Measuring the impact of the COVID-19 pandemic on breast cancer screening in Puerto Rico

Introduction: The COVID-19 pandemic has caused major changes to healthcare services, especially those related to early detection and screening practices like breast cancer. In Puerto Rico, breast cancer is the main cause of death, representing 18.9% of cancer deaths in women, making early detection even more important to prevent morbidity and mortality. This study aims to describe the impact of COVID-19 on breast cancer screening and assess differences in health utilization by age group and health regions in Puerto Rico. Method(s): This study used data on breast cancer screening medical claims from Puerto Rico Track, a project in collaboration with the Puerto Rico Public Health System and the Puerto Rico Institute of Statistics that aims to assess health access and utilization patterns in Puerto Rico. Claims including unilateral and bilateral mammography, sonommamography, and MRI were analyzed. Descriptive statistics and percentual changes between the COVID-19 baseline year (2016) compared with 2020 and 2021 were performed (overall, by age-group and health region). Result(s): A total of 193,793 screening tests were performed in 2016, compared to 66,463 in 2020, and 89,322 in 2021. Overall, a third of the medical claims for breast cancer screening (33.2%) were in the age group of 51-60 years. An overall decreasing percentual change was observed comparing 2016 vs. 2020 (65.7%), where the age group with the broadest gap reduction were among women 41-50 years old (68.2%). When comparing medical claims of 2016 (193,750) versus 2021 (89,320) (pre and post pandemic), an important decreasing change (53.9%) was observed. The age group with the highest decrease comparing 2016 to 2021 was the 41-50 years one (68.2%). The Western region of Mayaguez/Aguadilla had the highest decreasing percentual change, with a reduction of 73.6% in 2020 compared to 2016, and 62.6% when compared 2021 with 2016. Conclusion(s): Breast cancer screening was notably affected by the COVID-19 pandemic in Puerto Rico. A pattern of decreasing breast cancer screening was observed by health regions and by age. These efforts provide evidence of the need of tailored evidence-based interventions to increase breast cancer screening in the island.

A narrative review on radiation risk from imaging for COVID-19: Breaking the myths and the mithya

Radiotherapy-induced secondary malignancy is a well-known occurrence. During the COVID-19 pandemic, many people have undergone serial computed tomography (CT) imaging, and concerns have been raised regarding radiation-induced malignancies due to frequent scanning. Accordingly, various low and ultra-low-dose CT (LDCT) thorax protocols have been developed to reduce the dose of radiation. Major governing bodies worldwide have established guidelines regarding the indications for CT scans and chest X-rays during the pandemic. We, therefore, aimed to provide facts about the effects of radiation (both diagnostic and therapeutic). Through this article, we intend to break the myths and 'mithya' (misbeliefs) regarding diagnostic radiation and its association with cancer in this COVID-19 era. For this review, we performed a search in Google using specific keywords pertaining to imaging during COVID-19 and radiation risk. We also included the names of various global governing bodies in the Google search. We included only full text articles and guidelines from authentic websites. From this review, we conclude that if we follow the recommendations of various global governing bodies and use CT scan only in cases of moderate to severe COVID-related symptoms, adhere to the principle of 'as low as reasonably achievable' for radiation protection, and use LDCT scan protocols, we can significantly reduce the mean effective radiation dose delivered and the estimated cancer risk.Copyright © 2023 Cancer Research, Statistics, and Treatment. All rights reserved.

Experience of a single healthcare system with screening mammography before and after COVID-19 shutdown.

PURPOSE: To evaluate COVID-19's longitudinal impact on screening mammography volume trends. METHODS: HIPAA-compliant, IRB-approved, single institution, retrospective study of screening mammogram volumes before (10/21/2016-3/16/2020) and greater than two years after (6/17/2020-11/30/2022) a state-mandated COVID-19 shutdown (3/17/2020-6/16/2020) were reviewed. A segmented quasi-poisson linear regression model adjusting for seasonality and network and regional population growth compared volume trends before and after the shutdown of each variable: age, race, language, financial source, risk factor for severe COVID-19, and examination location. RESULTS: Adjusted model demonstrated an overall increase of 65 screening mammograms per month before versus a persistent decrease of 5 mammograms per month for >2 years after the shutdown (p < 0.0001). In subgroup analysis, downward volume trends were noted in all age groups <70 years (age < 50: +9/month before vs. -7/month after shutdown; age 50-60: +17 vs. -7; and age 60-70: +21 vs. -2; all p < 0.001), those identifying as White (+55 vs. -8, p < 0.0001) and Black (+4 vs. +1, p = 0.009), all financial sources (Medicare: +22 vs. -3, p < 0.0001; Medicaid: +5 vs. +2, p = 0.006; private insurance/self-pay: +38 vs. -4, p < 0.0001), women with at least one risk factor for severe COVID-19 (+30 vs. -48, p < 0.0001), and screening mammograms performed at a hospital-based location (+48 vs. -14, p = 0.0001). CONCLUSION: The screening mammogram volume trend more than two years after the COVID-19 shutdown has continued to decline for most patient populations. Findings highlight the need to identify additional areas for education and outreach.

Impact of COVID-19 in Cervical and Breast Cancer Screening and Systemic Treatment in Sao Paulo, Brazil: An Interrupted Time Series Analysis

PURPOSE COVID-19 caused a disruption in cancer management around the world, resulting in an estimated excess burden secondary to screening disruption and excess lag time for treatment initiation. METHODS We gathered information from primary reimbursement data sets of the public health system of Sao Paulo, Brazil, from April 2020 to November 2021, and compared these data with those of the pre-COVID-19 period. We used an interrupted time series model to estimate the effect of the COVID-19 pandemic on the rate of key procedures of breast and cervical cancer health care chain. RESULTS We estimated that 1,149,727, 2,693, and 713,616 pap smears, conizations, and mammograms, respectively, were missed or delayed during the COVID-19 pandemic, compared with those in the years immediately before the COVID-19 stay-at-home restrictions. Specifically, we observed an acute decrease of procedures after the COVID-19 stay-at-home restrictions, with a trend to recovery in the long term. Regarding the systemic treatment analysis, we observed a 25% reduction in the rate of initiation of adjuvant systemic treatment for early breast cancer (stage I/II). However, we did not find a clear effect on the other settings of systemic treatment for breast cancer. We estimated an excess of 156 patients starting palliative care for cervical cancer after the COVID-19 stay-at-home restrictions. CONCLUSION The COVID-19 pandemic significantly reduced the performance rate of pap smears, conizations, and mammograms. The initiation of adjuvant treatment for early-stage breast cancer was most susceptible to COVID-19's health system disruption. Furthermore, the downward trend of treatment of advanced cervical cancer was interrupted. Therefore, public health policies are urgently needed to decrease the incidence of advanced cervical and breast cancers caused by delayed diagnosis and treatment initiation. The COVID-19 control policies resulted in reduction of cancer patients' delivery of care. This study evaluated the pandemic's influence in key procedures of breast and cervical cancer chain of care in Sao Paulo, Brazil. We observed a substantial reduction in the number of mammograms, pap smears, and conizations performed since the onset of the COVID-19 pandemic. In addition, stage I and II breast cancer adjuvant treatment presented a reduced realization rate, whereas palliative treatment delivered for advanced cervical cancer increased. Our results support the need for public health policies focused on mitigating the long-term effects of COVID-19 in cancer-related mortality. (C) 2022 by American Society of Clinical Oncology

Impact of SARS-CoV-2 immunization on a breast screening programme

BACKGROUND: A common secondary effect after SARS-CoV-2 immunization is an increased in size of the axillary lymph nodes ipsilateral to the vaccinated site. Eventually, an increased in size of the axillary lymph nodes may lead to a misinterpretation of the breast screening mammogram, performed in asymptomatic women between the age 50 to 69 years old for early breast cancer diagnosis. The aim of our research was to evaluate the impact of the vaccination for SARS-CoV-2 in the breast screening programmes in terms of recall rates and number of false positive results. As a secondary purpose we would analysed the protocols adopted by different breast screening units around the world after SARS-CoV-2 vaccination. METHODS: Observational and retrospective study analysing breast screening mammograms from a single Breast Cancer Screening Unit in Madrid. The mammograms of previously vaccinated women were analysed, reviewing the axillary lymph nodes and the re-call rate secondary to axillary lymphadenopathies. RESULTS: Four hundred and twenty three screening mammograms were performed in May 2021 in the University Hospital Ramon y Cajal in Madrid, which is part of the Breast Screening Programme in Madrid, Spain. None of the women previously vaccinated for SARS-CoV-2 were recalled for complementary studies due to an increased in the axillary lymph nodes. CONCLUSIONS: The protocol stablished by the Spanish Society of Breast Image that stands up for a routine breast screening mammogram after SARS-CoV-2 immunization, has no increase in the recall rate or increase in number of false positives.

Impact of COVID-19 on breast cancer screening in the Brazilian Unified Health System (SUS)

Objectives: investigating the impact of the pandemic on breast cancer screening in the Unified Health System, in addition to comparing the data obtained from other countries. Method(s): a quantitative cross-sectional observational study was carried out, with references from the Cancer Information System - SISCAN on the number of mammograms performed from 2014 to 2022 by women in Brazil. Result(s): data regarding mammography in the high-risk population showed a drop of 38, 39% from 2019 to 2020. While in screening mammography, the decline was slightly more significant, at 39.18% in the same period. Regarding diagnostic mammography, the reduction was 33.15%, and in target population mammography, the peak was in 2019 with 2.721.075. On the other hand, the performance of mammography in patients already treated had a smaller decrease of 9.35%. Conclusion(s): there was a significant reduction in the number of mammograms performed in 2019 and 2020, which might lead to a late diagnosis of the disease and a worse prognosis.Copyright © 2023 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.

The impact of the COVID-19 pandemic on the diagnosis of malignant neoplasms during preventive medical examinations.

The restrictive social distancing strategy during the COVID-19 pandemic in the healthcare system has led to a reduction in measures for the active detection of malignant neoplasms (MNs). Objective. To evaluate the impact of a temporary stop the measures for the secondary prevention of MNs on the frequency of detected cases of the disease during preventive medical examinations (PMEs). Materials and methods. The efficiency of active MN detectability in 2020 versus the pre-COVID-19 period (2018-2019) was com-paratively analyzed in 17 regions of the Central Federal District (CFD) of Russia. Information on the coverage of the population with PMEs and on the frequency of detected cancer cases when using fluorographic, mammographic, and cytological studies was obtained from the study of the data contained in the information project <<Passport of an Oncology Dispensary>> of the P.A. Herzen Moscow Oncology Research Institute, as well as those available in the public domain on the Internet and on the official websites of regional health authorities. Results. The comparative analysis of the results of PMEs did not reveal significant differences in their efficiency in the studied regions of the Central Federal District of Russia in 2018 and 2019. Compared to the pre-COVID-19 period in 2020, there was a sta-tistically significant decline in the population coverage with primary care, which was 33.2+/-2.3% among both sexes (p<0.01), 25.8+/-2.3 for males (p<0.05) and 39.7+/-3.0% females (p<0.01). The frequency of detected cancer cases was 1.0 in the general population, 0.6 for males and 1.2 for females. There was an increase in the number of detected cases during fluorographic (+27.1%) and mammographic (+22.9%) studies and a decrease in the proportion of cytologically detected MNs (-33.2%). At the same time, due to a decline in the number of the surveyed population in 2020, there was a decrease in the number of detected cancer cases of the lung (-34.8%), breast (-37.1%), as well as tumors diagnosed cytologically (-65.9%). Conclusion. This investigation may suggest that at least 1.065 lung cancer cases and 1.875 breast ones were not diagnosed due to the temporary reduction in PMEs in the regions studied.Copyright © 2021, Media Sphera Publishing Group. All rights reserved.

Impact of the COVID-19 Pandemic on Clinical Findings in Medical Imaging Exams in a Nationwide Israeli Health Organization: Observational Study.

BACKGROUND: The outbreak of the COVID-19 pandemic had a major effect on the consumption of health care services. Changes in the use of routine diagnostic exams, increased incidences of postacute COVID-19 syndrome (PCS), and other pandemic-related factors may have influenced detected clinical conditions. OBJECTIVE: This study aimed to analyze the impact of COVID-19 on the use of outpatient medical imaging services and clinical findings therein, specifically focusing on the time period after the launch of the Israeli COVID-19 vaccination campaign. In addition, the study tested whether the observed gains in abnormal findings may be linked to PCS or COVID-19 vaccination. METHODS: Our data set included 572,480 ambulatory medical imaging patients in a national health organization from January 1, 2019, to August 31, 2021. We compared different measures of medical imaging utilization and clinical findings therein before and after the surge of the pandemic to identify significant changes. We also inspected the changes in the rate of abnormal findings during the pandemic after adjusting for changes in medical imaging utilization. Finally, for imaging classes that showed increased rates of abnormal findings, we measured the causal associations between SARS-CoV-2 infection, COVID-19-related hospitalization (indicative of COVID-19 complications), and COVID-19 vaccination and future risk for abnormal findings. To adjust for a multitude of confounding factors, we used causal inference methodologies. RESULTS: After the initial drop in the utilization of routine medical imaging due to the first COVID-19 wave, the number of these exams has increased but with lower proportions of older patients, patients with comorbidities, women, and vaccine-hesitant patients. Furthermore, we observed significant gains in the rate of abnormal findings, specifically in musculoskeletal magnetic resonance (MR-MSK) and brain computed tomography (CT-brain) exams. These results also persisted after adjusting for the changes in medical imaging utilization. Demonstrated causal associations included the following: SARS-CoV-2 infection increasing the risk for an abnormal finding in a CT-brain exam (odds ratio [OR] 1.4, 95% CI 1.1-1.7) and COVID-19-related hospitalization increasing the risk for abnormal findings in an MR-MSK exam (OR 3.1, 95% CI 1.9-5.3). CONCLUSIONS: COVID-19 impacted the use of ambulatory imaging exams, with greater avoidance among patients at higher risk for COVID-19 complications: older patients, patients with comorbidities, and nonvaccinated patients. Causal analysis results imply that PCS may have contributed to the observed gains in abnormal findings in MR-MSK and CT-brain exams.

Impact of COVID-19 on Public Interest in Breast Cancer Screening and Related Symptoms: Google Trends Analysis.

BACKGROUND: The COVID-19 pandemic has led to a decrease in cancer screening due to the redeployment of health care resources and public avoidance of health care facilities. Breast cancer is the most common cancer diagnosed in female individuals, with improved survival rates from early detection. An avoidance of screening, resulting in late detection, greatly affects survival and increases health care resource burden and costs. OBJECTIVE: This study aimed to evaluate if a sustained decrease in public interest in screening occurred and to evaluate other search terms, and hence interest, associated with that. METHODS: This study used Google Trends to analyze public interest in breast cancer screening and symptoms. We queried search data for 4 keyword terms ("mammogram," "breast pain," "breast lump," and "nipple discharge") from January 1, 2019, to January 1, 2022. The relative search frequency metric was used to assess interest in these terms, and related queries were retrieved for each keyword to evaluate trends in search patterns. RESULTS: Despite an initial drastic drop in interest in mammography from March to April 2020, this quickly recovered by July 2020. After this period, alongside the recovery of interest in screening, there was a rapid increase in interest for arranging for mammography. Relative search frequencies of perceived breast cancer-related symptoms such as breast lump, nipple discharge, and breast pain remained stable. There was increase public interest in natural and alternative therapy of breast lumps despite the recovery of interest in mammography and breast biopsy. There was a significant correlation between search activity and Breast Cancer Awareness Month in October. CONCLUSIONS: Online search interest in breast cancer screening experienced a sharp decline at the beginning of the COVID-19 pandemic, with a subsequent return to baseline interest in arranging for mammography followed this short period of decreased interest.

Sister, Give Me Your Hand: a Qualitative Focus Group Study on Beliefs and Barriers to Mammography Screening in Black Women During the COVID-19 Era.

AIMS/PURPOSE: To evaluate current day challenges and beliefs about breast cancer screening for Black women in two diverse northeast communities in the midst of the COVID-19 pandemic. BACKGROUND: Breast cancer is the second leading cause of cancer-related death in women in the USA. Although Black women are less likely to be diagnosed with breast cancer, they suffer a higher mortality. Early detection of breast cancer can be accomplished through routine screening mammography, yet the effect of the COVID-19 pandemic on mammography screening barriers and perception in minority communities is uncertain. METHODS: Five focus group interviews were conducted as the first phase of a mixed method study across two heterogeneously diverse locations, Camden, New Jersey, and Brooklyn, New York. RESULTS: Thirty-three women participated in this study; sixteen women were recruited at the New Jersey location and seventeen at the New York location. Only two thirds of the women stated that they had received a mammogram within the last 2 years. The major themes were binary: I get screened or I do not get screened. Subthemes were categorized as patient related or system related. CONCLUSIONS: Our findings on factors that affect breast cancer screening decisions during the COVID-19 era include barriers that are related to poverty and insurance status, as well as those that are related to medical mistrust and negative healthcare experiences. Community outreach efforts should concentrate on building trust, providing equitable digital access, and skillfully addressing breast health perceptions.

Patterns of Screening Mammography and Breast MRI During the COVID-19 Pandemic: A Retrospective, Chart-Review Study.

Objective: This study examined patterns of breast cancer screening during the COVID-19 pandemic. Methods: This retrospective study was approved by the Georgetown University IRB. Review of electronic medical records identified screening mammograms and breast MRIs between March 13, 2018 and December 31, 2020, for female patients aged 18 to 85 years. Descriptive statistics characterized patterns of breast cancer screening before and during the COVID-19 pandemic. Logistic regression analyses examined whether receipt of breast MRI differed over time and demographic and clinical factors associated with receipt of breast MRI in 2020. Results: Data included 47 956 mammography visits in 32 778 patients and 407 screening breast MRI visits in 340 patients. After an initial decrease following the declaration of the COVID-19 pandemic, both screening mammograms and screening breast MRI demonstrated early recovery. Although the mammography receipt remained sustained, the receipt of screening breast MRI decreased in late 2020. Odds of having a breast MRI did not differ between 2018 and 2019 (OR = 1.07; 95% CI = 0.92%-1.25%; P = 0.384) but were significantly lower in 2020 versus 2019 (OR = 0.76; 95% CI = 0.61%-0.94%; P = 0.011). No demographic or clinical factors were associated with receipt of breast MRI during the COVID-19 pandemic (all P-values ≥0.225). Conclusion: Breast cancer screening decreased following the declaration of the COVID-19 pandemic. Although both procedures demonstrated early recovery, the rebound in screening breast MRI was not sustained. Interventions promoting return to screening breast MRI may be needed for high-risk women.

Real world evidence from a Breast Screening pilot for the underprivileged: Experiences from Bruhat Bengaluru Mahanagara Palike hospitals

Background: In India, less than 5% of women get routine screening for breast cancer due to lack of awareness and the absence of a coordinated national breast cancer screening programme. A community health initiative was launched by Niramai in collaboration with City Health officials in Bangalore as a pilot to increase awareness and make breast health screening available to all. Free breast cancer screening using AI powered Thermalytix test is being offered to all the underprivileged women walking into Bruhat Bengaluru Mahanagara Palike (BBMP) government hospitals from November 14, 2017 till today (after a break for 15 months during COVID). Material(s) and Method(s): This observational study was conducted in 22 BBMP-affiliated primary health centers where outpatient women over the age of 18 years and not pregnant were enrolled. The procedure included a briefing on camp procedures, taking patient consent, identification of eligible candidates, general health education, and conducting the Thermalytix test by a healthcare worker who was trained to use the Thermalytix software tool. Women were triaged using the output generated by Thermalytix 180. Those triaged as red were referred for further detailed imaging investigation in a district hospital using mammography, ultrasound and FNAC/biopsy. Result(s): A total of 6935 women underwent Thermalytix screening in 22 BBMP hospitals during Nov 2017 to July 2022. A total of 1687 participants were excluded from the analysis as they did not meet the eligibility criteria. The median age of the 5248 eligible participants was 42 years (range 18-86). Among them, 90 women (1.71%) had previously noticed a lump in their breast, 431 women (8.12%) had breast pain, 16 women had complained of nipple discharge, and 5 women had noticed skin discoloration. When screened, 62 (1.2%) women were detected with abnormalities and triaged positive by Thermalytix. Among them 11 women have so far gone through diagnostic investigations, of which 8 were radiologically positive and were recommended for histopathology correlation. The overall test positivity rate of Thermalytix in this cohort was 1.2% and positive predictive value with radiological positivity as reference was found to be 9/11 = 81.81%. Furhter histological analysis reported 1 DCIS and 8 benign fibroadenoma. The tests were conducted in screening camps and the average cost of conducting the test in the field came to around 6.5 USD per person. Conclusion(s): Thermalytix could be a potential automated screening tool for population-level screening in resource constrained settings. The portable equipment enabled easy movement across different PHCs. Since it is a privacy-aware test, there was less refusal to participate in the test. Community mobilization with the help of the local government health officials was crucial to ensure walk-ins. Conflict of interest: Ownership: yes Board of Directors: yes Corporate-sponsored Research: yesCopyright © 2022 Elsevier Ltd. All rights reserved

COVID-19 Pandemisinin Kanser Erken Teşhis Tarama ve Eğitim Merkezleri Hizmetlerinin Kullanımına Etkisi

Objective: This study was conducted to evaluate the impact of the COVID-19 pandemic on the use of Cancer Early Diagnosis, Screening, and Education Centers (KETEM) services. Materials and Methods: In this study, which was conducted as a descriptive retrospective cohort type, a total of 52.955 patient application records made to KETEM between January 1st and December 31st, 2017-2020 and January 1st-1 October 2021 were examined. The data obtained within the scope of the study were expressed as frequency and percentage. Results: In the study, it was determined that the numbers decreased as compared to previous three years (2017, 2018 and 2019) 70.4%, 59.1%, 68.8% for mammography screenings, 75.8%, 68.8%, 65.8% for HPV-Pap smear scans and 46.1%, 81.9%, and 72.2% for colorectal scans, respectively. Conclusion: It was detected that mammography, HPV-Pap, smear, and colorectal screenings offered within the scope of KETEM services decreased significantly in 2020 and 2021 which includes the pandemic process, compared to the previous years. It is estimated that cancers that cannot be detected in the early period due to the decrease in the number of applications will cause a significant increase in cancer mortality in the following years. Accordingly, it is recommended that the society, especially the individuals in the risk group, not delay their applications to cancer screening services, to take the necessary pandemic measures to inform them about making their applications without delay, and to improve their awareness about this issue. Amaç: Bu çalışma COVID-19 pandemisinin Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri (KETEM) hizmetlerinin kullanımı üzerindeki etkisini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Retrospektif kohort tipinde betimleyici olarak yürütülen bu araştırmada, 2017-2020 yıllarında 1 Ocak-31 Aralık tarihleri ile 1 Ocak-1 Ekim 2021 tarihleri arasında bir ilin Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri'ne yapılan toplam 52.955 hasta başvuru kaydı incelenmiştir. Çalışma kapsamında elde edilen veriler frekans ve yüzde ile ifade edilmiştir. Bulgular: Çalışmada 2020 yılındaki mamografi tarama sayısının önceki üç yıla kıyasla (2017, 2018, 2019) sırasıyla %70.4, %59.1, %68.8 oranında;HPV-Pap smear tarama sayısının %75.8, %68.8, %65.8 oranında;kolorektal tarama sayısının ise sırasıyla %46.1, %81.9 ve %72.2 oranında düştüğü saptanmıştır. Sonuç: Bu araştırmada KETEM hizmetleri kapsamında sunulan mamografi, HPV-Pap smear ve kolorektal taramalarının pandemi sürecini kapsayan 2020 ve 2021 yıllarında önceki yıllara nazaran önemli düzeylerde azaldığı belirlenmiştir. Başvuru sayısındaki azalmaya bağlı olarak erken dönemde tespit edilemeyen kanserlerin ilerleyen yıllarda kanser mortalitesinde önemli bir artışa neden olacağı ön görülmektedir. Bu doğrultuda özellikle risk grubunda yer alan bireyler başta olmak üzere toplumun kanser tarama hizmetlerine başvurularını ertelememeleri, gerekli pandemi tedbirlerini alarak vakit kaybetmeden başvurularını gerçekleştirmeleri konusunda bilgilendirilmesi ve bu duruma yönelik farkındalıklarının geliştirilmesi önerilmektedir.

MaThAI: A MultiModal imaging combining Mammography and Thermalytix for better prioritization of mammography scans to detect early malignancies

Background: Breast cancer screening helps in early intervention and treatment. Post COVID, there is a huge backlog of women who missed their regular screening resulting in increased workload for radiologists, delayed reporting and intervention for malignant women. Thermalytix is an AI-based tool over thermal images that generates a 5 point score called B-Score where 5 is highest suspected risk for breast cancer and 1 is the lowest risk. In this study, we propose and evaluate a multimodal imaging modality called MaThAI that combines mammography and Thermalytix for prioritization of Mammography scans using B-Score. Material(s) and Method(s): Data from two clinical studies were pooled together and a total of 583 women who took both mammography and thermal scans were included in the study. Among them, 72 women were diagnosed to be malignant using mammography, ultrasound, and/or biopsy. Sensitivity and specificity of (i) Mammography alone (as reported by experienced radiologists), (ii) Thermalytix alone (using B-Score >=3 as positive) and (iii) MaThAI (considering a scan as positive if either Mammogram interpretation or Thermalytix interpretation or both were positive) were computed. As a second experiment, we assessed the benefit of MathAI prioritized mammography scans by estimating the reporting times for detecting 95% malignant patients. Result(s): The sensitivity and specificity of mammography were 81.9% and 98.8%, respectively, assuming BIRAD 0 as negative. Assuming BIRAD 0 as positive the sensitivity and specificity were 90.3% and 86.9%, respectively. Six malignancies were found in the 67 women with inconclusive reports (BIRADS 0). When Thermalytix B-Score was considered, the sensitivity and specificity were 94.4% and 81.0%, respectively. MaThAI showed an overall sensitivity and specificity of 98.6% (CI: 95.9%-100%) and 80.6% (CI: 77.2%-84.1%), respectively. The combo modality increased sensitivity over mammography alone by 16.7%, and Thermalytix alone by 4.2%, while decreasing the specificity of mammography by 6.3%. In the second experiment, we evaluated the benefit of MaThAI in prioritizing mammography scans using Thermalytix B-Score. Assuming mammography interpretation time is 20 minutes per exam and considering the order of the interpretation to be scan date + time, a single radiologist would have released the reports of 95% of the women with malignancy in 6720 minutes. Whereas using B-Score to reorder the scans for interpreting, the same radiologist would release the reports of 95% of the women with malignancy in 3080 minutes. Conclusion(s): MaThAI is a promising multimodal tool for breast screening that enables effective and efficient adjunct usage of thermal image along with mammography. It was effective in increasing the sensitivity of mammography by 16.7% and is estimated to reduce the reporting time for malignant patients by 54%. Conflict of interest: Ownership: Yes Board of Directors: Yes Corporate-sponsored Research: YesCopyright © 2022 Elsevier Ltd. All rights reserved

Effects of delayed callback from screening mammography due to the COVID-19 pandemic.

OBJECTIVE: To determine the frequency and distinguishing imaging characteristics of breast cancers detected on screening mammography which was initially evaluated as a probably benign lesion and the workup was delayed due to the COVID-19 pandemic. MATERIALS AND METHODS: REB-approved multicenter retrospective screening mammography studies and patient's chart review carried out between February 2020 and March 2020. According to an institutional decision, the frequency and imaging findings deemed probably benign on screening mammography after review by a breast fellowship-trained radiologist with workup deferred until after the first pandemic wave plateau in late July 2020 were recorded. Results were correlated with histopathology if tissue sample performed or an uneventful 2 years follow-up. Descriptive statistical analysis was used to describe the retrieved data set. RESULTS: Out of 1816 mammography screening between February 2020 and March 2020, 99 women, median age 58 years (range 35-84), 99 mammography had possibly benign findings with workup delayed, and two patients, age 49 and 56, had cancers (2.02%), misinterpreted as benign findings. Both malignant cases were focal asymmetries, with pathology of invasive ductal carcinoma, 12 mm and 9 mm in size. No in-situ carcinoma was detected. CONCLUSION: The low rate of cancer detected suggests that a delay callback may be a reasonable option for some likely benign findings when immediate callback is not an option, such as during a pandemic. Larger studies would be helpful to support our findings and may allow us to translate the adoption of such a model during potential future pandemic. CLINICAL RELEVANCE: The results of this study may be helpful for a future situation when delaying a call back from screening mammography is again required.

A study on assess the knowledge towards warning signs of breast cancer and prevention among the 4th year b.sc nursing student from SBCN

The most life-threatening illness that is the primary cause of female morality is Breast cancer. Breast cancer research has led to extraordinary breakthroughs in our understanding of the illness over the last two decades, leading in more effective medicines. Now days, In most Of all malignant diseases, one of the most deadly occurring cancer are those cancers occurring in the breast, accounting for 23 percent of all cancer fatalities. It is now a global issue, yet it is still detected in its advanced stages due to women's neglect in self-inspection. The greater parts of people learn from their disease is thorough practice of screening procedures. Others may come with a breast lump that was discovered by accident, a change in breast shape or size, or nipple discharge, although mastalgia is not unusual. To diagnose breast cancer, a physical examination, imaging, particularly mammography, and tissue biopsy are required. Early detection increases the chances of survival.Copyright © 2022 Novyi Russkii Universitet. All rights reserved.

Racial and Ethnic Disparities in Screening Mammography During COVID-19

Purpose: Studies conducted prior to COVID-19 suggested that racial/ethnic disparities in breast cancer screening percentages have substantially reduced over time. COVID-19 has had devastating effects on racial/ethnic minorities and resulted in delays in preventive breast cancer screening. Our purpose was to determine if racial/ethnic minorities were less likely to receive recommended breast cancer screening after the resumption of preventive care during the COVID19 pandemic. Method(s): HIPAA-compliant, institutional review board exempt retrospective cohort study was performed at a multi-location academic medical center located in the Midwest. Patients included women aged 50-74 years old between June 2021 and May 2022, derived from the electronic medical records. Primary outcomes variables included receipt of screening mammogram within the last two years. Primary exposure variables included race (American Indian/Alaska Native, Asian/Native Hawaiian/Other Pacific Islander, Black or African American, White) and ethnicity (Hispanic/Latino, and Not Hispanic/Latino). Binary outcomes were analyzed using logistic regression, adjusted for potential confounders (insurance, age, preferred language, employment status, rural status). Result(s): 37,509 female patients without histories of mastectomies were included (mean age 63.1). 73.8% of eligible patients received a mammogram within the last two years. By race, 74.7% of White patients, 57.6% of Black patients, 67.0% of Asian/Pacific Islander patients, and 60.1% of American Indian patients received a screening mammogram within the last two years. In our unadjusted analyses, Black (OR 0.46, 95% CI 0.41 to 0.52, p < 0.001), Asian (OR 0.69, 95% CI 0.60 to 0.79, p < 0.001), and American Indian patients (OR 0.51, 95% CI 0.39 to 0.66, p < 0.001) were less likely to receive recommended mammography screening. In our adjusted analyses, Black (OR 0.54, 95% CI 0.47 to 0.61, p < 0.001), Asian (OR 0.79, 95% CI 0.68 to 0.92, p = 0.003), and American Indian patients (OR 0.63, 95% CI 0.48 to 0.82, p = 0.001) were less likely to receive recommended mammography screening. By ethnicity, 74.1% of Non-Hispanic patients and 64.2% of Hispanic patients received a screening mammogram within the last two years. In our unadjusted analyses, Hispanic patients (OR 0.62, 95% CI 0.55 to 0.71, p < 0.001) were less likely to receive recommended mammography screening. In our adjusted analyses, Hispanic patients (OR 0.92, 95% CI 0.79 to 1.08, p = 0.338) were comparably likely to receive recommended mammography screening. Patients with non-English preferred languages, uninsured or Medicaid patients, and patients living in rural areas were less likely to receive recommended mammography screening (p < 0.001). Conclusion(s): Racial/ethnic minority patients were less likely to receive recommended cancer screening after the resumption of preventive breast cancer screening during the COVID-19 pandemic. Targeted outreach efforts are required to ensure equitable access to breast cancer screening for racial/ethnic minorities, patients with non-English preferred languages, uninsured, Medicaid, and rural patients.