1.Development and validation of risk prediction model for new-onset cardiovascular diseases among breast cancer patients: Based on regional medical data of Inner Mongolia.
Yun Jing ZHANG ; Li Ying QIAO ; Meng QI ; Ying YAN ; Wei Wei KANG ; Guo Zhen LIU ; Ming Yuan WANG ; Yun Feng XI ; Sheng Feng WANG
Journal of Peking University(Health Sciences) 2023;55(3):471-479
OBJECTIVE:
To develop and validate a three-year risk prediction model for new-onset cardiovascular diseases (CVD) among female patients with breast cancer.
METHODS:
Based on the data from Inner Mongolia Regional Healthcare Information Platform, female breast cancer patients over 18 years old who had received anti-tumor treatments were included. The candidate predictors were selected by Lasso regression after being included according to the results of the multivariate Fine & Gray model. Cox proportional hazard model, Logistic regression model, Fine & Gray model, random forest model, and XGBoost model were trained on the training set, and the model performance was evaluated on the testing set. The discrimination was evaluated by the area under the curve (AUC) of the receiver operator characteristic curve (ROC), and the calibration was evaluated by the calibration curve.
RESULTS:
A total of 19 325 breast cancer patients were identified, with an average age of (52.76±10.44) years. The median follow-up was 1.18 [interquartile range (IQR): 2.71] years. In the study, 7 856 patients (40.65%) developed CVD within 3 years after the diagnosis of breast cancer. The final selected variables included age at diagnosis of breast cancer, gross domestic product (GDP) of residence, tumor stage, history of hypertension, ischemic heart disease, and cerebrovascular disease, type of surgery, type of chemotherapy and radiotherapy. In terms of model discrimination, when not considering survival time, the AUC of the XGBoost model was significantly higher than that of the random forest model [0.660 (95%CI: 0.644-0.675) vs. 0.608 (95%CI: 0.591-0.624), P < 0.001] and Logistic regression model [0.609 (95%CI: 0.593-0.625), P < 0.001]. The Logistic regression model and the XGBoost model showed better calibration. When considering survival time, Cox proportional hazard model and Fine & Gray model showed no significant difference for AUC [0.600 (95%CI: 0.584-0.616) vs. 0.615 (95%CI: 0.599-0.631), P=0.188], but Fine & Gray model showed better calibration.
CONCLUSION
It is feasible to develop a risk prediction model for new-onset CVD of breast cancer based on regional medical data in China. When not considering survival time, the XGBoost model and the Logistic regression model both showed better performance; Fine & Gray model showed better performance in consideration of survival time.
Humans
;
Female
;
Adult
;
Middle Aged
;
Adolescent
;
Breast Neoplasms/epidemiology*
;
Cardiovascular Diseases/etiology*
;
Proportional Hazards Models
;
Logistic Models
;
China/epidemiology*
2.Ulnar-Mammary syndrome with TBX3 gene mutation in a Chinese family: A case report and literature review.
Ning PENG ; Min GUO ; Tiejian JIANG
Journal of Central South University(Medical Sciences) 2022;47(12):1769-1774
Ulnar-Mammary syndrome (UMS) is a rare monogenic disorder caused by mutations of the TBX3 gene. This paper reported a family of UMS. The proband, a 15-year old man, was presented with mammary gland dysplasia, ulnar limb defect, short stature, and delayed growth. Whole exome sequencing revealed a 1294_1301dup mutation in exon 6 of the TBX3 gene. Sanger sequencing was used to verify other members of the family, which suggested his mother also carried the same mutation, but merely resulting in the dysplasia of her left little finger. Notably, unilateral finger involvement without any systemic organ involvement was unusual in UMS patients. The proband then was treated with recombinant human growth hormone (rhGH) and human chorionic gonadotropin (hCG). After a year and a half, his height and secondary sexual characteristics were significantly improved. The clinical manifestations of the disease are highly heterogeneous, which is easy to be misdiagnosed and missed. When the diagnosis is unclear, genetic testing is helpful for auxiliary diagnosis.
Humans
;
Male
;
Female
;
Adolescent
;
T-Box Domain Proteins/genetics*
;
East Asian People
;
Breast Diseases/genetics*
;
Mutation
3.Diagnostic accuracy of Lumbar Spine Bone Mineral Density (BMD) measurements via Quantitative Computed Tomography (QCT) in the assessment of osteoporosis in Filipino women diagnosed with breast cancer using Dual-Energy X-ray Absorptiometry (DXA) as gold standard
Raquel Marie R. Cabatu ; Angela Krista V. Pedroso ; Irene g S. Bandon
The Philippine Journal of Nuclear Medicine 2021;16(1):8-15
Background:
Breast cancer, chemotherapy and endocrine treatment are risk factors for osteoporosis. Dual-energy x-ray
absorptiometry (DXA) remains the gold standard in the diagnosis of osteoporosis. A quantitative computed
tomography (QCT) with a bone mineral density analysis software on the whole abdomen CT may be used for
screening osteoporosis without additional radiation exposure or cost.
Objective:
To determine the accuracy of QCT in detecting osteoporosis among breast cancer patients using DXA as gold
standard.
Methods:
This is a cross-sectional analytic study of 76 Filipino women with breast cancer who underwent both DXA and
whole abdomen CT scans. The DXA measurements were obtained using Lunar iDXA manufactured by GE
Healthcare while the QCT measurements were made using the BMD analysis software available in the Philips
Extended Brilliance Workspace post-processing system.
Results:
Out of the 76 Filipino women with breast cancer, 92% were menopausal women with mean age of 58.9 (SD 8.7)
years, 69.7% had IDCA and 94.7% had mastectomy. Majority had normal BMD (44.7%), 34.2% had osteopenia
and 21.1% had osteoporosis based on DXA. QCT has 90% (95% CI: 55.5-99.8) sensitivity, 63.6% (95% CI: 30.1-
89.1) specificity, 69.2% (95% CI: 50.1-83.5) PPV, 87.5 (95% CI:50.8-97.9) NPV, 2.5 (95% CI:1.1-5.6) LR(+) and
0.16 (95% CI:0.02-1.06) LR (-).
Conclusion
The prevalence of osteoporosis and osteopenia among Filipino women with breast cancer was 21.1% and
34.2%. The sensitivity and specificity of QCT in detecting osteoporosis was 90% and 63.6%.
Osteoporosis
;
Bone Diseases, Metabolic
;
Breast Neoplasms
4.Effect of breastfeeding on the development of infection-related diseases during hospitalization in late preterm infants in 25 hospitals in Beijing, China.
Lu-Yan HAN ; Xiao-Jing XU ; Xiao-Mei TONG ; Xin ZHANG ; Jie LIU ; Li YANG ; Hui LIU ; Ju YAN ; Zhi-Fang SONG ; Ya-Bo MEI ; Rong MI ; Xuan-Guang QIN ; Yu-Huan LIU ; Yu-Jie QI ; Wei ZHANG ; Hui-Hui ZENG ; Hong CUI ; Hui LONG ; Guo GUO ; Xu-Lin CHEN ; Zhao-Yi YANG ; Fang SUN ; Xiao-Hui FU ; Chang-Yan WANG ; Zheng-Hong LI
Chinese Journal of Contemporary Pediatrics 2020;22(12):1245-1250
OBJECTIVE:
To investigate the incidence rate of infectious diseases during hospitalization in late preterm infants in Beijing, China, as well as the risk factors for infectious diseases and the effect of breastfeeding on the development of infectious diseases.
METHODS:
Related data were collected from the late preterm infants who were hospitalized in the neonatal wards of 25 hospitals in Beijing, China, from October 23, 2015 to October 30, 2017. According to the feeding pattern, they were divided into a breastfeeding group and a formula feeding group. The two groups were compared in terms of general status and incidence rate of infectious diseases. A multivariate logistic regression analysis was used to investigate the risk factors for infectious diseases.
RESULTS:
A total of 1 576 late preterm infants were enrolled, with 153 infants in the breastfeeding group and 1 423 in the formula feeding group. Of all infants, 484 (30.71%) experienced infectious diseases. The breastfeeding group had a significantly lower incidence rate of infectious diseases than the formula feeding group (22.88% vs 31.55%,
CONCLUSIONS
Breastfeeding can significantly reduce the incidence of infectious diseases and is a protective factor against infectious diseases in late preterm infants. Breastfeeding should therefore be actively promoted for late preterm infants during hospitalization.
Beijing/epidemiology*
;
Breast Feeding
;
China/epidemiology*
;
Communicable Diseases/epidemiology*
;
Female
;
Hospitalization
;
Hospitals
;
Humans
;
Incidence
;
Infant
;
Infant, Newborn
;
Infant, Premature
;
Male
;
Pregnancy
5.Kaiser score for diagnosis of breast lesions presenting as non-mass enhancement on MRI.
Bing ZHANG ; Linlin FENG ; Lin WANG ; Xin CHEN ; Xiaohui LI ; Quanxin YANG
Journal of Southern Medical University 2020;40(4):562-566
OBJECTIVE:
To evaluate the diagnostic efficacy of Kaiser score for breast lesions presenting as non-mass enhancement.
METHODS:
We collected data from patients with breast lesions presenting as non-mass enhancement on preoperative DCE-MRI between January, 2014 and June, 2019. All the cases were confirmed by surgical pathology or puncture biopsy. With pathology results as the gold standard, we evaluated the diagnostic efficacy of Kaiser score and MRI BI-RADS classification and the consistency between the diagnostic results by the two methods and the pathological results.
RESULTS:
A total of 90 lesions were detected in 88 patients, including 28 benign lesions (31.1%) and 62 malignant lesions (68.9%). For diagnosis of the lesions, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Kaiser Score were 100%, 75%, 89.9%, 100% and 92%, as compared with 93.5%, 46.4%, 79.5%, 76.5% and 78.9% of MRI BI-RADS, respectively. The diagnostic specificity of Kaiser score was significantly higher than that of BI-RADS classification (=0.021).
CONCLUSIONS
The Kaiser score system provides a diagnostic strategy for BI-RADS classification of breast lesions with non-mass enhancement and has a better diagnostic efficacy than BI-RADS classification alone. The use of Kaiser score can significantly improve the diagnostic specificity of such breast lesions for inexperienced radiologists.
Breast
;
Breast Diseases
;
diagnostic imaging
;
Humans
;
Magnetic Resonance Imaging
7.Diagnostic Significance of Fibrin Degradation Products and D-Dimer in Patients With Breast Cancer-Related Lymphedema
Sang Hyeong RYU ; Sang Won MIN ; Jae Ho KIM ; Ho Joong JEONG ; Ghi Chan KIM ; Dong Kyu KIM ; Young Joo SIM
Annals of Rehabilitation Medicine 2019;43(1):81-86
OBJECTIVE: To find out whether levels of fibrin degradation products (FDP) and D-dimer are increased in breast cancer-related lymphedema (BCRL) as in many vascular diseases. FDP and D-dimer have been used in blood tests to help differentiate deep vein thrombosis in the diagnosis of lymphedema. Levels of FDP and D-dimer are often elevated in patients with BCRL. METHODS: Patients with BCRL (group I), non-lymphedema after breast cancer treatment (group II), and deep venous thrombosis (group III) from January 2012 to December 2016 were enrolled. Levels of FDP and D-dimer were measured in all groups and compared among groups. RESULTS: Mean values of FDP and D-dimer of group I were 5.614±12.387 and 1.179±2.408 μg/μL, respectively. These were significantly higher than their upper normal limits set in our institution. Levels of FDP or D-dimer were not significantly different between group I and group II. However, values of FDP and D-dimer in group III were significantly higher than those in group I. CONCLUSION: Values of FDP and D-dimer were much higher in patients with thrombotic disease than those in patients with lymphedema. Thus, FDP and D-dimer can be used to differentiate between DVT and lymphedema. However, elevated levels of FDP or D-dimer cannot indicate the occurrence of lymphedema.
Breast Neoplasms
;
Breast
;
Diagnosis
;
Fibrin Fibrinogen Degradation Products
;
Fibrin
;
Hematologic Tests
;
Humans
;
Lymphedema
;
Vascular Diseases
;
Venous Thrombosis
8.Metastasis of Rhabdomyosarcoma to the Male Breast: a Case Report with Magnetic Resonance Imaging Findings
Myeongjong KIM ; Bong Joo KANG ; Ga Eun PARK ; Sung Hun KIM ; Jeongmin LEE ; Ahwon LEE
Investigative Magnetic Resonance Imaging 2019;23(1):75-80
Metastasis of rhabdomysarcoma to the breast is a very rare manifestation in adult males. Herein, we report a case of metastasis from embryonal rhabdomyosarcoma in the left hypothenar muscle that presented as a breast mass in a 38-year-old man, who four months later expired because of multiple bone metastases related to pancytopenia. We describe the various imaging findings, including mammograms, ultrasonography, computerized tomography (CT), positron emission tomography-computed tomography (PET-CT), and magnetic resonance imaging (MRI) of this rare disease. The various imaging findings of this lesion could be helpful for future diagnosis of male breast lesions.
Adult
;
Breast
;
Diagnosis
;
Electrons
;
Humans
;
Magnetic Resonance Imaging
;
Male
;
Neoplasm Metastasis
;
Pancytopenia
;
Rare Diseases
;
Rhabdomyosarcoma
;
Rhabdomyosarcoma, Embryonal
;
Ultrasonography
9.A benign lesion similar to breast cancer.
Yan ZHAO ; Wen-Chao WANG ; Ting LU
Chinese Medical Journal 2019;132(2):250-252
10.Durable Response of Androgen Receptor-Positive Male Breast Cancer to Goserelin
Hamdy ABDEL AZIM ; Loay KASSEM ; Kyrillus Samaan SHOHDY ; Boules ESHAAK ; Shady Elia ANIS ; Nermine Shawky KAMAL
Journal of Breast Cancer 2019;22(1):141-148
The luteinizing hormone-releasing hormone/androgen receptor (LHRH/AR) pathway is a promising treatment target in a subgroup of female patients with triple-negative breast cancer (TNBC). However, very little is known about the efficacy of this strategy in male patients with TNBC. In this report, we describe a male patient with AR-positive TNBC who was successfully treated using an LHRH agonist after pretreatment with several lines of chemotherapy and achieved a durable response. We also review the existing evidence supporting LHRH- and AR-targeted therapy for this rare disease.
Breast Neoplasms, Male
;
Drug Therapy
;
Female
;
Gonadotropin-Releasing Hormone
;
Goserelin
;
Humans
;
Lutein
;
Male
;
Male
;
Rare Diseases
;
Receptors, Androgen
;
Triple Negative Breast Neoplasms

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