Imaging features of pure and mixed forms of mucinous breast carcinoma with histopathological correlation.

METHODS:: A cross-sectional study identified cases of mucinous breast carcinoma from pathology records (2004-2012). Two radiologists classified imaging features by consensus and two pathologists classified cases into pure or mixed subtypes. Bi-variable analyses were performed using relevant statistical tests. RESULTS:: We identified 80 lesions in 77 female patients (median age 65 years, range 29-88): 58 lesions on mammograhy, 72 on ultrasound, and 25 on MRI. Statistically significant findings (p < 0.05) are as follows. On mammography, tumour margins tended to be indistinct (12, 48%) and spiculated (11, 44%) for pure and mixed lesions, respectively. Pure mucinous masses were less microcalcified (23, 77%) and mixed masses equally so. On ultrasound, pure tumours tended towards an irregular or oval shape (44, 42%) with mixed tumours having an irregular shape (78%). More pure tumours (53%) had posterior acoustic enhancement than mixed lesions (33%), and all pure tumours lacked posterior acoustic shadowing. Pure lesions had a heterogeneous echo pattern more than mixed tumours (78% vs 39%). On MRI, pure tumours tended towards a persistent kinetic curve (42%) whereas mixed tumours predominantly had a washout pattern (75%). Most pure tumours were T2 hyperintense (83%) whereas mixed lesions were T2 isointense or hyperintense (61%, 23%), respectively. CONCLUSION:: An analysis of imaging features can help to infer underlying histology of pure and mixed forms of mucinous breast carcinoma. ADVANCES IN KNOWLEDGE:: Pure mucinous carcinomas present less suspicious imaging features than mixed mucinous carcinomas and could be mistaken for non malignant lesions. An imaging analysis of mucinous breast carcinoma can help infer their underlying histology.

Serum and red-blood-cell folate demonstrate differential associations with BMI in pregnant women.

OBJECTIVE: To examine the association between BMI and folate concentrations in serum and red blood cells (RBC) in pregnant women. DESIGN: A cross-sectional comparison of folate concentrations in serum and RBC sampled simultaneously from the same individual. SETTING: The Ottawa Hospital and Kingston General Hospital, Ontario, Canada. SUBJECTS: Pregnant women recruited between 12 and 20 weeks of gestation. RESULTS: A total of 869 pregnant women recruited from April 2008 to April 2009 were included in the final analysis. Serum folate was inversely associated and RBC folate positively associated with BMI, after adjusting for folic acid supplementation, age, gestational age at blood sample collection, race, maternal education, annual income, smoking and MTHFR 677C→T genotype. In stratified analyses, this differential association was significant in women with the MTHFR CC variant. In women with the CT and TT variants, the differential associations were in the same direction but not significant. Folic acid supplementation during pregnancy did not alter the differential association of BMI with serum and RBC folate concentration. This indicates that the current RBC folate cut-off approach for assessing risk of neural tube defects in obese women may be limited. CONCLUSIONS: BMI is inversely associated with serum folate and positively associated with RBC folate in pregnant women, especially for those with the MTHFR CC variant.

Mail merge can be used to create personalized questionnaires in complex surveys.

BACKGROUND: Low response rates and inadequate question comprehension threaten the validity of survey results. We describe a simple procedure to implement personalized-as opposed to generically worded-questionnaires in the context of a complex web-based survey of corresponding authors of a random sample of 300 published cluster randomized trials. The purpose of the survey was to gather more detailed information about informed consent procedures used in the trial, over and above basic information provided in the trial report. We describe our approach-which allowed extensive personalization without the need for specialized computer technology-and discuss its potential application in similar settings. RESULTS: The mail merge feature of standard word processing software was used to generate unique, personalized questionnaires for each author by incorporating specific information from the article, including naming the randomization unit (e.g., family practice, school, worksite), and identifying specific individuals who may have been considered research participants at the cluster level (family doctors, teachers, employers) and individual level (patients, students, employees) in questions regarding informed consent procedures in the trial. The response rate was relatively high (64%, 182/285) and did not vary significantly by author, publication, or study characteristics. The refusal rate was low (7%). CONCLUSION: While controlled studies are required to examine the specific effects of our approach on comprehension, quality of responses, and response rates, we showed how mail merge can be used as a simple but useful tool to add personalized fields to complex survey questionnaires, or to request additional information required from study authors. One potential application is in eliciting specific information about published articles from study authors when conducting systematic reviews and meta-analyses.