Effectiveness of Tomosynthesis Versus Digital Mammography in the Diagnosis of Suspicious Lesions for Breast Cancer in an Asymptomatic Population.

Introduction The most frequent malignant tumor in women is breast cancer. A dense breast may mask lesions within the tissue. The constant improvement in diagnosis techniques has made the diagnosis more accurate. Digital mammography loses sensitivity in dense breasts as lesions may be masked by the over-position of tissue. Tomosynthesis increases sensitivity and specificity over diagnostic mammography. In this study, we examine the effectiveness of tomosynthesis versus digital mammography in asymptomatic patients. Materials and methods A cohort study of 1,499 Mexican patients that came for screening at a private health service from January to December 2015. A Breast Imaging Reporting and Database System (BI-RADS) classification was given by a breast radiologist with the digital mammography reading. Later, a second breast radiologist reviewed the same patients with tomosynthesis and assigned a second BI-RADS category. Results Patients were divided into three age groups. The one with the most had patients between 40-49 years (51.3%), where re-staging to a higher BI-RADS occurred in 40 patients. Re-staging to a lower category was most common in the group of age above 50, where 30 patients were assigned BI-RADS 2 after tomosynthesis. Dense breast (C and D) represented 38%. After tomosynthesis, 28 patients were classified as BI-RADS 4 or 5. The prevalence of diseases in groups BI-RADS 4 and BI-RADS 5 after re-staging and a breast cancer result was 0.024, with a sensitivity of 54% and a specificity of 88%. When re-staging 2D mammography with 3D tomosynthesis for suspicious lesions classified BI-RADS 3, 4, or 5, the prevalence was 0.23, with a sensitivity of 45% and a specificity of 98%. In this study, patients were asymptomatic, yet 20 breast cancers were detected, with a sensitivity of 54% and a specificity of 88%, exceeding the specificity of diagnostic mammography. Moreover, when re-staging to a BI-RADS of suspicious findings, the sensitivity was 45%, with a specificity of as high as 98%.

Pregnancy-Associated Breast Cancer: What Radiologists Must Know.

Pregnancy-associated breast cancer (PABC) is defined as breast cancer diagnosed during pregnancy, in the first year postpartum, or during breastfeeding. Imaging techniques play a significant role in the diagnosis of PABC. It is a challenging diagnosis since physiological changes seen in pregnancy and breastfeeding may limit clinical suspicion and imaging utility. The patient's well-being and the fetus must be taken into consideration for diagnosis and treatment.

Gardens as Science Learning Contexts Across Educational Stages: Learning Assessment Based on Students' Graphic Representations.

The educational use of daily-life contexts is considered a valuable strategy to promote meaningful science learning, since it facilitates the establishment of connections between previous knowledge, personal interests, and new learning. The aim of this work is to provide evidence to support the presence of gardens at educational centers, by assessing key science topics whose learning is promoted at the pre-school, primary, secondary, and university stages. To this end, we analyzed the paired graphic representations of "a garden" that students drew both before and after their participation in a garden-based learning program. Firstly, we obtained the frequency of appearance of every represented element, and afterward characterized the level of change between paired graphic representations. Sample size was of 24-19-25-29 pairs per stage, respectively. Across all stages, an overall improvement in students' graphic expression was observed, which can be attributed to their experience in the space. At the pre-school stage, the garden favored the establishment of some simple cause-effect relationships which were consolidated at the primary stage, and provided a climate of motivation and affectivity that was evident in the final drawings, given the enormous quantity of details represented, the level of the finished product, and the careful combination and variety of colors. The presence of elements related to water notably increased in final graphic representations from pre-school, primary, and secondary education, thus evidencing that the use of gardens facilitates an approach to responsible water management. At the university stage, students initially demonstrated good knowledge of conventional agriculture, while the gardening experience -which was based on permaculture practices- helped evolve their ideas toward an alternative model of cultivation. The most prevalent science learning across all stages was related to plant knowledge, particularly to their anatomical traits and diversity. Finally, the role of educational gardens as models for students was evidenced, which suggests the importance of teachers and institutions carefully considering which model to offer. Overall, our results support the legitimacy of incorporating gardens to educational centers, particularly for promoting contact with live plants and plant knowledge, and potentially for promoting contact with garden fauna and activities oriented toward learning about it.