Magnetic Resonance Imaging

What Is Breast Density and How Common Are Dense Breasts?
Breast density refers to the amount of dense tissue (like glands and fibrous tissue) you have compared to fatty tissue in your breasts. Dense breasts are very common. About half of all women have them.

Why Does Breast Density Matter?
Dense breast tissue makes it harder for doctors to see cancer on a mammogram because both appear white on the image. Even with dense breasts, mammograms are still the best screening tool for most women and can find most breast cancers. Having dense breasts also slightly increases your chance of getting breast cancer, but not enough on its own to put you in the high-risk category.

How Do I Know If I Am at High Risk for Breast Cancer?
Doctors look at your overall risk—not just breast density—to decide if you are at high risk. Some other important risk factors, beyond breast density, include:

Age: Most breast cancers happen in women older than 50 years.

Family history: Having a close relative (like a parent, sibling, or child) with breast or ovarian cancer—especially if they were diagnosed before 50 years of age—raises your risk.

Certain inherited genes: Some gene variations, like in BRCA1 or BRCA2, raise risk considerably.

Past breast biopsies: Some biopsy results, such as atypical cells, can increase your risk.

Hormone use: Using hormone replacement therapy may slightly raise your risk.

Doctors use special tools (called risk calculators) to estimate how likely you are to develop a disease. They give you a score, like a percentage. If your chance of getting breast cancer in your lifetime is 20% or more, you might be called high risk. Every woman should get a breast cancer risk assessment. It helps you and your doctor decide if you may benefit from extra screening tests.

What Should I Do If I Have Dense Breasts?
Talk to your doctor about all of your personal risk factors—not just breast density. Most women with dense breasts do not need extra tests beyond regular mammograms. If you are at high risk, your doctor may recommend extra screening tests, such as MRI (magnetic resonance imaging) or ultrasonography (this test can be used if MRI is not available, but it is not as accurate). Extra screening tests may lead to more false alarms (finding something that is not cancer), finding cancers that will not cause any problems (this is called overdiagnosis), more tests or treatments that you do not really need, higher costs that might not be paid by insurance, and more worry or stress.

Dense breasts are common and not usually something to worry about. Mammograms are the best way to screen for breast cancer. Extra tests are only needed if you have other risk factors that put you at higher risk. It is important to think about the pros and cons of extra screening based on your personal risk and values. Your doctor can help guide this decision.

Author/s:

Hannah S. Milch, Joann G. Elmore

Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement

Alex Haga — Tue, 07 May 2024 21:01:58 +0000

Date Added:

May 7, 2024

Journal/Publication:

JAMA

Publisher:

JAMA

Publication Date:

April 30, 2024

URL:

Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.5534

Keywords

breast cancer

cancer screening

breast neoplasms

Early Detection of Cancer

mammography

PMID (1):

38687503

MeSH

early detection of cancer

Magnetic Resonance Imaging

The USPSTF now recommends beginning biennial breast cancer screening at 40 rather than 50 in most women. James W. Mold, MD, MPH

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Importance: Among all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast cancer. Non-Hispanic White women have the highest incidence of breast cancer and non-Hispanic Black women have the highest mortality rate.

Objective: The USPSTF commissioned a systematic review to evaluate the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, modality, use of supplemental imaging, or personalization of screening for breast cancer on the incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer-specific or all-cause mortality, and collaborative modeling studies to complement the evidence from the review.

Population: Cisgender women and all other persons assigned female at birth aged 40 years or older at average risk of breast cancer.

Evidence assessment: The USPSTF concludes with moderate certainty that biennial screening mammography in women aged 40 to 74 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older and the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or magnetic resonance imaging (MRI), regardless of breast density.

Recommendation: The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).

Author/s:

US Preventive Services Task Force

Frontotemporal dementia

Erin Blanchette — Wed, 13 Dec 2023 17:01:01 +0000

Date Added:

December 13, 2023

Journal/Publication:

Canadian Medical Association Journal

Publisher:

Canadian Medical Association

Publication Date:

December 10, 2023

Issue:

Volume:

195

Pages:

E1660

URL:

Frontotemporal dementia

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.230407

Keywords

Frontotemporal Dementia

neurology

dementia

Alzheimer Disease

PMID (1):

38081627

MeSH

Frontotemporal Dementia

alzheimer disease

Pick Disease of the Brain

Cognition

brain

Temporal Lobe

Behavioral Symptoms/diagnosis

Magnetic Resonance Imaging

A concise review of fronto-temporal dementia. James W. Mold, MD, MPH

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Frontotemporal dementia should be considered in adults aged 50–75 years presenting with behavioural or language changes. After Alzheimer disease, it is the second most common cause of dementia among adults younger than 65 years.1 Frontal and temporal lobe degeneration results in behavioural or language impairment.

Author/s:

Raul Medina-Rioja, Gina Gonzalez-Calderon, Mario Masellis

Deficient Functioning of Frontostriatal Circuits During the Resolution of Cognitive Conflict in Cannabis-Using Youth

Brian Desmarais — Wed, 26 Jun 2019 19:39:50 +0000

Date Added:

June 26, 2019

Journal/Publication:

Journal of American Academy of Child Adolescent Psychiatry

Publication Date:

June 1, 2019

Issue:

Volume:

Pages:

702-711

URL:

Deficient Functioning of Frontostriatal Circuits During the Resolution of Cognitive Conflict in Cannabis-Using Youth

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.jaac.2018.09.436

Keywords

cannabis use

frontostriatal circuits

functional magnetic resonance imaging

resolution of cognitive conflict

youth

MeSH

Adolescent Psychiatry

Magnetic Resonance Imaging

Functional MRI evidence supporting important adverse effects of marijuana on the brains of adolescents. James W. Mold, MD, MPH

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Abstract

OBJECTIVE:

Disturbances in self-regulatory control are involved in the initiation and maintenance of addiction, including cannabis use disorder. In adults, long-term cannabis use is associated with disturbances in frontostriatal circuits during tasks that require the engagement of self-regulatory control, including the resolution of cognitive conflict. Understudied are the behavioral and neural correlates of these processes earlier in the course of cannabis use disentangled from effects of long-term use. The present study investigated the functioning of frontostriatal circuits during the resolution of cognitive conflict in cannabis-using youth.

METHOD:

Functional magnetic resonance imaging data were acquired from 28 cannabis-using youth and 32 age-matched healthy participants during the performance of a Simon task. General linear modeling was used to compare patterns of brain activation during correct responses to conflict stimuli across groups. Psychophysiologic interaction analyses were used to examine conflict-related frontostriatalconnectivity across groups. Associations of frontostriatal activation and connectivity with cannabis use measures were explored.

RESULTS:

Decreased conflict-related activity was detected in cannabis-using versus healthy control youth in frontostriatal regions, including the ventromedial prefrontal cortex, striatum, pallidum, and thalamus. Frontostriatal connectivity did not differ across groups, but negative connectivity between the ventromedial prefrontal cortex and striatum was detected in the 2 groups.

CONCLUSION:

These findings are consistent with previous reports of cannabis-associated disturbances in frontostriatal circuits in adults and point to the specific influence of cannabis on neurodevelopmental changes in youth. Future studies should examine whether frontostriatalfunctioning is a reliable marker of cannabis use disorder severity and a potential target for circuit-based interventions.

Author/s:

Cyr, M., Tau, G.Z., Fontaine, M., Levin, F.R., Marsh, R.