Review of Subtypes of Interval Breast Cancers With Discussion of Radiographic Findings.

Interval breast cancers are those detected in the interim between regular screening examinations and are an unfortunate reality for breast cancer screening programs. However, their incidence can help gauge the success of breast cancer screening programs. There are four main categories of interval cancers, including true negative, false negative, minimal sign, and occult. The mammographic characteristics of each type of interval cancer are reviewed with example cases from an urban academic institution. Pitfalls and strategies to reduce interval cancers are discussed in detail.

Calculation of breast volumes from mammogram: Comparison of four separate equations relative to mastectomy specimen volumes.

BACKGROUND AND OBJECTIVES: Accurately assessing breast volume (BV) relative to the volume of breast tissue to be removed could help objectively determine the optimal surgical candidates for breast conserving surgery. The objective of this study was to determine the optimal mammography-based method of BV estimation. METHODS: Mammography data was obtained for patients who underwent mastectomy for breast cancer from 2005 to 2015. This data was used to calculate BV using four previously published equations. Results were compared to mastectomy specimen volumes calculated from specimen weights and breast density. Five practitioners then independently assessed reproducibility and ease of use. RESULTS: Complete mammographic measurements were available for 65 breasts from 45 patients. Median age was 58 years (range 19-82). Mammographic breast density scores were available for 62 breasts. Of the 65 mastectomies performed, 16 (36%) were simple mastectomies. The equation BV = 1/3πRcc Rmlo Hmlo most closely approximated actual breast specimen volumes (R = 0.89, P < 0.0001). Internal correlation of calculated BV was excellent among all practitioners (lowest Pearson R = 0.963). CONCLUSIONS: Breast volumes can be reliably estimated utilizing measurements from a preoperative mammogram. This low-cost method of volumetric analysis can be employed to guide surgical decision making in treatment of patients with invasive breast cancer.

Mobile Mammography, Race, and Insurance: Use Trends Over a Decade at a Comprehensive Urban Cancer Center.

PURPOSE: To assess the use of a mobile mammography unit (MMU) as it relates to race and insurance status in the largest county in Kentucky. METHODS: We retrospectively reviewed 48,324 screening mammograms of 21,857 patients conducted over a 10-year period. Descriptive statistics for patient age, race, and insurance status were computed by entire cohort and within subsets of cohorts. This analysis was limited to trends in use by race and insurance status. To study the patterns of frequency distributions, indiscrete variables were performed using the Pearson χ(2) test. For continuous variable range, a 95% CI of mean was estimated. Comparisons with a P value less than .05 were considered statistically significant. RESULTS: Self-reported blacks constituted significant use of the MMU (29% v census data demographic reports of 19%). Race significantly correlated with likelihood to screen ≥ three times, with blacks (30.5%) more likely, and whites (27.8%) and Hispanics (20.2%) less likely (P < .001). Insurance status also affected frequency of use (P < .001). CONCLUSION: In this data set, blacks were more likely to repeat use of the MMU. Although preliminary, these data suggest outreach efforts of mobile mammography are appropriately reaching certain targeted populations.

Fit body and soul: a church-based behavioral lifestyle program for diabetes prevention in African Americans.

Faith-based initiatives for lifestyle change show promise in helping to promote healthy behaviors in African American communities. It has been suggested that faith communities and programs within faith communities can influence health care practices and health care planning especially in high risk, minority populations. African American individuals are more likely to attend and participate in faith-based services than Whites from similar backgrounds. Our proposed intervention, Fit Body and Soul, has been adopted and modified from the proven diabetes prevention program (DPP) lifestyle intervention program, and uses the church-community experiences of the "Body and Soul" study as a faith-based effort. The intervention has been developed keeping in mind the church mission and goal of being spiritually healthy and has adopted bible scripture to develop a 12-session intervention. In this article, we present the development of the church-based Fit Body and Soul behavioral lifestyle intervention using community-based participatory research in partnership with African American churches.

Using community-based participatory research to develop a culturally sensitive smoking cessation intervention with public housing neighborhoods.

PURPOSE: To describe surface and deep structure dimensions of a culturally sensitive smoking cessation intervention developed with southeastern US public housing neighborhoods. PROCEDURES: Community-based participatory research (CBPR) methods were used to develop this culturally sensitive smoking cessation intervention by the following research partners: academicians, neighborhood residents, community health workers, and community advisory board. This CBPR involved a cyclical process with the following phases: assembling a research team; identifying smoking cessation as the health need of interest; developing the research method; establishing evaluation, feedback, and dissemination mechanisms; implementing the initial "Sister to Sister" community trial; analyzing and interpreting the data; disseminating the results; revising the intervention; and, establishing mechanisms to sustain outcomes. Culturally sensitive dimensions emerged during this process and were categorized as surface structure and deep structure. FINDINGS: Surface structure dimensions included written materials, incentives and food, and protocol delivery strategies. Deep structure dimensions included kinships, collectivism, storytelling, and spiritual expressions. Community health workers and the advisory board contributed to the identification and integration of both surface and deep structure dimensions. The six-month continuous smoking abstinence outcomes from the initial community trial were 27.5% vs 5.77% for the intervention and comparison groups, respectively. CONCLUSIONS: Community-based participatory research (CBPR) methods facilitate processes in which culturally sensitive dimensions can be effectively identified and integrated into health promotion interventions for marginalized populations. The incorporation of surface structure dimensions increases acceptance and feasibility, while deep structure improves overall impact and efficacy of the intervention.