OBJECTIVE: This study aimed to assess the relationship between the body composition of children aged 3-5 years and breastfeeding status and duration. METHODS: The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC), a nationwide cross-sectional study. Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews. The body composition of preschool children was measured using bioelectrical impedance analysis. A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders. RESULTS: In total, 2,008 participants were included in the study. Of these, 89.2% were ever breastfed and the median duration of breastfeeding was 12 months (IQR 7-15 months). Among children aged 3 years, the height-for-age Z-score (HAZ) for the ever breastfed group was lower than that for never breastfed group (0.12 vs. 0.42, P = 0.043). In addition, the weight-for-age Z-score (WAZ) of the ever breastfed group was lower than that of the never breastfed group (0.31 vs. 0.65, P = 0.026), and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed. Compared to the formula-fed children, the fat-free mass of breastfed infants was higher for children aged 3 years (12.84 kg vs. 12.52 kg, P = 0.015) and lower for those aged 4 years (14.31 kg vs. 14.64 kg, P = 0.048), but no difference was detected for children aged 5 years (16.40 kg vs. 16.42 kg, P = 0.910) after adjusting for potential confounders. No significant difference was detected in the weight-for-height Z-score (WHZ), body mass index (BMI)-for-age Z-score (BAZ), fat-free mass index, and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3-5 years. CONCLUSION No obvious associations were detected between breastfeeding duration, BMI, and fat mass indicators. Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.
Infant ; Female ; Child, Preschool ; Humans ; Infant, Newborn ; Child ; Adolescent ; Breast Feeding ; Prospective Studies ; Cross-Sectional Studies ; Body Mass Index ; Body Composition

INTRODUCTION: Breast cancer is a leading cause of cancer death among women, and its age-standardised incidence rate is one of the highest in Asia. We aimed to review studies on barriers to breast cancer screening to inform future policies in Singapore. METHOD: This was a literature review of both quantitative and qualitative studies published between 2012 and 2020 using PubMed, Google Scholar and Cochrane databases, which analysed the perceptions and behaviours of women towards breast cancer screening in Singapore. RESULTS: Through a thematic analysis based on the Health Belief Model, significant themes associated with low breast cancer screening uptake in Singapore were identified. The themes are: (1) high perceived barriers versus benefits, including fear of the breast cancer screening procedure and its possible outcomes, (2) personal challenges that impede screening attendance and paying for screening and treatment, and (3) low perceived susceptibility to breast cancer. CONCLUSION Perceived costs/barriers vs benefits of screening appear to be the most common barriers to breast cancer screening in Singapore. Based on the barriers identified, increasing convenience to get screened, reducing mammogram and treatment costs, and improving engagement with support groups are recommended to improve the screening uptake rate in Singapore.
Breast Neoplasms/epidemiology* ; Early Detection of Cancer ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Mammography ; Mass Screening ; Singapore/epidemiology*

Breast Neoplasms/diagnosis* ; China/epidemiology* ; Early Detection of Cancer ; Female ; Humans ; Mass Screening

breast cancers. However, the sensitivity of mammographic screening is lower for dense breasts, which are an independent risk factor for breast cancers. Automated breast ultrasound (ABUS) is used as an adjunct to mammography for screening breast cancers in asymptomatic women with dense breasts. It is an effective screening modality with diagnostic accuracy comparable to that of handheld ultrasound (HHUS). Radiologists should be familiar with the unique display mode, imaging features, and artifacts in ABUS, which differ from those in HHUS. The purpose of this study was to provide a comprehensive review of the clinical significance of dense breasts and ABUS screening, describe the unique features of ABUS, and introduce the method of use and interpretation of ABUS.]]>
Artifacts ; Breast Neoplasms ; Breast ; Early Detection of Cancer ; Female ; Humans ; Mammography ; Mass Screening ; Methods ; Risk Factors ; Ultrasonography

Three-dimensional automated breast ultrasonography (ABUS) has been approved for screening Epub ahead of print studies as an adjunct to mammography. ABUS provides proper orientation and documentation, resulting in better reproducibility. Optimal image quality is essential for a proper diagnosis, and high-quality images should be ensured when ABUS is used in clinical settings. Image quality in ABUS is highly dependent on the acquisition procedure. Artifacts can interfere with the visibility of abnormalities, reduce the overall image quality, and introduce clinical and technical problems. Nipple shadow and reverberation artifacts are some of the artifacts frequently encountered in ABUS. Radiologists should be familiar with proper image acquisition techniques and possible artifacts in order to acquire high-quality images.
Artifacts* ; Breast* ; Diagnosis ; Early Detection of Cancer ; Mammography ; Mass Screening ; Nipples ; Ultrasonography, Mammary*

OBJECTIVE: To evaluate the interpretive performance and inter-observer agreement on digital mammographs among radiologists and to investigate whether radiologist characteristics affect performance and agreement. MATERIALS AND METHODS: The test sets consisted of full-field digital mammograms and contained 12 cancer cases among 1000 total cases. Twelve radiologists independently interpreted all mammograms. Performance indicators included the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and area under the receiver operating characteristic curve (AUC). Inter-radiologist agreement was measured. The reporting radiologist characteristics included number of years of experience interpreting mammography, fellowship training in breast imaging, and annual volume of mammography interpretation. RESULTS: The mean and range of interpretive performance were as follows: recall rate, 7.5% (3.3–10.2%); CDR, 10.6 (8.0–12.0 per 1000 examinations); PPV, 15.9% (8.8–33.3%); sensitivity, 88.2% (66.7–100%); specificity, 93.5% (90.6–97.8%); FPR, 6.5% (2.2–9.4%); and AUC, 0.93 (0.82–0.99). Radiologists who annually interpreted more than 3000 screening mammograms tended to exhibit higher CDRs and sensitivities than those who interpreted fewer than 3000 mammograms (p = 0.064). The inter-radiologist agreement showed a percent agreement of 77.2–88.8% and a kappa value of 0.27–0.34. Radiologist characteristics did not affect agreement. CONCLUSION: The interpretative performance of the radiologists fulfilled the mammography screening goal of the American College of Radiology, although there was inter-observer variability. Radiologists who interpreted more than 3000 screening mammograms annually tended to perform better than radiologists who did not.
Area Under Curve ; Breast ; Fellowships and Scholarships ; Mammography ; Mass Screening ; Medical Audit ; Observer Variation ; ROC Curve ; Sensitivity and Specificity

Breast magnetic resonance imaging (MRI) has been increasingly utilized, especially in screening for high-risk cases, because of its high sensitivity and superior ability to detect cancers as compared with mammography and ultrasound. Several limitations such as higher cost, longer examination time, longer interpretation time, and low availability have hindered the wider application of MRI, especially for screening of average-risk women. To overcome some of these limitations and increase access to MRI screening, an abbreviated breast MRI protocol has been introduced. Abbreviated breast MRI is becoming popular and challenges the status quo. This review aims to present an overview of abbreviated MRI, discuss the current findings, and introduce ongoing prospective trials.
Breast Neoplasms ; Breast ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Mass Screening ; Prospective Studies ; Ultrasonography

BACKGROUND: Direct-to-implant breast reconstruction following nipple-sparing mastectomy is becoming increasingly common. The weight of the breast specimen informs implant selection. However, specimens of the same weight may have different volume. Therefore, identifying the factors affecting the density of breast specimens may facilitate the selection of implants with an appropriate volume. METHODS: From December 2015 to May 2018, 108 patients underwent direct-to-implant reconstruction following nipple-sparing mastectomy. The weight of the breast specimens was measured using an electronic scale in the operating room. Furthermore, the volume of specimens was measured using the water displacement technique. Multiple regression analysis was performed on factors that can affect breast density, such as menopause, neoadjuvant chemotherapy (CTx), age, body mass index, and diabetes mellitus. RESULTS: The average density of breast specimens in patients older than 50 years (n=36) was 0.96±0.04 g/mL, which was significantly lower than the 1.01±0.08 g/mL observed in patients younger than 50 years (n=72) (P=0.007). The mean density of breast specimens in patients who underwent neoadjuvant CTx (n=25) was 0.96±0.06 g/mL, which was significantly lower than the value of 1.00±0.08 g/mL in those who did not (n=83). CONCLUSIONS: It is advisable to select an implant slightly larger than the mastectomy specimen weight in patients older than 50 years or in those who have undergone neoadjuvant CTx.
Body Mass Index ; Breast Implants ; Breast ; Diabetes Mellitus ; Drug Therapy ; Female ; Humans ; Mammaplasty ; Mastectomy ; Menopause ; Operating Rooms ; Water

BACKGROUND: Gynecomastia is a common condition that can cause severe emotional and physical distress in both young and older men. Patients in whom symptomatic recalcitrant gynecomastia persists for a long time are potential candidates for surgery. METHODS: From January 2014 to January 2016, 15 patients underwent correction of gynecomastia through a single 3-mm incision at our institution. Only patients with true gynecomastia underwent surgery with this new technique. Through the small incision, sharp dissection was performed in a clockwise and counterclockwise direction describing two half-circles. Health-related quality of life and aesthetic outcomes were evaluated using a modified version of the Breast Evaluation Questionnaire (BEQ). RESULTS: The patients’ average age was 23.5 years (range, 18–28 years), and their average body mass index was 23.2 kg/m² (range, 19.2–25.3 kg/m²). One case was unilateral and 14 cases were bilateral. The weight of glandular tissue resected from each breast ranged from 80 to 170 g. No excess skin was excised. Bleeding was minimal. The mean operating time was 25 minutes (range, 21–40 minutes). No complications were recorded. All lesions were histologically benign. The patients’ average score was 3.5 (on a 5-point Likert scale) in all domains of the BEQ for themselves and their partners. CONCLUSIONS: In this study, we demonstrated the safety and reliability of a new technique that allows mastectomy through an imperceptible 3-mm incision. We obtained high patient satisfaction scores using our surgical technique, and patients reported considerable improvement in their social, physical, and psychological well-being after surgery.
Body Mass Index ; Breast ; Gynecomastia ; Hemorrhage ; Humans ; Lipectomy ; Male ; Mastectomy ; Outcome Assessment (Health Care) ; Patient Satisfaction ; Quality of Life ; Skin

breast cancer is screening mammography. There have been many efforts to develop a blood-based diagnostic assay for breast cancer diagnosis; however, none have been approved for clinical use at this time. The purpose of this study was to determine the accuracy of a novel blood-based proteomic test for aiding breast cancer diagnosis in a relatively large cohort of cancer patients.METHODS: A blood-based test using multiple reaction monitoring (MRM) measured by mass spectrometry to quantify 3 peptides (apolipoprotein C-1, carbonic anhydrase 1, and neural cell adhesion molecule L1-like protein) present in human plasma was investigated. A total of 1,129 blood samples from 575 breast cancer patients, 454 healthy controls, and 100 patients with other malignancies were used to verify and optimize the assay.RESULTS: The diagnostic sensitivity, specificity, and accuracy of the MRM-based proteomic assay were 71.6%, 85.3%, and 77%, respectively; the area under the receiver operating characteristic curve was 0.8323. The proteomic assay did not demonstrate diagnostic accuracy in patients with other types of malignancies including thyroid, pancreatic, lung, and colon cancers. The diagnostic performance of the proteomic assay was not associated with the timing of blood sampling before or after anesthesia.CONCLUSION: The data demonstrated that an MRM-based proteomic assay that measures plasma levels of three specific peptides can be a useful tool for breast cancer screening and its accuracy is cancer-type specific.]]>
Anesthesia ; Biomarkers ; Blood Proteins ; Breast Neoplasms ; Breast ; Carbonic Anhydrases ; Cohort Studies ; Colonic Neoplasms ; Diagnosis ; Humans ; Lung ; Mammography ; Mass Screening ; Mass Spectrometry ; Neural Cell Adhesion Molecules ; Peptides ; Plasma ; Proteomics ; ROC Curve ; Sensitivity and Specificity ; Thyroid Gland