Background: Breast cancer is the most frequent malignancy in women worldwide and one of the most curable cancers if diagnosed at an early stage. Female patients presenting solid breast lesions are greatly predisposed to breast cancer development, and as such, effective screening of high-risk patients is valuable in early-stage breast cancer detection. Objectives: The aim of our study was to identify the most relevant demographic, reproductive and lifestyle risk factors for breast cancer among women with solid breast lesions living in western Romania, namely the urban region consisting of Timisoara and the rural surrounding regions. Methods: From January 2017 to December 2021, 1161 patients with solid breast lesions, as detected by sonoelastography, were divided into two groups: patients with benign lesions (1019, 87.77%) and patients with malignant nodules (142, 12.23%). The malignancy group was confirmed by a histopathological result. Variables including age, BMI, menarche, menopause, years of exposure to estrogen, number of births, breastfeeding period, use of oral combined contraceptives, smoker status, family medical history and living area (rural-urban) were recorded. Results: It was evidenced by our study that the main risk factors for malignancy were elevated age (OR = 1.07, 95% CI 1.05–1.08), BMI (OR = 1.06, 95% CI 1.02–1.10), living area (rural) (OR = 1.86, 95% CI 1.13–2.85) and family medical history (negative) (OR 3.13, 95% CI 1.43–8.29). The other proposed risk factors were not found to be statistically significant. Conclusions: Age and BMI were observed to be the most significant factors for breast cancer risk increase, followed by living in a rural area. A family history of breast cancer was shown to be inversely correlated with cancer risk increase.

In the past few years, elastography has gained ground as a complementary method to ultrasonography in noninvasive breast cancer screening. Despite positive outcomes, there is a further need to refine the method, especially regarding BIRADS scores 3 and 4A, where the distinction between benignancy and malignancy is established. The aim of the present study was to evaluate the best risk-stratification system using both qualitative and semiquantitative elastographic methods for solid breast nodules. A total of 1405 solid nodules, described in 657 female patients, were examined in our endocrine unit between January 2018 and December 2019. The inclusion criterion for our retrospective study was the presence of any solid breast mass in women of all ages (mean, 40.85 ± SD 27.11), detected during ultrasound examination using a HITACHI PREIRUS machine (Hitachi Medical Corporation, Tokyo, Japan). The Breast Imaging Reporting and Data System (BIRADS)–US criteria were used in the assessment of each nodule by conventional US (gray-scale mode) and Doppler evaluation. The Ueno score and strain ratio were also measured for all the described lesions. We considered multiple algorithms for the risk reassessment of solid breast nodules: classical BIRADS–US, EFSUMB BIRADS, worst-case scenario BIRADS and BIRADS TM. There were 93 malignant nodules out of 1405. The diagnosis was based on histopathological results for all the malignant lesions. Benign lesions were diagnosed based on histopathological results, Tru-Cut biopsy, mammography and MRI. The Sensitivity (Se), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV) and Accuracy (Acc) were obtained for all the proposed risk-stratification reporting systems: conventional BIRADS-US (Se, 74.23%; Sp, 63.95%; PPV, 13.53%; NPV, 97.79%; Acc, 65%); EFSUMB BIRADS (Se, 71.23%; Sp, 81.55%; PPV, 22.68%; NPV, 97.99%; Acc, 81%); worst-case scenario BIRADS (Se, 84.23%; Sp, 58.23%; PPV, 13.29%; NPV, 98.84%; Acc, 60%); BIRADS TM (Se, 81.23%; Sp, 75.84%; PPV, 20.35%; NPV, 98.81%; Acc, 77%). We found that the most efficient risk-stratification reporting system was the proposed one, BIRADS TM, which considers both upgrading and downgrading the conventional BIRADS-US, followed by the worst-case scenario BIRADS and EFSUMB BIRADS.

Background and Objectives: Breast cancer is one of the most widespread cancers among the female population around the world and is curable if diagnosed in an early stage. Consequently, breast cancer screening imaging techniques have greatly evolved and adjusted over the last decades. Alongside mammography, sonoelastography became an important tool for breast cancer detection. However, sonoelastography still has its limitations, namely, there is still a high occurrence of false positive results in the BIRADS 4 category. The aim of our study is to identify potential false positive predictors and to ascertain the factors influencing the quality of strain ultrasound elastography for the evaluation of suspicious solid breast lesions categorized as BIRADS 4B, 4C, and 5. Materials and Methods: We conducted a retrospective study in a single private medical center in Timisoara between January 2017 and January 2022 analyzing 1625 solid breast lesions by the sonoelastography strain using a standardized BIRADS-US lexicon. Results: Our study showed that most sonoelastography factors linked to incorrect and overdiagnosis were due to a nodule dimension (OR = 1.02 per unit increase), posterior acoustic shadowing (OR = 12.26), reactive adenopathy (OR = 6.35), and an increased TES score (TES3 OR = 6.60; TES4 OR = 23.02; TES5 OR = 108.24). Regarding patient characteristics, age (OR = 1.09 per unit increase), BMI, (OR = 1.09 per unit increase), and breastfeeding history (OR = 3.00) were observed to increase the likelihood of false positive results. On the other hand, the nodules less likely to be part of the false positive group exhibited the following characteristics: a regular shape (OR = 0.27), homogenous consistency (OR = 0.42), and avascularity (OR = 0.22). Conclusions: Older age, high BMI, patients with a breastfeeding history, and those who exhibit the following specific nodule characteristics were most often linked to false positive results: large tumors with posterior acoustic shadowing and high elasticity scores, accompanied by reactive adenopathy. On the other hand, homogenous, avascular nodules with regular shapes were less likely to be misdiagnosed.

Catalin Dumitru, Anghel Cernescu, Ivana Eremici, Cristina Maria Bortun, Daniel Achiriloaiei - Fatigue Behavior of Two Acrylic Denture Base Resins