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The article discusses highlights of a roundtable with an international expert group including Paolo Tarantino, Nina Ditsch, Angelika Wolfrum and Frederik Marmé, at the American Society of Clinical Oncology (ASCO) 2024 conference. Topics include treatment of metastatic breast cancer (MBC), survival for human epidermal growth factor receptor 2 (HER2)-low and -ultralow MBC patients, efficacy of antibody-drug-conjugates (ADC) in treating MBC, and suitability of CDK4/6 inhibitors for patients.

Health care disparities, which are differences in the attainment of full health potential among population groups, have been documented across medical conditions, clinical settings, and diagnostic and treatment modalities. Deeply rooted health care disparities due to many factors have affected how Black women (BW) view medical care including screening mammography. This article explores health care disparities around breast cancer in BW and how patient distrust, provider biases, race, and social determinants of health continue to have negative effects on breast cancer outcomes in BW, despite medical advances in breast cancer detection and management. In addition, this article addresses the importance of culturally competent care for BW around breast cancer awareness, screening, and treatment, and offers strategies to address disparities and rebuild trust. [ABSTRACT FROM AUTHOR]

Breast cancer is the second most common cancer among women worldwide, and the diagnosis by pathologists is a time-consuming procedure and subjective. Computer-aided diagnosis frameworks are utilized to relieve pathologist workload by classifying the data automatically, in which deep convolutional neural networks (CNNs) are effective solutions. The features extracted from the activation layer of pre-trained CNNs are called deep convolutional activation features (DeCAF). In this paper, we have analyzed that all DeCAF features are not necessarily led to higher accuracy in the classification task and dimension reduction plays an important role. We have proposed reduced DeCAF (R-DeCAF) for this purpose, and different dimension reduction methods are applied to achieve an effective combination of features by capturing the essence of DeCAF features. This framework uses pre-trained CNNs such as AlexNet, VGG-16, and VGG-19 as feature extractors in transfer learning mode. The DeCAF features are extracted from the first fully connected layer of the mentioned CNNs, and a support vector machine is used for classification. Among linear and nonlinear dimensionality reduction algorithms, linear approaches such as principal component analysis (PCA) represent a better combination among deep features and lead to higher accuracy in the classification task using a small number of features considering a specific amount of cumulative explained variance (CEV) of features. The proposed method is validated using experimental BreakHis and ICIAR datasets. Comprehensive results show improvement in the classification accuracy up to 4.3% with a feature vector size (FVS) of 23 and CEV equal to 0.15. [ABSTRACT FROM AUTHOR]

The article titled "What are the Causes of Exclusive Breastfeeding Failure? A Systematic Review" explores the factors that contribute to the failure of exclusive breastfeeding. The study used a systematic literature review method and analyzed data from various sources. The results revealed that factors inhibiting exclusive breastfeeding include the mother's knowledge, family support, mother's employment status, breast care, breastfeeding coupled with formula and complementary foods, and milk production during breastfeeding. The article emphasizes the importance of exclusive breastfeeding for the health and development of infants and highlights the benefits for both the baby and the mother. It also emphasizes the need for education and support to promote successful breastfeeding practices. The article references three other articles on different topics, including illegal financial technology practices, Indonesian food culture, and socioeconomic disparities in hospital utilization among female workers in Indonesia. These articles are published in different journals and are subject to copyright by their respective authors. [Extracted from the article]

Breast cancer in women continues to be a significant global health burden, especially in low- and middle-income countries. Awareness and early detection of breast cancer are critical in decreasing the mortality rate in these countries. Educating and training key stakeholders and developing in-country partnerships are necessary for sustainable breast cancer programs incorporating prevention and interventions at all levels. RAD-AID International is a nonprofit organization whose mission is to increase global health outreach through radiology education and the development of imaging technology in low-resource communities worldwide. A primary focus of the RAD-AID Guyana program is to increase breast cancer care outreach through capacity-building programs and engaging with global health partners in Guyana to increase public health awareness, education, and training of central and regional providers in breast cancer care. By addressing barriers to care in low-resource communities through increased capacity building, RAD-AID endeavors to improve breast cancer outcomes and reduce the burden of the disease in Guyana. The challenges to developing a functional, sustainable program in cancer diagnosis, treatment, and palliative care are appreciated, and strategies to overcome these challenges are recognized. The need for a multidisciplinary approach that includes nursing to facilitate primary prevention, early diagnosis, and treatment is emphasized. The lessons learned from RAD-AID's breast care education initiatives in Guyana contribute to the growing body of knowledge in global health outreach, emphasizing the importance of collaboration, capacity building, and tailored strategic interventions in combating breast cancer in underserved populations. [ABSTRACT FROM AUTHOR]

Introduction: Lack of breastfeeding in the first few days of life is an obstacle to early breastfeeding due to fear and anxiety about insufficient breastfeeding. A Proper breastfeeding experience can be enhanced through breast care, namely breast massage, nipple cleansing, and squeezing the breasts with warm and cold water. It naturally stimulates the breast to increase the hormone. Four out of 10 postpartum women complain that they are not producing enough milk for their babies. The purpose of this study was to examine the effects of a combination of lactation and breast massage care on postpartum breastfeeding production. Methods: A Quasi-experimental design with a one-group pretest- posttest design was used in this research. The population of this study was 32 respondents in total. Data collection in this study was carried out using researchers assessing the adequacy of breastfeeding before the intervention of a combination of lactation massage and breast care on postpartum aged one day and reassessing after being given a combination intervention of lactation massage and breast care on postpartum aged three days. Results: The average value of breastfeeding adequacy before being given a massage combination is 1.16, the average after being given a massage combination is 6.25, the average difference before and after is 5.09, and the p-value = 0.000. Conclusion: It can be concluded that the combination of lactation massage and breast care affects the adequacy of breastfeeding, with p value 0.000 (p <0.05). [ABSTRACT FROM AUTHOR]

Purpose To clarify the components of breastfeeding clothing worn by puerperal women during postpartum hospitalization that make it easier for midwives to perform breast care. Participants and Methods A self-administered questionnaire was distributed to 130 midwives at five facilities in Fukuoka Prefecture, and 78 responded (60% response rate). Respondents were asked to choose among 10 different types of breastfeeding clothes --including those that help or hinder breast care worn by puerperal women who receive breast care, and breastfeeding clothes used at work. Respondents were asked to rate the 10 types of breastfeeding clothes in terms of "ease of access to the breast during breast care" on a four-point scale, and to rate 10 elements valued in breastfeeding clothes worn by hospitalized puerperal women. Results The breastfeeding clothes that facilitated breast care included the negligee (full front opening), pajamas (full front opening), and pajamas (yukata type). Conversely, clothes that impeded breast care by midwives consisted of four types: negligee (no front opening), pajamas (no front opening), negligee (upper front opening), and negligee (with opening for breastfeeding). Approximately 87% of midwives had experienced breast care for puerperal women wearing these types of clothes. Midwives emphasized "ease of access to the breast" and "comfort" as important elements of breastfeeding clothes worn by hospitalized puerperal women. Approximately 65% of midwives required an opening in clothes during breast care, with 92% requiring a size of 20 sq. cm or larger. Conclusion Three types of breastfeeding clothes aided midwives in breast care: negligees (full front opening), pajamas (full front opening), and pajamas (yukata type). Approximately 87% of midwives have provided breast care to puerperal women who wore breastfeeding clothes that impeded breast care. This shows that the design of breastfeeding clothes affects the ease of performing breast care. Approximately 65% of midwives required an opening in clothes during breast care, with 92% requiring a size of 20 sq. cm or larger. Since midwives emphasized ease of access to the breast, it became clear that they preferred a wide opening in breastfeeding clothing worn by puerperal women. [ABSTRACT FROM AUTHOR]

In the context of ongoing global pandemics and political and economic instability, supporting public health organisations to improve their performance and develop their resilience is becoming a central issue in the organisational resilience research agenda. This paper offers a briefing on the viability and sustainability (v&s) approach and provides an example of application of the self‐transformation methodology (STM) at the breast care unit in an English Health Trust. The way of conducting the systemic application, the chosen methodology and tools and the way of interacting with the clients all exhibit the aspects of holistic flexibility. The paper demonstrates how the v&s approach and the STM enabled the collective identification of more effective policies and strategies for improving individual and organisational effectiveness for this health service unit, when interacting with a complex and changing environment. It also discusses the potential for adapting and replicating the approach across the healthcare sector. [ABSTRACT FROM AUTHOR]

Aim and objectives: To assess the adherence of a nursing care model in a multidisciplinary breast cancer unit in a tertiary hospital to the recommended competencies and quality indicators. Background: Aligning the competencies of the breast care nurse with international recommendations for this role helps better fulfil patient needs, increases satisfaction and ensures continuity of care. Design: Cohort study. Methods: Breast care nursing was assessed in all patients treated at the Functional Breast Unit from 1 July 2016 to 30 June 2017. Patients were followed for 1 year. Sociodemographic, clinical and pathological data, treatments performed and nursing interventions were collected. The strobe checklist has been used to report this study. Results: We analysed nursing interventions carried out in 382 patients attended over 1 year in a multidisciplinary breast cancer unit. All patients with early disease had contact with the nurse at different times during their primary treatment. Only 58% of patients with advanced disease had contact with the nurse during their first year of illness. Moreover, first contact with the nurse was delayed by more than a week from diagnosis, the interval recommended by international guidelines. Conclusion: The nursing care model meets the core competencies defined for the breast care nurse in patients with early breast cancer, but the first visit should be organised earlier, and follow‐up should extend beyond completion of primary treatment. Relevance to clinical practice: This study evaluated the breast care nurse model in one breast cancer unit according to international guidelines. Nursing care adhered to most guideline requirements in patients with early breast cancer, but not in those with advanced disease. New models of care need to be developed for women with advanced breast cancer in order to achieve true patient‐centred care. Patient or public contribution: No contribution from the patient or the public because the data collected was entered into the clinical history by the health professionals of the Breast Unit as part of their usual clinical practice. [ABSTRACT FROM AUTHOR]

Objective: Triple negative breast cancer (TNBC) has high relapse rates due to dysregulated inflammatory signaling pathways and significant changes in the tumor microenvironment, probably influencing the failure of several therapies. The Cysteinyl Leukotriene Receptor 1 (CYSLTR1), a leukotriene modulator of inflammation, has been shown to play an important role in cancer pathogenesis and survival but few studies have been reported on its role in breast cancer. Materials and Methods: The present work was conducted using publicly available platforms that have omics data to assess the clinical potential of CYSLTR1 expression and its prognostic validation in large cohorts of samples from breast cancer patients. Web platforms containing clinical information, RNA-seq and protein data were selected to perform in silico analyses of the potential marker CYLSTR1. Added together, the platforms included modules for correlation, expression, prognosis, drug interactions, and construction of gene networks. Results: Kaplan–Meier curves revealed that reduced levels of CYSLTR1 corresponded to an unfavorable outcome for overall survival (p<0.005) as well as relapse-free survival (p<0.001) in the basal subtype. Additionally, CYSLTR1 was downregulated in breast tumor samples compared to adjacent healthy tissue (p<0.01) and the basal subtype exhibited the lowest expression of CYSLTR1 relative to the other subtypes (p<0.0001). Furthermore, gene networking analysis showed strong associations of CYSLTR1 with two protein-coding genes (P2RY10 and XCR1) when tested on a TNBC dataset. Conclusion: Our data highlighted the relevance of CYSLTR1 since it may play an important role in TNBC therapy. However, further in vitro and in vivo studies should be directed towards validating our findings in an effort to improve our understanding of TNBC pathology. [ABSTRACT FROM AUTHOR]

Objective: Tumour regression is defined as continuity of changes leading to the elimination of a neoplastic population and is reflected as periductal fibrosis and intraductal tumour attenuation. The aim of this study was to describe the radiological and clinicopathological characteristics of high-grade breast ductal carcinoma in situ (DCIS) with regressive changes (RC). Materials and Methods: Thirty-two cases of high-grade DCIS with RC on biopsy specimens followed by excision were included. The mammographic, ultrasonographic (US), and magnetic resonance imaging (MRI) findings of cases were retrospectively reviewed according to the breast imaging reporting and data system (BI-RADS) lexicon. Clinical and histopathological findings [comedonecrosis, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status and Ki-67 proliferation index] were recorded. The rate of upgrade to invasive cancer after surgical excision and lymph node involvement were evaluated. Results: The most common mammographic finding was microcalcifications alone (68.8%). The most frequently seen findings on US were microcalcifications only (21.9%), followed by microcalcifications and hypoechoic area (18.7%). On MRI, most lesions presented as clumped non-mass enhancement with segmental distribution. ER/PR negativity (53.1%, 65.6%), HER2 positivity (56.3%) and high Ki-67 (62.5%), which are known to be associated with more aggressive behavior, were found to be proportionally higher. The rate of upgrade to invasive cancer was 21.8%. Conclusion: DCIS with RC lesions present most often as microcalcifications alone on both mammography and US. MRI features are not distinguishable from those of other DCIS lesions. DCIS with RC lesions show biomarker status reflecting more aggressive behavior and high upgrade rate to invasive cancer. [ABSTRACT FROM AUTHOR]

Approximately 6-10% of all breast carcinoma is metastatic at diagnosis, termed de novo metastatic breast carcinoma (dnMBC). Systemic therapy remains the first line of treatment in dnMBC, but there is growing evidence that adjuvant locoregional treatment (LRT) of the primary tumor increases progression-free and overall survival (OS). Although selection bias may exist, real-world data from nearly half a million patients show that patients are undergoing primary tumor removal because of the survival benefit. The main question for the advocates for LRT in this patient population is not whether primary surgery is beneficial in dnMBC patients, but rather who is a good candidate for it. Oligometastatic disease (OMD) is a distinct subset of dnMBC that affects a limited number of organs. A better OS can be achieved with LRT in breast cancer patients, especially in those with OMD, bone only, or favorable subtypes. Though there is currently no consensus among breast care specialists on how to treat dnMBC patients, primary surgery for dnMBC should be taken into consideration for a subset of patients following an extensive multidisciplinary discussion. [ABSTRACT FROM AUTHOR]

Objective: Coronavirus disease-2019 (COVID-19) has caused hospitals to suspend routine procedures. As the world recovers, there is concern that the outcome of many diseases has been impaired. This study aimed to assess the impact of the pandemic on breast cancer demography, clinicopathological characteristics and patient management at a teaching hospital in Kuala Lumpur, Malaysia. Materials and Methods: Pre-COVID data were collected between January 1, 2019, to March 18, 2020, when a national lockdown was implemented, which caused the suspension of services at the breast clinic of University Malaya Medical Centre (UMMC). COVID data was obtained from March 2020 until June 2021. Results: This study compared 374 breast cancer patients in the COVID-19 period with 382 patients in the pre-COVID period. There was no significant difference in the median (range) time to surgery between pre-COVID [45 (26.50–153.50) days] and COVID [44 (24.75–156.25) days] periods. The clinicopathological features of breast cancer showed reduction in in situ carcinoma and increase in Stage 4 diagnoses during the COVID period. There was a reduction in screening-detected carcinoma (9% vs. 12.3%), mastectomy followed by immediate reconstruction (5.6% vs. 14.5%) and adjuvant chemotherapy (25.8% vs. 32.9%) in the COVID period. Conclusion: In this center COVID-19 caused operational changes in breast cancer management, including a reduction in reconstructive procedures and adjuvant treatment. Healthcare disruption and fear of COVID may have caused delayed diagnosis, resulting in a higher frequency of Stage 4 disease and lower proportion of in situ carcinoma during the pandemic. However, there was no delay in the time to surgery, reduction in surgical volume, or change in surgery types. [ABSTRACT FROM AUTHOR]

Objective: Although Goldilocks mastectomy offers good aesthetic outcomes. Removal of the nipple-areolar complex (NAC) often has a negative psychological impact. The objective of this study was to assess the feasibility and esthetic outcome of this technique with salvage of the NAC using a dermal pedicle. Materials and Methods: The study included female patients suffering from breast carcinoma with large and or ptotic breast. Patients were offered Goldilocks mastectomy. Those who were unfit for anesthesia, those with locally advanced or metastatic disease or those refusing the procedure were excluded. Results: Fifteen female patients (18 breasts) with a mean age of 51.6 years underwent Goldilocks breast reconstruction with a trial of NAC preservation. The mean body mass index was 39.1 kg/m2. More than half (56%) were cup C, while 44% were cup D. Seven cases (46.7%) showed grade II ptosis and 8 (53.3%) were grade III. The mean operative time was 168 minutes (range 130–240 minutes). NAC ischemic changes were noted in five cases; two (11%) were partial while three (17%) were total. Two cases (11%) suffered from flap loss and one of them was total. No locoregional recurrence or distant metastases were observed. Conclusion: The Goldilocks mastectomy with nipple preservation is an appealing and feasible option for a certain group of patients who have large-sized and/or ptotic breasts. Nevertheless, it is a time-consuming technique with relatively higher rates of flap and NAC complications. Further, studies are required with a larger number of cases and longer follow-up. [ABSTRACT FROM AUTHOR]

Objective: The aim was to assess the prognostic variables in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer patients receiving lapatinib plus capecitabine. Materials and Methods: Retrospective data on HER2-positive metastatic breast cancer patients who received lapatinib and capecitabine were analyzed. Survival outcome was obtained with Cox regression analysis and the Kaplan–Meier method. Results: The study included 102 patients. Forty-four (43.1%) patients had de novo metastatic disease. The most frequent metastatic sites were, in order, bone (61.8%), brain (57.8%), liver (35.3%), and lung (34.3%). All of the patients had previously received chemotherapy based on trastuzumab. With combined lapatinib and capecitabine, complete response was observed in 7.8%, partial response in 30.4%, and stable disease in 24.5%. Progression-free survival was 8 (95% confidence interval, 5.1–10.8) months. In multivariable analysis, endocrine therapy (p = 0.02), de novo metastatic disease (p = 0.02), and age (p = 0.02) were prognostic factors for progression-free survival. However, the number of chemotherapy cycles with trastuzumab, palliative radiotherapy, history of breast surgery, and the number of metastatic sites were not significant in this respect. Conclusion: These results have demonstrated the effectiveness of lapatinib plus capecitabine in metastatic HER2-positive breast cancer patients. Furthermore, unfavorable prognostic factors for progression-free survival were shown to be hormone-negative tumor, de novo metastatic disease, and young age. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer is the most common malignant neoplasm among women in Poland. The primary treatment for breast cancer is surgery. The choice of surgical treatment method can significantly affect the quality of life of women with breast cancer. Materials and Methods: Women treated surgically because of breast cancer were included. The quality of life was assessed by survey using the quality of live questionnaire (QLQ)-C30 and QLQ-BR23 (European Organization for the Research and Treatment of Cancer) questionnaires, taking into account the following factors: The method of surgery performed and comparing breast conserving therapy (BCT) with mastectomy, and breast reconstruction or the lack of it. Results: The study included 243 subjects. Women had a reduced overall quality of life (53.88 points out of 100), in particular emotional (59.77) and sexual (17.49) functioning, and a poor body image assessment (61.57). Patients after BCT functioned better in physical (p = 0.001) and sexual (p = 0.007) terms, and also experienced lower pain intensity (p = 0.003) and shoulder discomfort (p = 0.024). The quality of life was significantly higher (p = 0.003) in the opinion of women who underwent breast reconstructive surgery. Conclusion: The quality of life of women depends on the surgical treatment method used when treating breast cancer. For this reason, the choice of method, whenever possible, should promote breast protection or its postoperative reconstruction. [ABSTRACT FROM AUTHOR]

Objective: Tubular breast carcinoma (TBC) is a rare subtype of breast carcinoma (BC) with a good prognosis. In this study, we aimed to assess the clinicopathological characteristics of pure TBC (PTBC), analyze factors that may influence long-term prognosis, examine the frequency of axillary lymph node metastasis (ALNM), and discuss the need for axillary surgery in PTBC. Materials and Methods: Fifty-four Patients diagnosed with PTBC between January 2003 and December 2020 at Istanbul Faculty of Medicine were included. Clinicopathological, surgical, treatment, and overall survival (OS) data were analyzed. Results: A total of 54 patients with a mean age of 52.2 years were assessed. The mean size of the tumor was 10.6 mm. Four (7.4%) patients had not undergone axillary surgery, while thirty-eight (70.4%) had undergone sentinel lymph node biopsy and twelve (22.2%) had undergone axillary lymph node dissection (ALND). Significantly, four (33.3%) of those who had undergone ALND had tumor grade 2 (p = 0.020) and eight of them (66.7%) had ALNM. Fifty percent (50%) of patients who were treated with chemotherapy had grade 2 and multifocal tumors and ALNM. Moreover, the frequency of ALNM was higher in patients with tumor diameters greater than 10 mm. Median follow-up time was 80 months (12–220). None of the patients had locoregional recurrence, but one patient had systemic metastasis. Furthermore, five-year OS was 97.9%, while ten-year OS was 93.6%. Conclusion: PTBC is associated with favorable prognosis, good clinical outcomes and high survival rate, with rare recurrences and metastases. [ABSTRACT FROM AUTHOR]

Objective: Seroma after mastectomy is a bothersome problem. Topical sclerosants are one method used to reduce seroma. The aim of this study was to evaluate if spraying flaps before closure with doxycycline or bleomycin after total mastectomy can prevent seroma. Materials and Methods: After institutional review board approval, using a computer-based randomization program, a prospective, double-blind, placebo-controlled randomized, superiority study was conducted during the period from the first of August 2017 to the first of August 2018. IRB proposal code was MS/17.08.66 and the trial was approved at 15/8/2017. The trial is available publicly at http://www.eulc.edu.eg/eulc_v5/Libraries/Thesis/ BrowseThesisPages.aspx?fn=PublicDrawThesis&BibID=12553049. The primary outcome of the study was to assess the incidence of seroma following total mastectomy after intervention comprising spraying of skin flaps with doxycycline or bleomycin versus placebo. Patients who were candidates for total mastectomy were randomized into control, doxycycline, and bleomycin groups. The postoperative data included length of the hospital stay, pain score among the three groups, post-operative drained fluid volume, post-operative day of drain removal, complication rates including infection, flap necrosis and hematoma, the incidence of seroma and aspirated seroma volume, and total number of postoperative visits. Results: Of 125 patients, 90 were candidates for total mastectomy. Analysis of these 90 showed that the incidence of seroma was similar; 43.4%, 40% and 40% in the control, doxycycline, and bleomycin groups, respectively (p = 0.99). Furthermore, wound complication rates were similar among all groups. Conclusion: Despite improved recognition and management of risk factors, seromas remain a common clinical concern in the postoperative setting of total mastectomy. These results suggest that sclerosant agents, specifically bleomycin and doxycycline, have no utility for prevention of post mastectomy seroma. [ABSTRACT FROM AUTHOR]

This study aims to determine the factors that influence the success of exclusive breastfeeding. Some of the factors studied include maternal factors, infant factors, environmental factors, socioeconomic factors, and support factors. The data filtering process is using PRISMA Flowchart. PRISMA is a Preferred Reporting Items for Systematic review and Meta-Analyses, developed to assist authors in reporting Systematic Reviews and Meta-Analyses. The results of this study show that the factors that influence the success of exclusive breastfeeding. Maternal Factors: Knowledge of breast milk, positive attitude towards breast milk, mental and physical readiness for breastfeeding, and support from family and environment. Support Factor: Support from husband, family, and community in providing exclusive breastfeeding. In conclusion, it was found that the factors that affect the success of exclusive breastfeeding in young mothers are influenced by several factors including maternal age, maternal milk production, support of the closest person, experience of breastfeeding mothers, and parity. Support is needed to provide counseling, knowledge about the importance of exclusive breastfeeding to their babies, and motivation to mothers and breast care. [ABSTRACT FROM AUTHOR]

An editorial is presented in the Breast Care journal titled "Breast Cancer Outcome: What Have We Achieved," highlighting the remarkable advancements in understanding and managing breast cancer over the past 30 years. Topics include significant progress in early detection, treatment options, and the emergence of personalized medicine, with a focus on recent trials like monarchE and NATALEE establishing new standards of care in high-risk luminal subtypes and Triple-Negative Breast Cancer.

日本の助産師のケアは、すべての母親の乳房問題を解決することはできません。この定性的、フォーカスグループインタビュー研究は、乳房ケアルーチンへの乳房超音波の導入に関する助産師の意見を明確にすることを目的としていました参加者は、5人と6人の助産師の2つのグループに分かれました。データは、フォーカスグループインタビューを実施することによって収集されました。インタビューデータは定性的に分析された。乳房ケアのための超音波の導入の3つの理由が助産師に明らかにされた。1つ目は、一定の助産能力の必要量を失い、母親の負担が増大する可能性であり、現状に不利な状況であった。2つ目は、助産師のスキルとケアの効率を向上させることによって母親の心理的安定性を高める可能性という肯定的なものでした。3つ目は、乳房超音波装置が簡単に操作できるように改良し、スキルを向上させるためのトレーニングを提供することです。助産師には、乳房ケアに乳房超音波を導入する利点が示されている。乳房超音波を乳房ケアに導入するためには、助産師が乳房超音波の操作方法を学ぶためのトレーニングコースを開発する必要があります。

Mother's milk is the best food for babies because it contains all the nutrients in the amount needed by babies to grow and develop optimally, especially aged 0-6 months. The obstacle to early breastfeeding is due to the small production of breast milk caused by mothers who do not take care of their breasts during pregnancy. Breast care is a good preparation for mothers to breastfeed their babies. The purpose of this study was to determine the relationship between breast care during pregnancy and milk production in post partum mothers. This research method uses a quantitative approach, the sampling technique used is non-probability sampling (purposive sampling) with a sample size of 37 respondents. In this study using a checklist sheet instrument, then the method of data analysis using the chi-square statistical test. The results of this study were 15 post partum mothers breastfeeding was not smooth due to not doing breast care, 3 (20%) out of 15 post partum mothers breastfeeding were not smooth but still doing breast care. Furthermore, there were 22 post partum mothers whose milk production was smooth, 20 (90.9%) of the 22 post partum mothers whose milk production was smooth due to breast care, then 2 (9.1%) of the 22 post partum mothers their milk production was smooth but not doing breast care. The results of the chi-square statistical test with a p-value of 0.000

The female breast is a symbol of femininity and plays a key role in the female body image. However, factors influencing the preferences for different breast shapes and sizes are still not elucidated. In particular, the role of the emerging social media in breast perception has not been analyzed yet. A representative cohort of 1,049 adults completed a web-based questionnaire containing hyperrealistic 3D models of the female breast in the United States. A machine-learning algorithm (Classification and Regression Tree [CART]) was implemented to identify the most influential factors. The study was able to identify the frequency of pornographic and social media consumption as the most influencing factor for altered breast preferences. Although digital media exposure did not alter satisfaction with the own breast among female participants, the tendency to undergo or history of conducted aesthetic surgery correlated with higher access frequency to digital media. Taken together, the overpowering impact of social media and pornographic consumption on the own body image was shown in preference alterations for different anatomical aspects of the breast in the whole population and distorted self-perception about the breast in female participants. [ABSTRACT FROM AUTHOR]

Breast cancer incidence among transgender and nonbinary (TGNB) individuals is not well characterized owing to the absence of robust data collection among this patient population. Consequently, breast cancer risks are largely unknown, and screening guidelines are not based on robust evidence. Additionally, TGNB patients experience barriers to access health care. A first step in improving data collection, research, and ultimately care of TGNB individuals is the identification of group members and demonstration to patients that our breast imaging centers are champions of LGBTQ+ health. At our institution, patients who present for breast imaging complete an iPad-administered breast imaging history and breast cancer risk assessment survey. Using the modified Tyrer-Cuzick model, the lifetime risk of developing breast cancer is estimated, and additional key history that may impact breast care and future breast imaging is collected. Under the previous clinic workflow, patients are identified as either "male" or "female" and complete a corresponding gender-specific survey. To improve care, we revised the survey using gender-inclusive language and developed four versions to allow patients to separately self-report their sex assigned at birth and gender identity. Relevant queries relating to hormone use and gender-affirming chest/breast surgery that are concordant with six gender-identity groups were added. Long-term collection of these inclusive data by imaging centers has the potential to enhance the data set available to improve breast care and better understand breast cancer risk and outcomes among TGNB populations. [ABSTRACT FROM AUTHOR]

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After the diagnosis of cancer patients require a lot of information because the disease affects all aspects of life. Some important issues regarding optimal counseling remain to be determined. This includes the time-related relevance of various topics and questions regarding who and when to consult on the topics. We analyzed the answers of 155 women with non-metastatic breast cancer undergoing primary surgery, primary chemotherapy, and having completed adjuvant treatment regarding the above-mentioned issues. We found that counseling must consider the treatment situation. Breast cancer patients in the follow-up phase reported that they preferred being counseled by female consultants. Our results largely support a counseling concept which puts the breast care nurse at the center of interest rather than psychologists and social service workers. A breast care nurse centered counseling system for women with non-metastatic breast cancer appears to meet patients' needs best. [ABSTRACT FROM AUTHOR]

Nurses play an instrumental role in the early detection of postoperative hematomas. The importance of nurse education regarding signs and symptoms of hematoma formation in patients during postoperative recovery is discussed. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common tumor in middle-aged and older women. In 2003, the European Parliament recommended to Member States that all women with breast cancer should be treated by a multidisciplinary team and that a network of certified breast centers be organized (the centers have been called Breast Units (BUs)). With the present study, we aim to explore the impact of the introduction of the BU organizational model in the Liguria region, Italy, through different outcome indicators. An explorative retrospective analysis was conducted through the period from 2013 to 2019 to assess the impact of the introduction of the BU model in our region. We identified two periods: before (2014–2015) and after (2017–2018) the introduction of this organizational model to assess its value impact through the definition of six measurable outcome indicators. Length of hospitalization, repeated specialist outpatient diagnostic procedures and the rate of subjects who started radiotherapy treatment within 60 days improved after the introduction of BUs. The passive health migration rate only improved significantly for one local health unit (LHU), while reintervention and diagnosis–surgery time did not show any enhancement after the introduction of the BU model. The BU model seems to provide an increase in several aspects of the healthcare offered to breast cancer patients in Liguria, specifically in those areas where a shared guideline could assist healthcare workers. Future research, such as pilot studies, are needed to assess the impact of the introduction of the BU model in our reality. [ABSTRACT FROM AUTHOR]

Patients with breast cancer may be offered adjuvant radiation therapy (RT) after surgery. Up to 95% of these patients develop radiation dermatitis (RD) during or following RT. Randomized clinical trials and other literature provide evidence that RD can be prevented or reduced. The aim of this article is to propose a Clinician Guide and Evidence-based Skin Care Plan to prevent and/or reduce radiation dermatitis and promote the comfort of breast cancer patients receiving RT. As an integrative review, the databases searched were CINAHL and Medline, using the key terms: breast cancer, skin care, radiation, radiation therapy, radiotherapy, radiation dermatitis, and radiation skin reaction, prevention, and management. Search criteria included English language, full text, published between 2012 through 2020, and peer-reviewed. The search yielded 320 articles. Relevant articles were evaluated using the Quality Assessment Tool (QAT), and highly rated articles were selected to be included in the review of literature. The outcomes were the development of a Clinician Guide to offer holistic, patient-centered care and an Evidence-based Skin Care Plan. The research literature supports a standard skin care regimen, along with use of an emollient cream to the treatment area, use of deodorants depending on patient preferences, and application of a topical steroid cream daily throughout treatment and two weeks post RT. Clinician's weekly assessments of patients offers therapeutic support and ensures optimal skin care during and post-RT. The comfort of breast cancer patients receiving RT requires the best level of evidence regarding the efficacy of interventions, coupled with clinician's judgement, and patient's preferences and wishes. The clinician-patient relationship is essential in addressing the physical, emotional, social, spiritual, and functional challenges associated with a cancer diagnosis and adjunctive radiation therapy to improve long-term survival. [ABSTRACT FROM AUTHOR]

Patient-centered care is a health care approach optimized for the needs of the patient. As patients have sought more autonomy in recent years, this model has been more frequently adopted. Breast radiologists aspiring to advance patient-centered care should seek greater ownership of the breast diagnostic imaging and intervention workflows, helping their patients navigate the complex breast care landscape with patients' preferences taken into account. Applying this approach to breast radiology will increase patient satisfaction and compliance while also limiting wasted health care dollars, unnecessary diagnostic delays, and overall confusion. Herein, the benefits of patient-centered breast radiology are discussed, and numerous suggestions and case examples are provided to help readers reshape their practice toward the priorities of their patients. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Treatment Patterns, Safety, and Patient-Reported Outcomes among Adult Women with Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer with or without Unknown BRCA1/2 Mutation(s): Results of a Real-World Study from the United States, United Kingdom, and Four EU Countries" which appeared in the June 23, 2022 issue.

Many mothers feel that they have failed to give exclusive breastfeeding to their babies because of errors and lack of information previously obtained. The purpose of this study was to determine the increase in breast care practices in third trimester pregnant women. This study uses a pre-experimental research design with a One Group Pretest-Postest approach. The research sample was 32 pregnant women obtained by purposive sampling technique. Data analysis used Wilcoxon statistical test with 0.05. The practice of breast care in third trimester pregnant women with a sufficient percentage then increased to good after being given health education. Statistical test obtained p value 0.000 which means there is an increase in breast care in third trimester pregnant women after being given health education. The practice of breast care in third trimester pregnant women if done properly and correctly, then the mother can breastfeed well after giving birth so that the nutritional needs of the child can be met.

Simple Summary: Three-dimensional (3D) cell cultures have several advantages over conventional monolayer two-dimensional (2D) cultures as they can better mimic tumor biology. This study delineates the changes in microRNAs (miRNAs) expression patterns of breast cancer cells cultured in 3D and 2D conditions. 3D organotypic cultures showed morphological changes such as cell–cell and cell–extracellular matrix interactions associated with a loss of polarity and reorganization on bulk structures in both basal Hs578T and luminal T47D breast cancer cells. Data indicate that downregulated miRNAs in Hs578T 3D cultures, relative to the 2D condition, contribute to a positive regulation of biological processes such as response to hypoxia and focal adhesion, whereas overexpressed miRNAs were related to negative regulation of the cell cycle. Remarkably, the reprogramming of miRNAs transcriptional profile was accompanied by changes in the expression of key miRNA/mRNA coregulation networks, such as miR-935/HIF-1A, which correlated with the expression found in clinical breast tumors and predicted poor patient outcomes. These data have implications in our understanding of cancer biology and impact the miRNA/mRNA regulatory axes of cells grown in 3D cultures. Our data represent a guide for novel miRNAs candidates for functional analysis, including the response to therapy and biomarkers discovery in breast cancer. The 3D organotypic cultures, which depend on the growth of cells over the extracellular matrix (ECM) used as a scaffold, can better mimic several characteristics of solid cancers that influence tumor biology and the response to drug therapies. Most of our current knowledge on cancer is derived from studies in 2D cultures, which lack the ECM-mediated microenvironment. Moreover, the role of miRNAs that is critical for fine-tuning of gene expression is poorly understood in 3D cultures. The aim of this study was to compare the miRNA expression profiles of breast cancer cells grown in 2D and 3D conditions. On an on-top 3D cell culture model using a basement membrane matrix enriched with laminin, collagen IV, entactin, and heparin-sulfate proteoglycans, the basal B (Hs578T) and luminal (T47D) breast cancer cells formed 3D spheroid-like stellate and rounded mass structures, respectively. Morphological changes in 3D cultures were observed as cell stretching, cell–cell, and cell–ECM interactions associated with a loss of polarity and reorganization on bulk structures. Interestingly, we found prolongations of the cytoplasmic membrane of Hs578T cells similar to tunneled nanotubes contacting between neighboring cells, suggesting the existence of cellular intercommunication processes and the possibility of fusion between spheroids. Expression profiling data revealed that 354 miRNAs were differentially expressed in 3D relative to 2D cultures in Hs578T cells. Downregulated miRNAs may contribute to a positive regulation of genes involved in hypoxia, catabolic processes, and focal adhesion, whereas overexpressed miRNAs modulate genes involved in negative regulation of the cell cycle. Target genes of the top ten modulated miRNAs were selected to construct miRNA/mRNA coregulation networks. Around 502 interactions were identified for downregulated miRNAs, including miR-935/HIF1A and miR-5189-3p/AKT that could contribute to cell migration and the response to hypoxia. Furthermore, the expression levels of miR-935 and its target HIF1A correlated with the expression found in clinical tumors and predicted poor outcomes. On the other hand, 416 interactions were identified for overexpressed miRNAs, including miR-6780b-5p/ANKRD45 and miR-7641/CDK4 that may result in cell proliferation inhibition and cell cycle arrest in quiescent layers of 3D cultures. In conclusion, 3D cultures could represent a suitable model that better resembles the miRNA transcriptional programs operating in tumors, with implications not only in the understanding of basic cancer biology in 3D microenvironments, but also in the identification of novel biomarkers of disease and potential targets for personalized therapies in cancer. [ABSTRACT FROM AUTHOR]

Menopausal hormone therapy (HT) aims to improve a woman's quality of life by treating bothersome menopausal symptoms associated with low estrogen levels. Although HT is prescribed to millions of women worldwide, its breast-related adverse effects have always been a concern. Some of the common adverse effects of HT are breast fullness, increased breast density, and increased breast cancer (BC) risk. Health care professionals need to be aware of the influence of HT on breast tissue to provide appropriate counseling as part of informed decision making. Our review summarizes the influence of HT on breast symptoms, breast density, mammograms, and BC risk. [ABSTRACT FROM AUTHOR]

Background: Previous studies indicate significant gaps exist in current practices and perceptions of oncofertility care. Objectives: We aim to understand the clinical experience regarding oncofertility care among health providers in a multidisciplinary breast care team. Methods: A qualitative, descriptive study was conducted. Data were collected through in-depth interviews with 16 health care providers who worked in a hospital in Taipei. Verbatim transcriptions were analyzed using constant analysis methods. Results: Health care providers’ experiences regarding fertility care for reproductive-age women with breast cancer were divided into two themes: personal perspectives and barriers. Personal perspectives consisted of six subthemes including empathizing with the patient’s suffering during the diagnosis and treatment, safety as a prerequisite, satisfying the women’s needs, respecting the women’s choice, questioning women’s ability to raise children, and returning to family life. There were also six subthemes under barriers. These subthemes were poor communication among the multidisciplinary team, lack of initial screening, insufficient support in the women’s families, treatment considerations, lack of evidence-based information regarding oncofertility, and non-follow-up protocol. Conclusion: Nurses should evaluate the fertility needs of women with cancer and identify potential gaps during oncofertility care. Education strategies and tactics should be improved in order to overcome difficulties arising from health care providers’ personal perspectives and barriers to the provision of optimal fertility care in women with cancer. [ABSTRACT FROM AUTHOR]

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Based on the initial survey conducted by researchers for 10 breastfeeding mothers, 6 mothers experience symptoms of ASI dam. ASI dams can occur if the mother does not get enough nutritional intake to produce breast milk fother baby,nutrition ntake is the most important thing in producing breast milk difficult to get out. The purpose of this study is to determine what factors are related to the incidence ASI dam in postpartum mothers in the working area of payung sekaki puskesmas pekanbaru in 2018. This type of research is quantitative using correlation analysis with Ci-square. This research was carried out in the working are of the payung sekaki puskesmas pekanbaru on july 4 – 31, 2018 with a population of 103. The stratified random sampling sampling technique was obtainet by 82 respondents. The result showed that there was a relationship between knowledge with the incidenci of breats milk in post partum mothers in the Payung Sekaki Health Center Work Area. results with p-value = 0.016, there is a relationship between breast care and the incidence of ASI dams in the Payung Sekaki Health Center Work Area. The results with p-value = 0.001 and there is relationship between breastfeeding position and the inciden of ASI dam in the Payung Sekaki Health Center Work Area. results with p-value = 0.02. From the research conducted it can be concluded that there is a relationship between maternal knowledge, breast care and the position of the mother while breastfeeding with the incidence of breast milk dam.Berdasarkan Survey awal yang dilakukan oleh peneliti kepada 10 orang ibu menyusui diperoleh sebanyak 6 orang ibu yang mengalami gejala bendungan ASI. Bendungan ASI dapat terjadi apabila ibu tidak memperoleh asupan gizi yang cukup untuk memproduksi ASI untuk bayinya, asupan gizi merupakan hal yang terpenting dalam memproduksi ASI, kurangnya asupan gizi membuat ASI akan sukar untuk keluar.Tujuan penelitian ini adalah Untuk mengetahui faktor apakah yang berhubungan dengan kejadian bendungan ASI pada ibu postpartum di Wilayah kerja Puskesmas Payung Sekaki Pekanbaru Tahun 2018. Jenis penelitian ini adalah kuantitatif menggunakan analisis korelasi dengan Ci-square. Penelitian ini di laksanakan di wilayah kerja puskesmas Payung Sekaki Pekanbaru tanggal 04 – 31 Juli 2018 dengan populasi 103. Teknik penarikan sampel Stratified Random Sampling diproleh 82 Responden. Hasil penelitian didapatkan ada hubungan antara pengetahuan dengan kejadian bendungan ASI pada ibu post partum di Wilayah Kerja Puskesmas Payung Sekaki. hasil dengan p-value = 0,016, ada hubungan hubungan antara perawatan payudara dengan kejadian bendungan ASI di Wilayah Kerja Puskesmas Payung Sekaki. hasil dengan p-value = 0,001 dan ada hubungan posisi menyusui dengan kejadian bendungan ASI di Wilayah Kerja Puskesmas Payung Sekaki. hasil dengan p-value = 0,02. Diharapkan kepada Pihak puskesmas Payung Sekaki Pekanbaru khususnya tenaga kesehatan untuk selalu melakukan promosi dan penyuluhan di wilayah kerja puskesmas Payung Sekaki Pekanbaru, untuk berperan aktif dalam meningkatkan pengetahuan ibu tentang pencegahan terjadinya bendungan ASI.

Breastfeeding is one of the global health issues in the 21st century, given that breastfeeding has a significant effect on infant mortality. The absence of breastfeeding in the first days after giving birth is one of the reasons for not creating exclusive breastfeeding. The inhibition of breastmilk secretion can be caused by inhibition of oxytocin secretion which is very instrumental in smoothing out ASI expenditure. Stimulation of the hormone prolactin and oxytocin can be done through breast care and oxytocin massage. Kamonji Health Center is the health center with the lowest exclusive breastfeeding coverage in Palu City, which is 57.3%. The purpose of this study was to find out the comparative time of mother's milk delivery which was given oxytocin massage and breast care within 2 hours postpartum in the Kamonji Community Health Center work area. This study is a quasi-experimental study with the design of The posttest-only control group. The number of samples was 30 people, taken by consecutive sampling technique and divided by 15 respondents into the oxytocin and breast care massage groups. The intervention was carried out within 2 hours postpartum and then observed when the first ASI was discharged after the third stage ended. Data normality test using Shapiro-Wilk test, data analysis using Mann Whitney test obtained a significance value of 0.044, with the average time of mother's breastmilk given oxytocin massage was 14.19 hours and breast care 5.57 hours. The conclusion of the study is that there is a difference in the time of mother's milk to be given oxytocin massage and breast care in the fourth stage of labor. Based on the results of this study it is recommended to do breast care to help accelerate the release of breast milk.

Objective: The objective of this research is to know the effect of oxytocin massage and breast care on the increase of breast milk production. Method: This pre-experimental research was performed through the One Group Pretest–Posttest design. The sampling was done through non-probability sampling and purposive sampling, obtaining 30 samples. The data were collected in the form of a questionnaire, which was then analyzed using the Mc Nemar test. Result: It was known that the production of breast milk during pre-intervention was poor on 18 respondents and adequately a lot on the other 12 respondents. Meanwhile, during the post-intervention, the production of breast milk on the 18 respondents whose previously breast milk production was poor then become adequate on the seven respondents, while the remaining 11 respondents still produced less breast milk. The statistical test result showed a P value of 0.016, which means that the P is less than 0.05. Conclusion: Oxytocin massage and breast care affected the increase of breast milk production considered based on the frequency and duration of breastfeeding as well as the infants’ weight in Lawanga Public Health Center, Poso District.

BACKGROUND: Breast care is an important routine during pregnancy and breastfeeding. Its absence leads to inadequate milk production before and after childbirth. OBJECTIVE: This study aimed to determine the status of breast care during pregnancy, which is related to milk production and disease after childbirth in the Tinggede Health Center, Sigi Regency, Central Sulawesi. METHODS: The method used was an analytic survey with a cross-sectional approach and the samples were 82 breastfeeding mothers in the working area of the Tinggede Health Center. The sampling used a total population, and data were obtained by interview and observation. Furthermore, the analysis technique used Chi-Square. RESULTS: The results showed there was a relationship between breast care during pregnancy with milk production (p = 0.001), and breast care status with a disease (p = 0.012). The common diseases suffered by breastfeeding mothers due to inadequate care are non-protruding nipples, infections, blocked milk ducts, mastitis, and lumps. CONCLUSIONS: Breastfeeding mothers' failure to care for their breasts during pregnancy can lead to lack of milk production and diseases such as non-protruding nipples, infections, blocked milk ducts, mastitis, and lumps. [ABSTRACT FROM AUTHOR]

Background: Despite the proven effectiveness of mammography in screening and early breast cancer detection, there is still a huge disparity in both access to breast care and the quality of services provided in Nigeria. Non-governmental organizations (NGOs) have attempted to bridge this gap through awareness campaigns and subsidized breast imaging services., Objectives: To document the mammographic findings of adult females in a private NGO and assess the benefits of mammography practice in our locality., Material and Methods: This was a retrospective evaluation of mammographic examinations carried out over a two-year period (January 2020- December 2021) in a private cancer foundation in Abuja, Nor t h Ce nt r al Nigeria. Demographic details, clinical and mammographic features were analyzed with a statistical level of significance set at p≤0.05., Result: The age range of 565 women evaluated in this study was 31-84 years with the majority (55.7%) of them in the 40-49 year range. More than half (52.7%) of the women had had at least one previous mammogram. Screening was the predominant indication for mammograms in 361 women (63.9%) while 204(36.1%) were symptomatic. Breast pain (59.6%) and breast lump (26.3%) were the most common clinical indications. The predominant breast density pattern was the American College of Radiologists Breast Imaging and Reporting Data System (ACR BIRADS) type B (Scattered fibroglandular densities) in 241 women (42.7%). Mammogram was normal in 206 women (34.7%) while 52 (8.8%) had intraparenchymal findings. The final assessment showed that most of the mammograms were BIRADS category 1(69.6%) and 2(13.8%) signifying normal and benign findings. Body mass index, parity, age at first pregnancy, menopausal status, and breast density had significant relationships with the final BIRADS category., Conclusion: Mammography is an invaluable part of breast care in our locality. Evaluation of mammographic services in our private NGO showed a predominance of screening mammography while a majority of the women with symptomatic breast diseases had normal and benign findings., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

To develop a method for calculating rates of testing for breast cancer recurrence in patients who have already undergone initial treatment for breast cancer, we calculated rates in a cohort of Medicare breast cancer patients and an age‐matched noncancer cohort. We first used only tests with claims including diagnosis codes indicating invasive breast cancer and then used all tests regardless of diagnosis code. For each method, we calculated testing rates in the breast cancer cohort above the background rate in the noncancer population. The two methods provided similar estimates of testing prevalence and frequency, with exception of prevalence of CT. [ABSTRACT FROM AUTHOR]

The article presents the cover of the magazine along with its editorial staff.

This paper describes a series of steps taken to elevate the Hoag Breast Program to the next level. The hope is that some of our ideas will be useful to you and your breast program. [ABSTRACT FROM AUTHOR]