A New Kernel Method for Microcalcification Detection: Spin Glass-Markov Random Fields

Background: Our 2004 survey of breast cancer survivors in the Katowice region (Poland) showed that the detection of the disease was triggered by self-examination in 58.9%, mammography in 19.2%, and clinical examination in 19.7% of cases. The purpose of the current study (2019/2020) was to determine if the implementation of national screening (mammography) in 2007 resulted in an increase of the relative contribution of mammography to detection of cancer. Methods: Subjects were 215 breast cancer patients, members of self-support groups in Katowice region. The questionnaire included questions on early detection of breast cancer, participation in screening, and socio-economic status. Results: Early detection of cancer was initiated by self-examination in 63.7%, mammography in 22.8%, clinical examination in 13.5% of subjects. Age at detection depended on the method (p < 0.001): 54.1 ± 10.8 years for self-examination, 60.0 ± 7.6 years for mammography, and 58.7 ± 10.8 years for clinical examination. Conclusions: Both in 2004 and 2020 self-examination is the most frequent method of early detection of breast cancer in the study area. The contribution of mammography remains on a low level (23%). This finding could be explained by a low participation in screening and by age of 50 years used as the entry criterion to national screening of breast cancer in Poland.

Background Earlier detection of breast cancer through mammography screening has reduced disease-specific mortality; however, confounding issues such as technical challenges, breast density, and tumor size can result in false negatives and ultimately later stage diagnosis. Next generation liquid biopsy has the potential to complement mammography and enable earlier detection for more women. We have previously demonstrated high sensitivity and specificity for early detection of invasive breast cancer (IBC) by utilizing a novel category of cancer-associated small RNAs, termed orphan noncoding RNAs (oncRNAs), through a liquid biopsy platform. Here, we further improve the ability to detect breast cancer in a larger, multi-source cohort through an AI-driven approach and demonstrate potential for detection of ductal carcinoma in-situ (DCIS). Methods We utilized The Cancer Genome Atlas (TCGA) small RNA-seq database to discover a library of 20,538 oncRNAs, through a female-specific analysis, that were significantly enriched among 1,103 breast tumors compared to 349 normal tissue samples spanning multiple tissue sites. The diagnostic performance of these oncRNAs were assessed in an independent cohort of archived serum samples from 663 female individuals, sourced from Indivumed (Hamburg, Germany), Proteogenex (Inglewood, CA), and MT Group (Los Angeles, CA), including 279 breast cancer patients of various stages (221 IBC and 58 DCIS; mean age: 57.0 ± 13.8 years; ever-smoker: 25.8%) and 304 age-matched controls (mean age: 58.5 ± 13.9 years; ever-smoker: 23.4%) without breast cancer. All samples were collected between 2010–2022 at time of diagnosis for breast cancer patients. We sequenced the small RNA content of these samples at an average depth of 25.28 ± 9.37 million 50-bp single-end reads. We detected 18,025 (87.8%) unique breast cancer-specific oncRNA species within at least one sample from the study cohort. We then trained a generative AI model using 5-fold cross-validation to predict cancer status for all samples. Results Our oncRNA-based model achieved an overall AUC of 0.95 (95% CI, 0.93–0.97) for prediction of IBC versus cancer-free controls with a sensitivity of 0.87 (0.82–0.91) at 90% specificity. We observed high sensitivities, also at 90% specificity, across all tumor stages and tumor sizes (Table 1). Sensitivities for the earliest stage and smallest tumor size were 0.87 (0.78–0.93) and 0.81 (0.61–0.93) for Stage I (n=83) and T1a–b ( &amp;gt;1mm to ≤10mm; n=26), respectively. Additionally, in a small single-source cohort, we also saw high model accuracy and sensitivity for DCIS, which we aim to confirm in additional cohorts. While our overall cancer cohort primarily consisted of individuals with luminal breast cancer, our model had high sensitivities across all breast cancer subtypes at 0.90 (0.84–0.94), 0.73 (0.59–0.85), and 0.86 (0.42–1.0) for luminal (n=181), HER2 positive (n=49), and triple negative (n=7), respectively. Conclusions We further demonstrate the potential utility of oncRNAs as a blood-based biomarker using an AI algorithm for sensitive and accurate early detection of breast cancer in a large cohort. Additionally, we have shown that this oncRNA-based assay performs well in detecting small, early-stage invasive breast tumors, with potential to detect precursors of breast cancer. Table 1: Model sensitivity in breast cancer by tumor stage and size For each tumor stage and size, as defined by the AJCC 7th Edition breast cancer staging system, sensitivity and 95% Pearson-Clopper confidence intervals (CI) are reported at 90% specificity for the number of samples (N). Citation Format: Noura Tbeileh, Taylor Cavazos, Mehran Karimzadeh, Jeffrey Wang, Alice Huang, Dung Ngoc Lam, Seda Kilinc, Jieyang Wang, Xuan Zhao, Andy Pohl, Helen Li, Lisa Fish, Kimberly Chau, Marra Francis, Lee Schwartzberg, Patrick Arensdorf, Hani Goodarzi, Fereydoun Hormozdiari, Babak Alipanahi. Cell-free orphan noncoding RNAs and AI enable early detection of invasive breast cancer and ductal carcinoma in-situ [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-13-08.

BackgroundMost women living in low‐ and middle‐income countries (LMICs) present with advanced‐stage breast cancer. Limitations of poor serviceable health systems, restricted access to treatment facilities, and lack of breast cancer screening programmes all likely contribute to the late presentation of women with breast cancer living in these countries. Women are diagnosed with advanced disease and frequently do not complete their care due to a number of factors, including financial reasons as health expenditure is largely out of pocket resulting in financial toxicity; health system failures, such as missing services or health worker lack of awareness on common signs and symptoms of cancer; and sociocultural barriers, such as stigma and use of alternative therapies. Clinical breast examination (CBE) is an inexpensive early detection technique for breast cancer in women with palpable breast masses. Training health workers from LMICs to conduct CBE has the potential to improve the quality of the technique and the ability of health workers to detect breast cancers early.ObjectivesTo assess whether training in CBE affects the ability of health workers in LMICs to detect early breast cancer.Search methodsWe searched the Cochrane Breast Cancer Specialised Registry, CENTRAL, MEDLINE, Embase, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal, and ClinicalTrials.gov up to 17 July 2021.Selection criteriaWe included randomised controlled trials (RCTs) (including individual and cluster‐RCTs), quasi‐experimental studies and controlled before‐and‐after studies if they fulfilled the eligibility criteria.Data collection and analysisTwo review authors independently screened studies for inclusion, and extracted data, assessed risk of bias, and assessed the certainty of the evidence using the GRADE approach. We performed statistical analysis using Review Manager software and presented the main findings of the review in a summary of findings table.Main resultsWe included four RCTs that screened a total population of 947,190 women for breast cancer, out of which 593 breast cancers were diagnosed. All included studies were cluster‐RCTs; two were conducted in India, one in the Philippines, and one in Rwanda. Health workers trained to perform CBE in the included studies were primary health workers, nurses, midwives, and community health workers. Three of the four included studies reported on the primary outcome (breast cancer stage at the time of presentation). Amongst secondary outcomes, included studies reported CBE coverage, follow‐up, accuracy of health worker‐performed CBE, and breast cancer mortality. None of the included studies reported knowledge attitude practice (KAP) outcomes and cost‐effectiveness.Three studies reported diagnosis of breast cancer at early stage (at stage 0+I+II), suggesting that training health workers in CBE may increase the number of women detected with breast cancer at an early stage compared to the non‐training group (45% detected versus 31% detected; risk ratio (RR) 1.44, 95% confidence interval (CI) 1.01 to 2.06; three studies; 593 participants; I2 = 0%; low‐certainty evidence).Three studies reported diagnosis at late stage (III+IV) suggesting that training health workers in CBE may slightly reduce the number of women detected with breast cancer at late stage compared to the non‐training group (13% detected versus 42%, RR 0.58, 95% CI 0.36 to 0.94; three studies; 593 participants; I2 = 52%; low‐certainty evidence).Regarding secondary outcomes, two studies reported breast cancer mortality, implying that the evidence is uncertain for the impact on breast cancer mortality (RR 0.88, 95% CI 0.24 to 3.26; two studies; 355 participants; I2 = 68%; very low‐certainty evidence). Due to the study heterogeneity, we could not conduct meta‐analysis for accuracy of health worker‐performed CBE, CBE coverage, and completion of follow‐up, and therefore reported narratively using the 'Synthesis without meta‐analysis' (SWiM) guideline. Sensitivity of health worker‐performed CBE was reported to be 53.2% and 51.7%; while specificity was reported to be 100% and 94.3% respectively in two included studies (very low‐certainty evidence). One trial reported CBE coverage with a mean adherence of 67.07% for the first four screening rounds (low‐certainty evidence). One trial reported follow‐up suggesting that compliance rates for diagnostic confirmation following a positive CBE were 68.29%, 71.20%, 78.84% and 79.98% during the respective first four rounds of screening in the intervention group compared to 90.88%, 82.96%, 79.56% and 80.39% during the respective four rounds of screening in the control group.Authors' conclusionsOur review findings suggest some benefit of training health workers from LMICs in CBE on early detection of breast cancer. However, the evidence regarding mortality, accuracy of health worker‐performed CBE, and completion of follow up is uncertain and requires further evaluation.

Fibroadenoma is the most benign breast neoplasm. These tumors grow in young women with the highest frequency in young women 21-25 years, with a prevalence of more than 9% of the female population affected by fibroadenoma. Breast cancer still has a high likelihood of being cured when it comes early or early. Early detection of breast cancer is an examination program to recognize breast cancer while still small, and before the cancer has a chance to spread. One of the early detection efforts is clinical breast examination (SADANIS) which is carried out at least once every 3 years or if abnormalities are found in the process of self breast examination (BSE) and carried out by trained health workers. The purpose of the study was to determine the relationship between knowledge and early detection of breast cancer risk in young women through SADANIS examination. Observational research method with cross sectional approach. The sample is a student of SMK 1 Palu and a student of AKBID Cendrawasih Palu. The results showed that there was a significant relationship between knowledge about SADANIS examination and the practice of SADANIS examination in young women. In line with the Wantini and Indrayani (2018) study that there is a meaningful relationship between knowledge with early detection of breast cancer through SADANIS examination based ontest Fisher Exact's with a p-value of 0.012&lt;α (0.05), so there is a strong relationship between young women's knowledge BSE in early detection of breast cancer as evidenced by the p-value 0.007&lt;α (0.05). The conclusion is that the knowledge of young women about sadanis examination is still low Keywords: Knowledge, Early Detection of Breast Cancer, Adolescent Girls, SADANIS

Early detection of breast cancer is carried out by using mammographic images. Due to low contrast nature of these images, it is difficult to detect signs such as micro calcifications and masses. This paper describes novel algorithms for early detection of breast cancer using image processing techniques. Novel algorithms are implemented for 1) Mass region extraction to get exact shape of the mass 2) Superposition of boundary of mass on mammogram helps doctors to view the boundary easily as mass region overlaps with breast parenchyma 3) Extraction of texture features like mean, standard deviation, entropy, kurtosis etc, geometric features like area perimeter L:S, ENC, (Elliptical normalized circumference) wavelet based features, so that signatures can be assigned for identification and classification of benign and malignant masses. Fourteen patients' mammograms have been processed. Features of six patients have been extracted that have masses.

Simple SummaryBreast cancer screening is associated with benefits, such as mortality reduction and improved quality of life, and harms, such as false-positive results, overdiagnoses, and costs. Novel screen tests could be considered to reduce the harms and increase the benefits of screening. Liquid biopsies have been proposed as a novel method for the early detection of breast cancer. However, studies show that liquid biopsies based on cell-free DNA have a low sensitivity for early-stage breast cancer. Using the microsimulation model MISCAN-Fadia, we model the benefits, harms, and costs of the early detection of breast cancer using liquid biopsies for varying levels of liquid biopsy sensitivity and specificity. We found that liquid biopsies are unlikely to be an alternative to digital mammography, given the test performance based on a CCGA substudy. When liquid biopsies are unable to detect the precursor lesion of breast cancer—ductal carcinoma in situ (DCIS)—they need to be able to detect small, early-stage tumors, with high specificity, at low costs in order to be an alternative to digital mammography. We estimated a maximum liquid biopsy price of USD 187, which is substantially lower than currently listed prices.Breast cancer screening is associated with harms, such as false-positives and overdiagnoses, and, thus, novel screen tests can be considered. Liquid biopsies have been proposed as a novel method for the early detection of cancer, but low cell-free DNA tumor fraction might pose a problem for the use in population screening. Using breast cancer microsimulation model MISCAN-Fadia, we estimated the outcomes of using liquid biopsies in breast cancer screening in women aged 50 to 74 in the United States. For varying combinations of test sensitivity and specificity, we quantify the impact of the use of liquid biopsies on the harms and benefits of screening, and we estimate the maximum liquid biopsy price for cost-effective implementation in breast cancer screening at a cost-effectiveness threshold of USD 50,000. We investigate under what conditions liquid biopsies could be a suitable alternative to digital mammography and compare these conditions to a CCGA substudy. Outcomes were compared to digital mammography screening, and include mortality reduction, overdiagnoses, quality-adjusted life-years (QALYs), and the maximum price of a liquid biopsy for cost-effective implementation. When liquid biopsies are unable to detect DCIS, a large proportion of overdiagnosed cases is prevented but overall breast cancer mortality reduction and quality of life are lower, and costs are higher compared to digital mammography screening. Liquid biopsies prices should be restricted to USD 187 per liquid biopsy depending on test performance. Overall, liquid biopsies that are unable to detect ductal carcinoma in situ (DCIS) need to be able to detect small, early-stage tumors, with high specificity, at low costs in order to be an alternative to digital mammography. Liquid biopsies might be more suitable as an addition to digital mammography than as an alternative.

Trends in Mammography and Clinical Breast Examination: A Population-Based Study

Reproductive health for housewives in the work area of the Passo Health Center is carried out based on problems from the partner group, namely low knowledge and minimal information about women's reproductive health, especially cervical cancer and breast cancer as well as skills in practicing or performing the BSE method resulting in low awareness of the importance women's reproductive health, this is shown through the low behavior of early detection carried out by housewives both the IVA test for early detection of cervical cancer and the application of the BSE method for early detection of breast cancer. With the aim of increasing the knowledge, skills and health of housewives in the target group regarding reproductive health, especially cervical cancer and breast cancer as a prevention effort. As well as increasing the knowledge of mothers about basic clinical information on cervical cancer and breast cancer, methods of detection as prevention and treatment methods, the number of mothers who are detected and can be treated. The solutions applied to the above problems are (1). Counseling to increase the knowledge of housewives about women's reproductive health (cervical Ca and breast Ca); (2). perform early detection of cervical cancer and early detection (screening) of breast cancer. The method used for the implementation of the solution is (1). Lectures, questions and answers and discussions both audio (sound) and visual (pictures and video) to increase mothers' knowledge about women's reproductive health; (2). Visual inspection method with acetic acid, also known as visual inspection with acetic acid (IVA test) for early detection of cervical cancer in housewives of the target group; Evaluation is carried out for each implementation of activities to encourage understanding of housewives to behave healthily towards reproductive health.

Background and methodsThe prevention and control of breast cancer in sub-Saharan Africa (SSA) is an increasingly critical public health issue. Breast cancer is the most frequent female cancer in SSA and mortality rates from this disease are the highest globally. Breast cancer has traditionally been considered a disease of high-income countries, and programs for early detection have been developed and implemented in these settings. However, screening programs for breast cancer in SSA have been less effective than in high-income countries. This article reviews the literature on breast cancer in SSA, focusing on early detection practices. It then examines the case for and against mammography and other early detection approaches for breast cancer in SSA.ResultsWomen with breast cancer in SSA are younger compared with high-income countries. Most women present with advanced disease and because treatment options are limited, have poor prognoses. Delay between symptom onset and healthcare seeking is common. Engagement with early detection practices such as mammography and breast examination is low and contributes to late stage at diagnosis.DiscussionWhile early detection of breast cancer through screening has contributed to important reductions in mortality in many high-income countries, most countries in SSA have not been able to implement and sustain screening programs due to financial, logistical and sociocultural constraints. Mammography is widely used in high-income countries but has several limitations in SSA and is likely to have a higher harm-to-benefit ratio. Breast self-examination and clinical breast examination are alternative early detection methods which are more widely used by women in SSA compared with mammography, and are less resource intensive. An alternative approach to breast cancer screening programs for SSA is clinical downstaging, where the focus is on detecting breast cancer earlier in symptomatic women. Evidence demonstrates effectiveness of clinical downstaging among women presenting with late stage disease.ConclusionsApproaches for early detection of breast cancer in SSA need to be context-specific. While screening programs with mammography have been effective in high-income countries, evidence suggests that other strategies might be equally important in reducing mortality from breast cancer, particularly in low-resource settings. There is a strong argument for further research into the feasability and acceptability of clinical downstaging for the control of breast cancer in SSA.

Mammography and finding of suspicious masses during self-examinations and clinical breast examinations form the primary screening tools for early detection of breast cancer. Mammography is essential for early detection of cancer, prior to any other means. Many abnormalities other than cancer are shown by screening mammography, leading to biopsy of the suspicious defect. Any enhancement that reduces the number of unnecessary biopsies is welcomed. Digital enhancement may aid in early detection of some patterns, such as microcalcification clusters, indicating the onset of DCIS (ductal carcinoma in situ) that accounts for 20% of all mammographically detected breast cancers, and early detection may enable a complete cure. The individual calcifications are hard to detect, due to their size and shape variability and the inhomogeneous background structure. Our study addresses only early detection of microcalcifications. We present an algorithm which locates microcalcifications based on local gray-scale variability, tissue structures and image statistics. The mammographs are digitally enhanced to accent textures and a previously developed threshold filter creates a binary mask of the calcification's spatial location.

Can Breast Self-examination and Clinical Breast Examination Along With Increasing Breast Awareness Facilitate Earlier Detection of Breast Cancer in Populations With Advanced Stages at Diagnosis?

Early detection of breast cancer, a significant public health problem in the world, is the key for improving breast cancer early prognosis. Mammography is considered the most reliable and widely used diagnostic technique for early detection of breast cancer. However, it is difficult for radiologists to perform both accurate and uniform evaluation for the enormous mammograms with widespread screening. Microcalcification clusters is one of the most important clue of the breast cancer, and their automated detection is very helpful for early breast cancer diagnosis. Because of the poor quality of the mammographic images and the small size of the microcalcifications, it is a very difficult task to perform detecting the early breast cancer. In this paper, we propose a novel approach based on hybrid subspace fusion for detection microcalcification clusters, and successfully apply it to detection task in digital mammograms. In such a system, subspace learning algorithms will be selectively fused according to the ability of preserving the classification information. Experimental results show that the proposed method improved the performance and stability of microcalcification cluster detection and could be adapt to the noise environments better. The proposed methods could get satisfactory results on sensitivity and reduce false positive rate, which provide some new ideas and methods for the research and development of computer-aided detection system in the breast cancer detection community.

Early detection of the breast cancer using infrared technology – A comprehensive review

Early Detection of Breast Cancer in Women

Background: The existence of Higher Education has three main tasks, namely carrying out education and teaching, research, and community service. These three things constitute the Tridharma of Higher Education. In Indonesia, breast cancer is the second most common cancer suffered by women after oral/cervical cancer. Breast cancer generally attacks women who are over 40 years old. However, young women can get this cancer. To find early symptoms of breast cancer can be detected early by women themselves. Women can routinely perform the Breast Self-Examination (BSE) method by massaging and feeling around their breasts to find out whether or not there are lumps around the breasts. BSE is an effective way to detect breast cancer as early as possible.&#x0D; Objective: Carry out community service by conducting activities to teach breast self-examination (BSE) to young women.&#x0D; Method: This community service activity consists of counseling related to information on early detection of breast cancer and followed by a demonstration of breast self-examination (BSE) using the Breast Phantom tool.&#x0D; Result: Counseling and early detection of breast cancer was attended by 45 students of Madrasah Aliyah. Most students do not know about early detection of breast cancer and how to check BSE. After being given information about BSE, adolescents felt satisfied and committed to be able to carry out early detection of breast cancer.&#x0D; Conclusion: Community service activities have been carried out regarding information on early detection of breast cancer in young women.