Search Results (2,271)

Background/Objectives: This study seeks to evaluate the clinical characteristics of newly diagnosed male breast cancers within the traditionally underserved Bronx population at risk for poorer health outcomes. Methods: We retrospectively searched our database for male patients who presented for mammographic evaluation between 1 January 2016 and 1 October 2024. The primary outcomes were the prevalence of biopsy-proven male breast cancer and its association with gynecomastia and TNM stage at diagnosis. Clinical data, including TNM staging, receptor status, risk factors, and patient demographics, were recorded for patients with biopsy-proven breast cancer based on biopsy results. Two dedicated breast imagers retrospectively evaluated mammograms of these patients to determine by consensus the presence of gynecomastia. Analyses were descriptive in nature. Results: During the study period, 423 screening mammograms and 1775 diagnostic mammograms were performed on male patients. Twenty-six male patients with biopsy-proven breast cancer were identified (two were bilateral and four were multifocal). In total, 69% of our male breast cancer patients (18 out of 26) demonstrated gynecomastia, which was similar across demographic groups, ranging from 63 to 75%. Out of the three patients with Stage 4 disease, two were Black and one was White. Stage 3 or higher disease was seen in 29% of our Black patients, 12% of our White patients, and 0% of our Hispanic patients. Conclusions: Male breast cancer in this Bronx population was frequently associated with gynecomastia and showed notable demographic disparities. Black patients presented with more advanced disease than other demographic groups. These descriptive findings highlight areas of further investigation and may help inform future outreach and early detection efforts in high-risk, underserved communities. This retrospective, single-institution analysis was limited by a small sample size and did not include formal statistical testing; therefore, the findings are descriptive and warrant validation with larger cohorts. Full article

Background and Clinical Significance: Breast cancer is the most frequent malignancy in women. Metastatic breast cancer is considered a treatable but incurable condition, with a median overall survival of only 2–3 years. Among its subtypes, triple-negative breast cancer (TNBC) accounts for a high proportion of breast cancer-related deaths. It is characterized by an aggressive clinical course, early recurrence, and a strong propensity for visceral and brain metastases. Case Presentation: We report the case of a Caucasian woman who developed systemic disease recurrence with lung and mediastinal lymph node metastases, occurring two years after her primary diagnosis and treatment for TNBC. The patient received three months of chemotherapy combined with an adjuvant integrative protocol consisting of melatonin, cannabidiol, and oxygen–ozone therapy. This combined approach led to the complete disappearance of the lung nodules. Subsequently, stereotactic radiotherapy was performed and, in association with the ongoing integrative treatment, resulted in a significant reduction in mediastinal adenopathy. Introduction of immunotherapy, supported continuously by the same adjuvant strategy, achieved a complete and durable remission. Strikingly, the patient remained disease-free five years after the diagnosis of lung and mediastinal metastases. Conclusions: This clinical case highlights the potential benefit of using melatonin, cannabidiol, and oxygen–ozone therapy as part of an integrative approach in patients with aggressive metastatic TNBC. While it is not possible to establish causality from a single case, the sustained remission observed suggests that such unconventional adjuvant strategies could play a supportive role in enhancing the efficacy of standard oncologic therapies. Full article

Effective and transparent medical diagnosis relies on accurate and interpretable classification of medical images across multiple modalities. This paper introduces an explainable multi-modal image analysis framework based on a dual-stream architecture that fuses handcrafted descriptors with deep features extracted from a custom MobileNet. Handcrafted descriptors include frequency-domain and texture features, while deep features are summarized using 26 statistical metrics to enhance interpretability. In the fusion stage, complementary features are combined at both the feature and decision levels. Decision-level integration combines calibrated soft voting, weighted voting, and stacking ensembles with optimized classifiers, including decision trees, random forests, gradient boosting, and logistic regression. To further refine performance, a hybrid class-specific feature selection strategy is proposed, combining mutual information, recursive elimination, and random forest importance to select the most discriminative features for each class. This hybrid selection approach eliminates redundancy, improves computational efficiency, and ensures robust classification. Explainability is provided through Local Interpretable Model-Agnostic Explanations, which offer transparent details about the ensemble model’s predictions and link influential handcrafted features to clinically meaningful image characteristics. The framework is validated on three benchmark datasets, i.e., BTTypes (brain MRI), Ultrasound Breast Images, and ACRIMA Retinal Fundus Images, demonstrating generalizability across modalities (MRI, ultrasound, retinal fundus) and disease categories (brain tumor, breast cancer, glaucoma). Full article

Breast cancer remains a leading cause of mortality among women worldwide, motivating the development of transparent and reproducible risk models for clinical decision making. Using the open-access SEER Breast Cancer dataset (November 2017 release), we analyzed 4005 women diagnosed between 2006 and 2010 with infiltrating duct and lobular carcinoma (ICD-O-3 8522/3). Thirty-one clinical and demographic variables were preprocessed with one-hot encoding and z-score standardization, and the lymph node ratio was derived to characterize metastatic burden. Two supervised models, L1-regularized logistic regression and a feedforward artificial neural network, were compared under identical preprocessing, fixed 60/20/20 data splits, and stratified five-fold cross-validation. To define clinically meaningful endpoints and handle censoring, we reformulated mortality prediction as fixed-horizon classification at 3 and 5 years, and evaluated discrimination, calibration, and operating thresholds. Logistic regression demonstrated consistently strong performance, achieving test ROC-AUC values of 0.78 at 3 years and 0.75 at 5 years, with substantially superior calibration (Brier score less than or equal to 0.12, ECE less than or equal to 0.03). A structured hyperparameter search with repeated-seed evaluation identified optimal neural network architectures for each horizon, yielding test ROC-AUC values of 0.74 at 3 years and 0.73 at 5 years, but with markedly poorer calibration (ECE 0.19 to 0.23). Bootstrap analysis showed no significant AUC difference between models at 3 years, but logistic regression exhibited greater stability across folds and lower sensitivity to feature pruning. Overall, L1-regularized logistic regression provides competitive discrimination (ROC-AUC 0.75 to 0.78), markedly superior probability calibration (ECE below 0.03 versus 0.19 to 0.23 for the neural network), and approximately 40% lower cross-validation variance, supporting its use for scalable screening, risk stratification, and triage workflows on structured registry data. Full article

Invasive lobular carcinoma (ILC) accounts for approximately 15% of breast cancers and the most common neoplasm in the female population. Cervical involvement is exceptionally rare and often underrecognized. This relationship is well-defined in the context of breast and ovarian cancer syndrome related to BRCA gene mutations. However, it is also observed in rare but underreported cases of cervical metastases originating from breast cancer. The objective of this manuscript is to describe a rare case of cervical recurrence of invasive lobular carcinoma and summarize comparable case to guide future gynecologic follow-up strategies. Therefore, we report the case of a 60-year-old woman who developed a late cervical recurrence of ILC ten years after her initial breast cancer diagnosis. The patient had previously undergone mastectomy for ER-positive, PR-positive, HER2-negative ILC, followed by five years of adjuvant endocrine therapy. She remained disease-free until presenting with post-menopausal bleeding, urinary symptoms, and acute renal failure. Pelvic examination and ultrasonography revealed an enlarged, indurated cervix with bilateral hydroureteronephrosis. Biopsy demonstrated a discohesive infiltrate consistent with metastatic lobular carcinoma, confirmed by immunohistochemistry (GATA3+, CK7+, ER/PR+, E-cadherin−, CK20−, CDX2−). Staging PET-CT showed additional metastases involving bone, peritoneum, and lymph nodes. The patient began systemic therapy with ribociclib plus letrozole, achieving radiologic improvement of the cervical lesion and abdominal disease. After a follow-up of several months, she maintains stable disease but has persistent chronic renal impairment secondary to obstructive uropathy. This case highlights the ability of ILC to recur after long latency and to metastasize to unusual gynecologic sites such as the cervix. We also review the literature on cervical recurrence from lobular carcinoma to emphasize the importance of gynecologic surveillance in breast cancer survivors and to identify areas that require further investigation. Full article

This study discusses the challenges encountered in breast cancer screening coverage in Brazil. The aim was to verify mammography coverage in Brazil. A cross-sectional study was carried out using data provided by the Ministry of Health verifying the following information: method of detection, analysis of coverage, clinical and sociodemographic variables of breast cancer. We observed significant differences in the number of mammograms performed between Brazilian regions and between levels of education, which may be determining factors for adherence to the examination, as well as differences related to the collection period analyzed. Raising awareness among the population about the importance of mammography and training health professionals are fundamental to increasing coverage. It is necessary to invest in awareness-raising strategies and in a health care network prepared to welcome women with suspicious signs and symptoms, ensuring investigation and treatment. Full article

Background/Objectives: The Korean Survey for Cancer Survivorship (KSCS) aims to comprehensively assess cancer survivors’ health behaviors, quality of life (QoL), and socioeconomic challenges. This study evaluated the feasibility of the KSCS protocol and identified key factors influencing psychological health and QoL among cancer survivors. Methods: The nationwide survey targeted survivors diagnosed with breast, colorectal, liver, lung, stomach, prostate, and gynecological cancers who had completed active treatment within 1 to 10 years. The respondents were given the option to participate in the survey either online or in-person. The questionnaire has 229 questions, including internationally validated tools such as the EQ-5D-3L, PHQ-9, and GAD-7. Results: A total of 983 cancer survivors completed the survey (92.7% online, 8.3% in-person) and were categorized by post-diagnosis duration. Survivors diagnosed within 1–3 years reported higher rates of moderate-severe depression (11.4% vs. 8.3%), moderate-severe anxiety (5.9% vs. 5.1%), and poorest QoL (63.0% vs. 50.9%) compared to those diagnosed more than 5 years ago. Employment changes, such as loss of job, change of workplace, or work leave, were significantly associated with worse health outcomes, including higher rates of moderate-severe depression (OR = 4.39; 95% CI 2.43–7.96), moderate-severe anxiety (OR = 3.63; 95% CI 1.68–0.88), and having extreme QoL problems (OR = 6.37; 95% CI 2.03–20.00). Conclusions: The KSCS protocol is feasible for nationwide implementation and provides comprehensive data on health, psychological, and socioeconomic challenges among cancer survivors. Preliminary findings highlight employment’s critical role in cancer survivors’ well-being and the need for survivorship care that integrates socioeconomic and clinical factors. Full article

Background and Clinical significance: Cowden syndrome is an autosomal dominant disorder caused by germline loss-of-function mutations in the PTEN tumor suppressor gene. It is characterized by multiple hamartomas and an increased lifetime risk of malignancies affecting the breast, thyroid, endometrium, and gastrointestinal (GI) tract. Pediatric presentations may include macrocephaly, scrotal tongue, and intellectual disability. Gastrointestinal involvement is frequent, with juvenile-like hamartomatous polyps occurring in at least half of patients and distributed throughout the GI tract, posing a risk for malignant transformation. Early diagnosis and surveillance are crucial for improving patient outcomes. Case Presentation: We report a case of a 10-year-old Caucasian female with Cowden syndrome, with a history of a malignant germ cell tumor of the ovary consisting of a yolk sac tumor and low-grade immature teratoma diagnosed at age six, and thyroidectomy at age nine. The patient has mild intellectual disability. Routine radiological surveillance revealed a right colon intraluminal mass, prompting referral for pediatric gastroenterology evaluation. Endoscopy identified multiple polyps throughout the colon, stomach, and small intestine. Polypectomy of larger lesions was performed, and histopathology confirmed juvenile-like hamartomatous polyps without dysplasia or malignancy. This case highlights the necessity of comprehensive gastrointestinal evaluation in pediatric Cowden syndrome patients. Endoscopic surveillance is essential for early detection and management of polyps. Conclusions: Given the multisystem involvement and elevated cancer risk associated with PTEN mutations, a multidisciplinary approach that includes genetic counseling, dermatologic evaluation, and ongoing oncologic monitoring is recommended. Increased awareness of gastrointestinal manifestations enables timely intervention and may reduce morbidity and mortality in this high-risk population. Full article

Background/Objectives: The management of advanced HER2-positive and HER2-low breast cancer is evolving rapidly. This study aimed to generate national, evidence-based clinical recommendations for Colombia, addressing the lack of standardized local guidance. Methods: A systematic literature search (2020–2024) was conducted. The evidence was evaluated using AGREE II, RoB 2, ROBINS-I, and JBI tools. Recommendations were developed using the GRADE approach and a structured modified Delphi consensus process involving 34 national experts. Results: A total of 22 clinical recommendations were formulated. These address HER2 quantification and reporting, first-line and subsequent-line therapy, and management of brain metastases. Five recommendations (23%) were classified as strong, supported by high-certainty evidence, while 17 (77%) were conditional, reflecting the need for adaptation to local contexts and resource availability. Conclusions: This consensus provides updated, context-specific clinical guidance to optimize the care of patients with advanced HER2-positive and HER2-low breast cancer in Colombia. The recommendations are designed to standardize care, improve patient outcomes, and promote equitable access to innovative therapies within the Colombian healthcare system. Full article

Background: Bone scintigraphy using technetium-99m hydroxymethylene diphosphonate (^99mTc-HMDP) is extensively employed to detect bone metastases. However, incidental myocardial uptake may indicate wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM), a frequently overlooked diagnosis with important clinical implications. Case Presentation: Two elderly female patients with a history of breast cancer were subjected to ^99mTc-HMDP bone scintigraphy as part of a routine evaluation for possible bone metastases. Both cases demonstrated incidental myocardial uptake (Perugini Grade 2 and Grade 3, respectively), raising suspicion for ATTRwt-CM, which was subsequently confirmed by endomyocardial biopsy. Review of the Literature: We reviewed published studies reporting cardiac uptake on bone scintigraphy, summarizing the frequency, patient demographics, and tracer types, and emphasizing the clinical relevance of this finding in cancer patients. Conclusions: In oncology patients, bone scintigraphy performed during routine metastatic screening may facilitate early detection of ATTRwt-CM, enabling timely diagnosis and treatment initiation, potentially improving clinical outcomes. Full article

Background/Objectives: Assigned female at birth (AFAB) individuals who identify as transgender or gender-diverse (TGD) with concurrent breast cancer or high-risk genetic mutations represent a unique population, requiring consideration of oncologic and aesthetic goals. These patients sought chest masculinization with oncologic gender-affirming mastectomy (OGAM) or non-binary reconstruction to alleviate gender dysphoria and treat their breast cancer. There is limited literature on surgical techniques in this patient population. Methods: A retrospective chart review of AFAB TGD adults (>18 years of age) who underwent OGAM or non-binary reconstruction at the University of Washington between 2019 and 2023 was conducted. All patients had a consultation with a plastic surgeon for reconstruction and a minimum of one year follow-up. Demographic data, oncologic status, post-operative complications, and revision surgical history were collected. Results: Eight AFAB TGD individuals met the inclusion criteria. The mean age at the time of mastectomy was 35.13 years (SD = 8.04), and the mean BMI was 29.88 (SD = 6.40). Indications for mastectomy included a breast cancer diagnosis (N = 4) or a strong family history of breast cancer or genetic predisposition (N = 4). Two (25%) patients underwent nipple-sparing mastectomies (NSM), two patients (25%) underwent skin-sparing mastectomy with Goldilocks reconstruction, and four patients (50%) underwent simple mastectomy (oncologic gender-affirming mastectomy), flat closure with free nipple graft (FNG). Two patients had staged nipple mastectomy with secondary nipple reduction and fat grafting. Six patients had immediate reconstruction, four (50%) patients underwent immediate double-incision OGAM with FNG, and two (25%) patients underwent Goldilocks procedures—one with and one without FNG. One patient (12.5%) experienced a surgical site infection, and three patients (37.5%) underwent revision surgery. No patients had positive margins following their mastectomy. Conclusions: This case series highlights the importance of a multidisciplinary and highly personalized approach for AFAB and TGD individuals undergoing oncologic gender-affirming mastectomy or non-binary reconstruction. We reviewed reconstructive options performed at our institution, demonstrating safe oncologic and reconstructive techniques that emphasized collaboration between breast and plastic surgeons. Full article

Background/Objective: Breast cancer-related lymphedema (BCRL) is a frequent postoperative complication associated with shoulder functional impairment. Early diagnosis and comprehensive assessment are recommended, yet the literature shows heterogeneity regarding instrumental tools and the role of soft tissue ultrasound is not yet standardized. The aim of this retrospective observational study is to evaluate correlations between shoulder impairment and lymphedema in breast cancer patients. Methods: Medical records of 27 outpatient women after breast cancer surgery (mean age ± SD: 55.10 ± 9.58) were evaluated. Clinical variables included anamnestic data regarding surgery and oncology treatments, limb circumferences, passive shoulder range of motion (PROM), axillary web syndrome (AWS) and BMI. Assessment tools included DASH, ECOG, and VAS. Millimetric ultrasound measurements of the dermo-epidermal complex and subcutaneous tissue, at standardized sites, were performed to study limb lymphedema. Results: Lymphedema was found in 35.7% of patients. They showed higher rates of lymphadenectomy, AWS, higher BMI, limited shoulder flexion (p = 0.002) and abduction (p = 0.004), and higher DASH scores (31.99 ± 15.70 vs. 26.16 ± 17.8) compared with patients without lymphedema. There was a preliminary correspondence between circumferential and ultrasound measurement sites of patients’ lymphedema limbs. Conclusions: Ultrasound evaluation associated with functional assessment may support the early diagnosis of shoulder impairment and higher limb lymphedema risk to improve rehabilitation treatments in patients after breast cancer surgery. Full article

Background: Tumor-lysate vaccines can capture tumor heterogeneity; however, their effectiveness may be reduced by antigen instability and short antigen presentation. Here, we aimed to improve antigen protection and prolong presentation by using a slow-degrading polymeric nanocarrier and an approved adjuvant. Methods: We encapsulated breast cancer cell lysates (MCF-7 and MDA-MB-231) in poly(ε-caprolactone) (PCL) nanoparticles using a double-emulsion (w/o/w) method and co-administered them with alum. We then characterized particle size, PDI, zeta potential, morphology, and in vitro release. Next, we evaluated nitric oxide (NO), TNF-α/IL-10 responses, and cytocompatibility in J774 macrophages. Finally, we quantified serum antibody titers in Balb/c mice after six biweekly immunizations, generated hybridomas, purified IgG, and tested antibody-mediated cytotoxicity alone and together with doxorubicin. Results: PCL nanoparticles were ~220–255 nm (PDI 0.10–0.19; ζ −2 to −3 mV) and released ~90–95% of encapsulated lysate by 800 h (~33 days). Encapsulated lysate (40 μg/mL) modestly increased NO versus control and increased further with alum (p < 0.05). TNF-α increased 7.4–9.72-fold, whereas IL-10 rose 2.82–3.11-fold. Importantly, encapsulated antigen + alum produced the highest ELISA responses after the sixth dose (6.36-fold for MCF-7 and 7.00-fold for MDA-MB-231 versus control; p < 0.05). Hybridoma-derived antibody signals increased through day 42, and Protein G purification yielded up to ~395 μg and ~318 μg IgG. Purified antibodies reduced cell viability, and viability decreased further when antibodies were combined with doxorubicin (to ~31.6% in MCF-7 and ~40.3% in MDA-MB-231). Conclusions: Overall, sustained PCL-mediated antigen release combined with alum strengthened humoral responses to tumor lysate and enabled recovery of functional antibodies with diagnostic capture and in vitro cytotoxic activity. In future work, key mechanistic steps such as lymph-node trafficking and cross-presentation should be tested directly. Full article

The single-cell spatial transcriptomics (ST) data with cell type and spatial location, i.e., $(C,x,y)$ with C as cell type and $(x,y)$ as its spatial location, produced by recent biotechnologies, such as CosMx and Xenium, contain a huge amount of information about cancer tissue samples, thus have great potential for cancer research via detection of ST-Community which is defined as a collection of cells with distinct cell-type composition and similar neighboring patterns based on nearby cell-percentages. But for huge CosMx single-cell ST data, the existing clustering methods do not work well for st-community detection, and the commonly used kNN compositional data method shows lack of informative neighboring cell patterns. In this article, we propose a novel and more informative disk compositional data (DCD) method for single-cell ST data, which identifies neighboring patterns of each cell via taking into account of ST data features from recent new technologies. After initial processing single-cell ST data into the DCD matrix, an innovative DCD-TMHC computation method for st-community detection is proposed here. Extensive simulation studies and the analysis of CosMx breast cancer data, which is an example of single-cell ST dataset, clearly show that our proposed DCD-TMHC computation method is superior to other existing methods. Based on the st-communities detected for CosMx breast cancer data, the logistic regression analysis results demonstrate that the proposed DCD-TMHC computation method produces better interpretable and superior outcomes, especially in terms of assessment for different cancer categories. These suggest that our proposed novel and informative DCD-TMHC computation method here will be helpful and have an impact on future cancer research based on single-cell ST data, which can improve cancer diagnosis and monitor cancer treatment progress. Full article