This work includes a brief overview of the applications of the powerful and easy-to-perform method of microwave radiometry (MWR) for the diagnosis of various diseases. The main goal of this paper is to develop a method for diagnosing breast oncology based on machine learning algorithms using thermometric data, both real medical measurements and simulation results of MWR examinations. The dataset includes distributions of deep and skin temperatures calculated in numerical models of the dynamics of thermal and radiation fields inside biological tissue. The constructed combined dataset allows us to explore the limits of applicability of the MWR method for detecting weak tumors. We use convolutional neural networks and classic machine learning algorithms (k-nearest neighbors, naive Bayes classifier, support vector machine) to classify data. The construction of Kohonen self-organizing maps to explore the structure of our combined dataset demonstrated differences between the temperatures of patients with positive and negative diagnoses. Our analysis shows that the MWR can detect tumors with a radius of up to 0.5 cm if they are at the stage of rapid growth, when the tumor volume doubling occurs in approximately 100 days or less. The use of convolutional neural networks for MWR provides both high sensitivity (sens=0.86) and specificity (spec=0.82), which is an advantage over other methods for diagnosing breast cancer. A new modified scheme for medical measurements of IR temperature and brightness temperature is proposed for a larger number of points in the breast compared to the classical scheme. This approach can increase the effectiveness and sensitivity of diagnostics by several percent.

/pdf/improving-the-efficiency-of-oncological-diagnosis-of-the-26udroxd.pdf

Improving the Efficiency of Oncological Diagnosis of the Breast Based on the Combined Use of Simulation Modeling and Artificial Intelligence Algorithms

Objective: There has been a void of data regarding Ki-67 expression in breast cancer in the Caribbean. Ki-67 is a widely used marker to determine the grade and prognosis of breast cancer. Ki-67 has been shown to be a valuable tool in predicting the response to chemotherapy and hormonal therapy in breast cancer patients. The objective of this preliminary study aims to describe the Ki-67 (Ki) status in this population and its correlations with other parameters in breast cancer histology. This study also aims to lay the groundwork for Ki-67 analysis in this population so that future studies may better describe it. Method: The methodology involved gathering data from histology reports for all breast cancer-related biopsies from the 1st of January 2018 to the 12th of July 2021. This data was retrospectively analyzed. Results: Twenty-three Ki-67 cases were obtained, 19 of which had Ki expression >10%. This >10% group was mostly staged from T1c up (one T1, three T1c cases, two T2 cases, four T3 cases while nine were not T staged). Two were N2/M1 while 9 were N0 and two were M0, the rest were not staged. The mean age was 65.6 years with a range of 54 and a standard deviation of 12.5. Lymphovascular invasion was confirmed in four cases and suspected in three. Axillary lymph node dissection (ALND) yielded >10 nodes involved in two cases while <5 nodes in the remaining. The most common receptor status was hormone positive/ human epidermal growth factor receptor-2 (HER) negative (eight). Invasive Ductal Carcinoma (IDC) occurred in 10 cases while intermediate grade was in 14 cases. The Ki 6-10 % group consisted of two cases, one staged at T1aN0Mx while the other T2NxMx. Lymphovascular invasion was suspected in one. The average age was 67.5 years. ALND yielded less than five nodes in one case and 5-10 nodes in the other. Grades were high and intermediate. Histology was invasive ductal carcinoma/ductal carcinoma in situ (IDC/DCIS), and ductal carcinoma in situ ( DCIS) respectively. The Ki <6% group comprised two cases, staged at T1NxMx and T3N2M1. Lymphovascular invasion was absent in both. The mean age was 58.5 years. ALND yielded >10 nodes in one case and <5 in the other. Grades were high and intermediate. Histology was IDC/DCIS in both. There were no sentinel nodes involved in all but two cases belonging to the Ki >10% group. Conclusion: This preliminary study was the first to describe the Ki-67 marker in the Caribbean population. The vast majority of this population has a Ki-67 level of>10%. Higher Ki-67 expression is associated with larger tumors, lymphovascular invasion, metastases, and higher tumor grades. There is a need for consistent Ki-67 reporting in histology samples before follow-up studies are conducted.

/pdf/a-preliminary-analysis-of-ki-67-expression-in-breast-cancer-276nbfgy.pdf

A Preliminary Analysis of Ki-67 Expression in Breast Cancer in the Caribbean

The National Comprehensive Cancer Network recommends that patients with hormone receptor-positive early breast cancer be considered for adjuvant endocrine therapy (ET) after primary treatment like surgical excision. Adjuvant chemotherapy (CT) use primarily depends on risk of recurrence. Biomarkers such as Ki-67 potentially have most value in patients with intermediate risk factors, such as involvement of 1-3 positive nodes. This study evaluated the use of Ki-67 testing and treatment patterns in patients with HR+, human epidermal growth factor receptor 2-negative early breast cancer.This was an observational retrospective cohort study of patients with electronic medical records from January 2010 to August 2018 treated for HR+, HER2- early breast cancer at Sarah Cannon sites in the United States (US). Overall, 567 patients were randomly selected after using the eligibility criteria: female or male ≥18 years, without distant metastases, and with available physician and pathology reports. Multivariable logistic regression was used to investigate factors predicting Ki-67 testing and test results. Descriptive analyses were applied to treatment patterns.Multivariable logistic regression analyses found no clinical or pathological factors that predicted whether Ki-67 testing had been ordered by physicians. Of all tested patients (N = 130), having Grade-2 tumors (OR, 7.95 [95% CI: 2.05, 30.9]; p = 0.0027) or Grade-3 tumors (OR, 95.3 [95% CI, 11.9, 760.7]; p < 0.001) at initial diagnosis was a predictor of high Ki-67 expression (≥20%). Ki-67 expression was tested in 23.6% (61/258) of patients with 1-3 positive nodes; 54.1% of them (33/61) had high Ki-67 expression (≥20%). While having a higher grade tumor predicted high Ki-67 (≥20%), 28.6% of patients with Grade-1 tumors also had high Ki-67 expression. Neo-adjuvant therapy was received by 16.0% of patients (91/567), most of whom (66/91; 72.5%) received CT alone. Adjuvant therapy, either endocrine and/or chemotherapy, was received by 92.6% (525/567) of patients and by 67.0% (61/91) of those who received neo-adjuvant therapy. Most (428/525, 81.5%) received ET in the adjuvant treatment setting.High grade tumors predicted high Ki-67 (≥20%) expression, but Ki-67 testing was not widely used in these US patients. Most HR+, HER2- early breast cancers were treated with adjuvant ET, with or without CT. 

/pdf/a-real-world-retrospective-study-of-the-use-of-ki-67-testing-1ys4vymj.pdf

A real-world retrospective study of the use of Ki-67 testing and treatment patterns in patients with HR+, HER2− early breast cancer in the United States

/pdf/a-real-world-retrospective-study-of-the-use-of-ki-67-testing-35blpo5h.pdf

Savannah Scardo

Papers

A real-world retrospective study of the use of Ki-67 testing and treatment patterns in patients with HR+, HER2− early breast cancer in the United States

A real-world retrospective study of the use of Ki-67 testing and treatment patterns in patients with HR+, HER2− early breast cancer in the United States