Diabetes, Obesity, and Inflammation: Impact on Clinical and Radiographic Features of Breast Cancer.
Diabetes, Obesity, and Inflammation: Impact on Clinical and Radiographic Features of Breast Cancer.
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DOI：
10.3390/ijms22052757
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发表时间：
2021-03-09
影响因子：
5.6
通讯作者：
McNally LR
中科院分区：
文献类型：
--
作者：
Miller B;Chalfant H;Thomas A;Wellberg E;Henson C;McNally MW;Grizzle WE;Jain A;McNally LR
肥胖、糖尿病和炎症会增加患乳腺癌的风险，乳腺癌是女性最常见的恶性肿瘤。乳腺癌治疗和改善预后的支柱之一是通过基于成像的筛查进行早期发现。对于某些合并疾病的患者，个体化成像策略可能会起到一定的作用。在此，我们回顾了有关肥胖和糖尿病女性常规影像检查方法的准确性、抗炎药改善检测的潜在作用以及可能对这些患者进行乳腺癌筛查的新的分子成像技术的文献。我们证明，对于传统的成像方式，增加的敏感性往往伴随着特异性的丧失，导致不必要的活检和过度治疗。肥胖女性的体型限制会影响图像质量，而糖尿病会增加乳房致密组织的风险。众所周知，在常规筛查乳房X光检查中，密度增加会模糊癌症的诊断。具有雌激素受体、人表皮生长因子受体2(HER2)、吡啶类似物和配体靶向受体探针等靶点的新型分子显像剂具有减少假阳性结果的潜力。它们还可以通过提高分辨率来提高检测率，并为治疗决策提供信息。这些新兴的成像技术有望改善肥胖糖尿病患者乳房致密的乳腺癌诊断，但还需要更多的工作来验证它们的临床应用。
Obesity, diabetes, and inflammation increase the risk of breast cancer, the most common malignancy in women. One of the mainstays of breast cancer treatment and improving outcomes is early detection through imaging-based screening. There may be a role for individualized imaging strategies for patients with certain co-morbidities. Herein, we review the literature regarding the accuracy of conventional imaging modalities in obese and diabetic women, the potential role of anti-inflammatory agents to improve detection, and the novel molecular imaging techniques that may have a role for breast cancer screening in these patients. We demonstrate that with conventional imaging modalities, increased sensitivity often comes with a loss of specificity, resulting in unnecessary biopsies and overtreatment. Obese women have body size limitations that impair image quality, and diabetes increases the risk for dense breast tis-sue. Increased density is known to obscure the diagnosis of cancer on routine screening mammography. Novel molecu-lar imaging agents with targets such as estrogen receptor, human epidermal growth factor receptor 2 (HER2), pyrimi-dine analogues, and ligand-targeted receptor probes, among others, have potential to reduce false positive results. They can also improve detection rates with increased resolution and inform therapeutic decision making. These emerg-ing imaging techniques promise to improve breast cancer diagnosis in obese patients with diabetes who have dense breasts, but more work is needed to validate their clinical application.
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影响因子：
3.8
作者：
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通讯作者：
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通讯作者：
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作者：
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通讯作者：
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