We proposed to compare the accuracy and effectiveness of digital breast tomosynthesis (DBT), plus digital or synthetic mammography, with digital mammography alone in women attending population-based breast cancer screenings. We performed a systematic review and included controlled studies comparing DBT with digital mammography for breast cancer screening. Search strategies were applied to the MEDLINE, Embase, LILACS, and CENTRAL databases. With moderate quality of evidence, in 1,000 screens, DBT plus digital mammography increased the overall and invasive breast cancer rates by 3 and 2 (RR 1.36, 95% CI 1.18 to 1.58 and RR 1.51, 95% CI 1.27 to 1.79, respectively). DBT plus synthetic mammography increased both overall and invasive breast cancer rates by 2 (RR 1.38, 95% CI 1.24 to 1.54 and RR 1.37, 95% CI 1.22 to 1.55, respectively). DBT did not improve recall, false positive and false negative rates. However due to heterogeneity the quality of evidence was low. For women attending population-based breast cancer screenings, DBT increases rates of overall and invasive breast cancer. There is no evidence with high or moderate quality showing that DBT compared with digital mammography decreases recall rates, as well as false positive and false negative rates.

/pdf/accuracy-and-effectiveness-of-mammography-versus-mammography-vhmfc9q28k.pdf

Accuracy and Effectiveness of Mammography versus Mammography and Tomosynthesis for Population-Based Breast Cancer Screening: A Systematic Review and Meta-Analysis

Breast cancer is the most common cancer in women worldwide, and advanced breast cancer is the leading cause of cancer death in women. In present study, we aim to investigate that role of T-cell lymphoma invasion and metastasis-inducing protein1 (TIAM1) on NVP-BEZ235 resistance to breast cancer MCF7 and MDA-MB-361 cells. Briefly, MCF7 and MDA-MB-361 cells were treated with NVP-BEZ235 and the relative expressions of TIAM1 at both mRNA level and protein level were determined by RT-PCR and western blot. In addition, MCF7 and MDA-MB-361 cells were transfected with TIAM1 knockdown or overexpression vector. Then the IC50 of NVP-BEZ235 on MCF7 and MDA-MB-361 cells were detected by MTT assay. Finally, FGFR/STAT3 pathway protein members were investigated by western blot. Consequently, we found that the mRNA and protein expressions of TIAM1 and FGFR1/3 were dramatically upregulated in NVP-BEZ235-treated group in both MCF7 and MDA-MB-361 cells. Interestingly, TIAM1 knockdown via shRNA decreased the IC50 of NVP-BEZ235 of breast cancer cells, while TIAM1 overexpression increased the IC50 of NVP-BEZ235 of breast cancer cells, which suggested that TIAM1 was one of the contributors for NVP-BEZ235 resistance. In addition, FGFR members including FGFR1/3 showed similar results to TIAM1. Importantly, FGFR inhibitor AZD4547 decreased the IC50 of NVP-BEZ235, which suggested that FGFR downregulation reduced the NVP-BEZ235 resistance to breast cancer cells. In summary, our present study revealed that TIAM1 conferred NVP-BEZ235 resistance to breast cancer cells via activating FGFR/STAT3 pathway.

TIAM1 Upregulation Confers NVP-BEZ235 Resistance to Breast Cancer Cells Through FGFR/STAT3 Pathway.

One of the most important causes of women death because of malignancies is breast cancer. In the recent decades, mastectomy was the primary treatment for some stages of breast cancer but nowadays, breast conservative therapy is a suitable therapeutic protocol for patients who suffer from breast cancer especially in early stages (І, П) disease. Breast conservative therapy is considered an adequate therapeutical method for patients with early stage of breast cancer. This method consists of partial mastectomy, axillary dissection and radiotherapy. Beside the therapeutic effect of conservative therapy, cosmetic outcome of patients is also substantially better than mastectomy. Also conservative therapy means conservative surgery combined with radiotherapy, reduces the risk of local recurrence of breast cancer. Chemotherapy is also another choice to add to this treatment protocol.

Breast Conservative Therapy: A Literature Review.

Local Recurrence and Survival Outcomes of Multifocal/Multicentric Breast Cancer after Breast Conserving Therapy: a systematic review and meta-analysis

The incidence of multifocal (MF) and multicentric (MC) carcinomas varies widely among clinical studies, depending on definitions and methods for pathological sampling. Magnetic resonance imaging is increasingly used because it can help identify additional and conventionally occult tumors with high sensitivity. However, false positive lesions might incorrectly influence treatment decisions. Therefore, preoperative biopsies must be performed to avoid unnecessary surgery. Most studies have shown higher lymph node involvement rates in MF/MC tumors than in unifocal tumors. However, the rate of local recurrences is usually low after breast conservative treatment (BCT) of MC/MF tumors. It has been suggested that BCT is a reasonable option for MC/MF tumors in women aged 50-69 years, with small tumors and absence of extensive ductal carcinoma in situ. A meta-analysis showed an apparent decreased overall survival in MC/MF tumors but data are controversial. Surgery should achieve both acceptable cosmetic results and negative margins, which requires thorough preoperative radiological workup and localization of lesions. Boost radiotherapy techniques must be evaluated since double boosts might result in increased toxicity, namely fibrosis. In conclusion, BCT is feasible in selected patients with MC/MF but the choice of surgery must be discussed in a multidisciplinary team comprising at least radiologists, surgeons and radiotherapists.

Is breast conservative surgery a reasonable option in multifocal or multicentric tumors

Introduction It is widely supported that multicentric disease of the breast (MCDB) is a contraindication of breast conservative surgery (BCS). Materials and methods This is a multicentric study (two breast cancer units from Greece, one from France) involving patients with at least two primary tumors in separate quadrants of the breast and no diffuse suspicious microcalcifications on mammography. Sixty-one patients were included in the study, but 49 were followed up to the end. Patients were randomly assigned in total mastectomy (TM) and BCS groups. End point of the study was disease-free survival rates three and five years after initial operation. Results Three years after BCS, local recurrence (LR) was observed in two patients (7%) and one after five years (total recurrence rate: 11%). A TM was performed in these patients, and in two there was no LR or distant metastasis (DM) five years after. The third patient was disease free two-years later. Three years after TM, eight patients (36.4%) had DM and 14 (63.6%) did not (p = 0.004). Five years after TM, eight patients (36.4%) had DM and 14 patients (63.6%) di not (p = 0.03). Conclusion The results showed that conservative surgery was an alternative surgical option in multicentric breast cancer with good results regarding disease-free survival and recurrence.

Breast conserving surgery in multicentric breast cancer, preliminary data of our experience.

Clinical feasibility of a new oncoplastic technique for breast lumps of the external quadrants: half moon lateral crescent technique

Breast tomosynthesis (BT) is a novel imaging technology in which an x-ray fan beam sweeps in an arc across the breast, producing tomographic images and it can reduce tissue overlap encountered in conventional two-dimensional (2D) and thus has the potential to improve detection of breast cancer and facilitate accurate differentiation of lesion types. The purpose of this article was to assess the positive predictive value (PPV) of breast cancer with BT versus full-field digital mammography (FFDM) and the assessment of detec- tion of both techniques in the present series.

Tomosynthesis improves breast cancer detection: our experience.

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Breast conserving surgery in multicentric breast cancer, preliminary data of our experience.

Clinical feasibility of a new oncoplastic technique for breast lumps of the external quadrants: half moon lateral crescent technique

Tomosynthesis improves breast cancer detection: our experience.