Ultrasound-Guided Needle Biopsy of Suspected Microcalcifications in the Breast.

Background: Sonography plays an important role in characterizing breast masses and in guiding needle core biopsies and wire localizations of suspicious sonographis abnormalities. Objective: The aim of this study was to show the possibilities of high frequency ultrasound devices in the presentation of microcalcifications of the breast, and the use of these possibilities in performing needle biopsy under ultrasound control. Methods: This was a retrospective study conducted from May 2017 to December 2020 on 32 women, 29-86 years of age using mammograms and ultrasound to show suspected microcalcifications (radiological findings of BI RADS 4B and 4C), and needle biopsy led by ultrasound that confirmed the diagnosis of breast cancer. Patients with suspected microcalcifications on mammography that had previously had the diagnosis of breast cancer confirmed in the same or contralateral breast were excluded from the study. Histology results from each core biopsy and surgical excision were reviewed. The positive predictive values of sonography and mammography for this population were calculated, and the sensitivity, specificity, and negative predictive value of sonography were determined. For analysis of the agreement of ultrasound findings with mammography the McNemar x2-test for dependent samples was used. Results: The sensitivity of mammography in the detection of microcalcifications in this study was 100%. The sensitivity of the ultrasound apparatus with a high frequency probe in the detection of microcalcifications after mammography examination in this study was 87.55%, while the specificity was 42.85%. Conclusion: Ultrasonic devices with high-frequency probes enable the display of accumulations of microcalcifications previously verified by mammography, and thus enable the performance of needle biopsy of suspected microcalcifications under ultrasonic control. An alternative is the much more complicated and significantly more expensive stereotactic biopsy under the control of mammography.

Urban Air Pollution Associated with the Incidence of Autoimmune Thyroid Diseases.

Background: Endocrine disrupting air pollutants such as sulphur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), fine particle matter (PM2.5), and ozone (O3) can affect thyroid gland function on the level of synthesis, metabolism, and the action of its hormones. Objective: The aim of this study was to establish whether increased air pollution could contribute to an increased incidence of autoimmune thyroid diseases (AITD). Methods: A retrospective analysis was conducted of the medical records of 82000 patients at the University Clinical Centre in Tuzla, Bosnia and Herzegovina. The target group of this study comprised a total of 174 patients from the Lukavac area. Daily data on concentrations of air pollutants were collected from the air quality monitoring station located in Lukavac. The study covered the period from 2015 to 2020. Results: The results of the monitoring confirmed the presence of air pollutants in concentrations above the permitted limits throughout the entire observed period. Concentrations of PM2.5, SO2, NO2, CO, and O3 were in the range of 1.90-431.40 µg/m3, 3.60-620.50 µg/m3, 3.40-66.20 µg/m3, 48.00-7002.00 µg/m3, and 0.70-89.40 µg/m3, with means of 64.08 µg/m3, 77.48 µg/m3, 22.57 µg/m3, 1657.15 µg/m3, and 31.49 µg/m3, respectively. During the six-year period, 174 cases of AITD were registered, of which 150 (86.21%) were women and 24 (13.79%) men. Hashimoto's thyroiditis was found in 33 patients (18.97%), whilst 141 patients (81.03%) were diagnosed with atrophic thyroiditis. The highest total incidence of autoimmune thyroiditis was recorded in 2017, when it reached 99.49, 95% CI. Conclusion: The effects of chronic exposure to a mixture of air pollutants on the function of the thyroid gland are still not sufficiently well-known, but the numerical tendency towards a higher incidence of AITD in this study, albeit without statistical significance (p>0.05), still underlines the need for additional research.

The Epidemiological Characteristics of Autoimmune Thyroiditis in the Tuzla Canton in the Period from 2015 to 2020.

BACKGROUND: Bosnia and Herzegovina (B&H) is one of the countries of Southeast Europe with the lack of data about chronic autoimmune thyroid diseases (CAITD) epidemiology. OBJECTIVE: This research aimed to assess incidence of CAITD in the Tuzla Canton of B&H during a 6-year period (2015-2020). METHODS: We retrospectively evaluated 82,000 hospital records of inpatients and outpatients with possible thyroid symptoms residing in Tuzla Canton of B&H (total of 445,028 inhabitants). The study included patients with laboratory and clinical proof of autoimmune thyroid diseases (AITD). Incidence rates were calculated with age standardisation using European standard population. Trends in incidence were evaluated as moving three-year averages. RESULTS: During the observed period, 1875 patients satisfied the diagnostic criteria for CAITD with male to female ratio of 1: 8.01. Median age of all cases was 46 years (interquartile range: 31 to 61) and women and men were on average the same age at the time of diagnosis. The overall standardized incidence was found to be 71.25 per 105 (%95 CI=63.36-79.15). The overall standardized incidence in men was 16.25 per 105 and 123.74 per 105 in women. In the end of the observed period, AITD prevalence was 427.52 per 105 (% 95 CI=408.17-446.87). CONCLUSION: There was a slight decline of incidence in our region during the observed period. This decrease might be the result of combination of various factors, mainly the Corona epidemics outbreak and emigration. On the basis of the lower incidence rate in the Tuzla Canton, one can assume that iodine prophylaxis carried out in order to eradicate goitre had satisfied expectations because there had not been any enormous increase in patients with AITD.

Tumor marker CA 15-3 in breast cancer patients.

OBJECTIVE: The aim of this study was to determine whether there is a correlation between the serum concentration of the tumor marker CA 15-3 and breast cancer, which has not been proven by the existence of regional and distant metastases, and breast cancer with the presence of regional and distant metastases. PATIENTS AND METHODS: The study was a retrospective-prospective study, and was conducted on 100 women aged 40-70 years of age in the period of January 2007 until June 2011, in whom, after surgery, breast cancer was histologically verified, where before the surgery serum tumor marker CA 15-3 levels were established. The serum tumor marker CA 15-3 concentrations are determined in all patients after radiological diagnosis of suspected breast cancer (radiological findings concluded as BI RADS 4 and 5). The study excluded patients with liver cirrhosis, liver cancer and lung cancer. The study group consisted of patients with metastatic breast cancer, and the control group of patients with breast cancer comprised those shown to be without verified metastatic disease. To calculate the correlation, Spearman's correlation coefficient was used. A difference in p values of less than 0.05 (p<0.05) was considered statistically significant. RESULTS: The serum tumor marker CA 15-3 was elevated in all patients with proven remote or clubbing metastasis in 35.5% of patients with metastasis spreading to regional lymph nodes. CONCLUSION: There is a significant correlation between serum concentrations of the tumor marker CA 15-3 and the presence of metastasis, and serum concentrations of tumor markers and the dissemination of the underlying disease.