time from diagnosis to surgery, needle localization, and age. Missing data precluded using breast density as a predictor. Conclusions: Women younger than 60 years whose surgery included placement of a wire for localization of tissue to be removed and who underwent surgery soon after diagnosis are the least likely to require reoperation after BCS. Data integrity is critical to the success of research using EHRs and registry information. Implications for Nursing: Nurses may improve patient outcomes by helping women considering BCS solve problems that may delay surgery. Nurses can contribute to the success of nursing research by thoroughly and accurately recording patient information in EHRs. [ABSTRACT FROM AUTHOR]

To assess the effectiveness of breast support previous studies monitored breast kinematics and kinetics, subjective feedback, muscle activity (EMG), ground reaction forces (GRFs) and physiological measures in isolation. Comparing these variables within one study will establish the key performance variables that distinguish between breast supports during activities such as running. This study investigates the effects of changes in breast support on biomechanical, physiological and subjective measures during running. Ten females (34D) ran for 10 min in high and low breast supports, and for 2 min bare breasted (2.8 m·s−1). Breast and body kinematics, EMG, expired air and heart rate were recorded. GRFs were recorded during 10 m overground runs (2.8 m·s−1) and subjective feedback obtained after each condition. Of the 62 variables measured, 22 kinematic and subjective variables were influenced by changes in breast support. Willingness to exercise, time lag and superio-inferior breast velocity were most affected. GRFs, EMG and physiological variables were unaffected by breast support changes during running. Breast displacement reduction, although previously advocated, was not the most sensitive variable to breast support changes during running. Instead breast support products should be assessed using a battery of performance indicators, including the key kinematic and subjective variables identified here. [ABSTRACT FROM AUTHOR]

Background: Frequent dairy consumption in childhood has been related to higher growth-hormone concentrations that may affect mammary gland and pubertal development. Objective: We evaluated the relation of dairy intake to breast composition at Tanner stage 4 and age at menarche. Design: A total of 515 Chilean girls are included in the Growth and Obesity Cohort Study. The subjects have been followed longitudinally since they were 3-4 y old (from 2006 to the present). Starting in 2013, diet was assessed every 6 mo via a 24-h recall. The breast fibroglandular volume (FGV) was measured with the use of dual-energy X-ray absorptiometry at Tanner stage 4. The date of menarche was reported every 6 mo. Our analysis included 290 girls with data on prospective diet and breast composition and 324 girls with data on prospective diet and age at menarche. Results: The mean ± SD breast FGV and percentage of fibroglandular volume (%FGV) (i.e., FGV divided by total breast volume times 100) at Tanner stage 4 was 81.7 ± 32.2 cm3 and 42.0% ± 16.7%, respectively. Only sweetened, artificially flavored milk-based drinks were associated with the %FGV with girls who consumed >125 g/d having a %FGV that was 4.5% (95% CI: 0.9%, 8.1%) higher than that of girls who consumed none (P-trend = 0.007). Yogurt intake was associated with a lower FGV. Specifically, girls who consumed >125 g yogurt/d had -10.2 cm3 (95% CI: -20.2, -0.3 cm3) less FGV than did girls who consumed no yogurt (P-trend = 0.03). The majority (90.7%) of girls in our cohort attained menarche before the data analyses with a mean ± SD age at menarche of 11.9 ± 0.7 y. In multivariable models, low-fat dairy, low-fat milk, and yogurt intakes were associated with a later age at menarche. In particular, girls who consumed >125 g yogurt/d had menarche, on average, 4.6 mo (95% CI: 1.9, 7.4 mo) later than girls who consumed no yogurt (P-trend = 0.01). Conclusion: More-frequent consumption of sweetened, artificially-flavored milk-based drinks is associated with a higher %FGV, whereas higher yogurt intake is associated with a lower FGV and delayed age at menarche in Chilean girls. [ABSTRACT FROM AUTHOR]