UNASSIGNED: Several image-based diagnostic methods have been developed to examine the features of breast lesions among women, while the value of combining palpation imaging and ultrasound by a bimodal breast examination system is still unknown.
UNASSIGNED: A real-world study was conducted among 424 patients who visited Fujian Maternal and Child Health Hospital and Fujian Obstetrics and Gynecology Hospital, and used the Bimodal Breast Exam (BBE) systems which combines palpation imaging and ultrasound imaging. Among them, 97 patients had additional ultrasound, mammogram, or pathological examination. These patients were used to evaluate the consistency and efficacy of the BBE in interpreting the features of breast lesions as compared to results of ultrasound, mammogram, and pathological examinations.
UNASSIGNED: The BBE system detected 1517 lesions with palpation imaging, 1126 lesions with ultrasound examination (950 solid lesions and 176 cysts), and 391 non mass lesions. Among them, 404 patients were diagnosed as benign and 20 were diagnosed as malignant tumor. However, 12, 9 and 4 cases were diagnosed as malignant tumors by ultrasound, mammogram and pathological examination, respectively. Compared with the integrative results of ultrasound, mammogram and pathology, the sensitivity of BBE is 55.6%, and the specificity is 90.9%, with a kappa coefficient of 0.387 (0.110, 0.665), indicating moderate consistency.
UNASSIGNED: In clinical practice, BBE can be used to evaluate features of breast lesions with a high specificity. The diagnostic efficacy is comparable to the integrative results of ultrasound, mammography, and pathological examination.

BACKGROUND: Tuberculous mastitis (TBM), is an uncommon form of extra-pulmonary tuberculosis. Clinical and radiological overlap of tuberculous mastitis with malignancy and other granulomatous conditions, along with its paucibacillary nature, make it a diagnostic challenge. In our study, we aim to assess the radiological response of microbiologically negative granulomatous mastitis cases to anti-tuberculous treatment (ATT) in an endemic country.
METHODS: Eighty-seven cases demonstrating granulomatous lesions on breast biopsy were identified. Of these, 49 patients who were treated with ATT and had at least two serial ultrasound follow-ups were included in our study. Mammogram and ultrasound were used for initial imaging. Subsequently, ultrasound was used for serial follow-up. Mantoux skin test, acid fast staining and histological examination of tissue sample were the other investigations used.
RESULTS: Radiologically, on ultrasound, well-circumscribed hypoechoic masses were noted in 18 patients, followed by ill-defined collections with tubular extensions in 15 cases, abscesses in 8, and a focal heterogeneity in 8 patients. Following ATT, 17 patients showed radiological resolution in 4 weeks, 18 of them at 3 months, and nine of them in 6 months.
CONCLUSIONS: Excellent and prompt radiological response to ATT, indicates the need for a high degree of suspicion for tuberculous mastitis (TBM), in endemic countries, even though microbiological tests may turn out negative.

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UNASSIGNED: Breast cancer is currently the most prevalent and impacting cancer among women and mammography has been recommended for screening by The European Commission Initiative on Breast Cancer since 2003. The objective of this study is to estimate the interest in breast cancer screening breast cancer in European countries by analyzing data from online searches for the term \"mammography\" obtained via Google Trends.
UNASSIGNED: The relative search volumes (RSVs) of the term \"mammography\" translated into various languages and relating to the January 2010-December 2022 period were downloaded from Google Trends. The between-countries differences growth of interest was estimated by a regression model in which the country-time interaction term was introduced.
UNASSIGNED: France [coefficient (coeff): 0.23; 95% confidence interval (CI): 0.18-0.28], United Kingdom (coeff: 0.22; 95% CI: 0.18-0.27) and Germany (coeff: 0.21; 95% CI: 0.16-0.25) showed the higher growth in mammography interest when compared to the average growth. The lowest growths were observed in Eastern European countries: Croatia (coeff: -0.13; 95% CI: -0.18 to -0.09), Serbia (coeff: -0.14; 95% CI: -0.18 to -0.09), Greece (coeff: -0.14; 95% CI: -0.18 to -0.09), Slovenia (coeff: -0.15; 95% CI: -0.2 to -0.11) and Bosnia-Herzegovina (coeff: -0.15; 95% CI: -0.2 to -0.11).
UNASSIGNED: These exploratory findings suggest that online interest in mammography is lower in countries with lower screening coverage and higher breast cancer mortality. These countries could adopt strategies to raise awareness of breast cancer prevention.

UNASSIGNED: To evaluate the role of paracetamol in reducing pain and discomfort during the mammography procedure.
UNASSIGNED: This randomized double-blind placebo-controlled trial was conducted at DIR, Ojha and LEJ Campus of DUHS from November 2019 to May 2021. All females aged above 40 years undergoing first time mammogram (screening or diagnostic) were enrolled. Of 639 included participants, 321 were included in paracetamol and 318 in placebo group. Patients in both the groups took medication orally which was customized by the Dow Pharmacy. The degree of pain felt during the mammography procedure was the outcome variable that was measured using Visual Analogue Scale.
UNASSIGNED: The overall pain was found in 506 (79.19%) women. Pain was significantly higher in women who were in placebo group as compared to patients who were in paracetamol group, i.e., 280 (55.3%) and 226 (44.7%) (p-value <0.001). After adjustment of other covariates, the odds of pain was 3.64 times significantly higher in women who were in placebo group than that of women in paracetamol group (OR 3.64, 95% CI 2.31-5.74). Moreover, >25kg/m2 BMI was 2.84 times, 22.6-25 kg/m2 BMI was 2.29 times, nulligravida was 3.56 times, menopausal status was 2.23 times, pre-menopausal status was 4.51 times, and family history of breast cancer was 2.33 times significantly more likely to have pain. No post-trial complications were observed in both the groups.
UNASSIGNED: The use of paracetamol prior to the mammography procedure was found to be an effective intervention to reduce the pain among women.Clinical Trials: Identifier: NCT04381104.

BACKGROUND: Breast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This study used mobile health principles to develop a mobile web app-based mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains.
OBJECTIVE: This study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure.
METHODS: Using community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled trial design, we developed the wMammogram intervention. This study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as mammogram receipt, intention to receive breast cancer screening after the intervention, and participants\' satisfaction with and acceptance of the intervention.
RESULTS: A significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences.
CONCLUSIONS: This study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations.
BACKGROUND: ClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.

UNASSIGNED: Mammogram screening (MS) is the gold-standard method for early detection of breast cancer (BC), and its use has been proven to minimize BC-related deaths and reduce treatment costs. However, recent epidemiological surveys have reported that rates of mammogram uptake by the Saudi female population are low. Here, we assessed the knowledge of BC and perceived barriers to MS uptake among pre-eligible northern Saudi women.
UNASSIGNED: We administered a standard and validated Arabic questionnaire to 400 women aged 40-69 years. SPSS version 21.0 (IBM Corporation, Armonk, NY, USA) was used for data analysis. We applied logistic regression analysis to find the factors associated with participants\' knowledge of BC and MS. Spearman correlation test was applied to find the correlation between knowledge and barrier scores.
UNASSIGNED: The study participants reported that smoking habits (61.3%) and unhealthy food habits (57.8%) were the most common risk factors for BC. Of the studied participants, 56.3% had low or medium degrees of knowledge about BC risk factors and MS. The degree of knowledge was significantly associated with education level (adjusted odds ratio [aOR], 2.35; 95% confidence interval [CI]. = 1.61-3.13; P = 0.008) and a family history of BC (aOR, 3.66; 95% CI, 1.94-5.49; P < 0.001). Fear of a BC diagnosis (50.8%) and concerns regarding test procedures were the most common barriers to MS uptake. We also found a negative correlation between participants\' knowledge and perceived barriers to MS (rho = -0.389, P < 0.001).
UNASSIGNED: We recommend that concerned authorities offer women multiple health education sessions covering BC risk factors and the necessity for pre-eligible women to undergo MS spaced at regular intervals at different facilities. Furthermore, a multicentric mixed-methods survey is warranted to find the qualitative aspects of barriers to MS.

Breast cancer is ranked as the most common type of cancer effecting women worldwide. Early detection is associated with improved morbidity and mortality, along with decreased recurrence rates, due to regular breast cancer screening recommendations advised for women over the age of 40. Women in the Kingdom of Saudi Arabia (KSA) typically present with advanced symptoms at later stages due to lower-than-average rates of breast cancer awareness and screening.
A case-control study was conducted utilizing data collected over 20 years in the primary care clinics linked to at a tertiary hospital to demonstrate the role of structured breast cancer screening programs within well-established primary care setting. Results were compared with outcomes of cancer cases diagnosed in the community through opportunistic diagnosis.
A total 292 patients included in the study had an overall mean survival time of 160 months, with a statistically significant higher survival time noted amongst the primary care group of 49 patients (p<0.01) by approximately 85 months. Clinical stages and clinical response rates between the two patient groups were found to be statistically significant (p<0.01), where 35 (73.3%) primary care patients were stage IIA and below, compared to 41 (30%) oncology patients. Patients who were diagnosed with breast cancer in the primary care group with well-established breast cancer screening programs were noted to present with breast cancer at earlier stages, have better prognosis and lower mortality as opposed to the oncology patient group.
Our study highlights the need of structured breast cancer screening programs within well supported primary health services in Saudi Arabia and the region. Such programs were associated with improved survival outcomes and more favorable clinical responses. There is an urgent need to enable primary care services with the appropriate resources to significantly impact patient morbidity and mortality.

UNASSIGNED: To evaluate the impact of using computational data management resources and analytical software on radiation doses in mammography and radiography during the COVID-19 pandemic, develop departmental diagnostic reference levels (DRLs), and describe achievable doses (ADs) for mammography and radiography based on measured dose parameters.
UNASSIGNED: This ambispective cohort study enrolled 795 and 12,115 patients who underwent mammography and radiography, respectively, at the King Fahd Hospital of the University, Al-Khobar City, Saudi Arabia between May 25 and November 4, 2021. Demographic data were acquired from patients\' electronic medical charts. Data on mammographic and radiographic dose determinants were acquired from the data management software. Based on the time when the data management software was operational in the institute, the study was divided into the pre-implementation and post-implementation phases. Continuous and categorical variables were compared between the two phases using an unpaired t-test and the chi-square test.
UNASSIGNED: The median accumulated average glandular dose (AGD; a mammographic dose determinant) in the post-implementation phase was three-fold higher than that in the pre-implementation phase. The average mammographic exposure time in the post-implementation phase was 16.3 ms shorter than that in the pre-implementation phase. Furthermore, the median values of the dose area product ([DAP], a radiographic dose determinant) were 9.72 and 19.4 cGycm2 in the pre-implementation and post-implementation phases, respectively.
UNASSIGNED: Although the data management software used in this study helped reduce the radiation exposure time by 16.3 ms in mammography, its impact on the mean accumulated AGD was unfavorable. Similarly, radiographic exposure indices, including DAP, tube voltage, tube current, and exposure time, were not significantly different after the data management software was implemented. Close monitoring of patient radiation doses in mammography and radiography, and dose reduction will become possible if imaging facilities use DRLs and ADs via automated systems.

OBJECTIVE: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality. Breast arterial calcification (BAC) on mammograms is not associated with breast cancer risk. However, there is increasing evidence supporting its association with cardiovascular disease (CVD). This study examines the association between BAC and ASCVD and their risk factors within an Australian population-based breast cancer study.
METHODS: Data from the controls who participated in the breast cancer environment and employment study (BCEES) were linked with the Western Australian Department of Health Hospital Morbidity database and Mortality Registry to obtain ASCVD outcomes and related risk factor data. Mammograms from participants with no prior history of ASCVD were assessed for BAC by a radiologist. Cox proportional hazards regression was used to examine the association between BAC and later occurrence of an ASCVD event. Logistic regression was used to investigate the factors associated with BAC.
RESULTS: A total of 1020 women with a mean age of 60 (sd = 7.0 years) were included and BAC found in 184 (18.0%). Eighty (7.8%) of the 1020 participants developed ASCVD, with an average time to event of 6.2 years (sd = 4.6) from baseline. In univariate analysis, participants with BAC were more likely to have an ASCVD event (HR = 1.96 95% CI 1.29-2.99). However, after adjusting for other risk factors, this association attenuated (HR = 1.37 95% CI 0.88-2.14). Increasing age (OR = 1.15, 95% CI 1.12-1.19) and parity (pLRT < 0.001) were associated with BAC.
CONCLUSIONS: BAC is associated with increased ASCVD risk, but this is not independent of cardiovascular risk factors.