Core biopsy (CB) has now largely replaced fine-needle aspiration cytology (FNAC) in the preoperative assessment of breast cancer in the UK. We studied the contribution of FNAC and CB in the preoperative diagnosis of screen-detected breast carcinoma. Data were prospectively collected on 150 840 women who underwent breast screening over a 4-year period from 1999 to 2003. Data on women who had both FNAC and CB taken from the same lesion preoperatively and in whom surgical excision of the lesion subsequently confirmed malignancy was analysed. In 763 cancers, FNAC was inadequate (C1) in 8% and benign (C2) in 10%. Most of these cases presented with microcalcification (25% were C1 or C2). Core biopsy was not representative (B1) or benign (B2) in 7%. The absolute and complete sensitivities were 65 and 82% for FNAC and 80 and 93% for CB in the diagnosis of cancer. Core biopsy was abnormal (B3 or above) in 86% of the cancers missed by FNAC and FNAC was abnormal (C3 or above) in 65% of those missed by CB. Core biopsy is better than FNAC at preoperative diagnosis of screen-detected breast cancer as it missed fewer cancers. However, combining FNAC resulted in a better preoperative diagnosis rate. The National Health Service Breast Screening Programme (NHSBSP) was introduced in the United Kingdom in 1987, following publication of the findings of an expert committee the previous year. At present, all women aged 50 -70 years are offered two-view screening mammography every 3 years. Patients with radiologically suspicious lesions are recalled for further assessment that may include clinical examination, special mammographic views, ultrasound and collection of tissue for pathological assessment by fine-needle aspiration cytology (FNAC), core biopsy (CB), or more recently, by wide bore vacuum biopsy.In the early stages of NHSBSP, FNAC was the test used in the assessment. Core biopsy was introduced in the assessment process in late 1990s. The experience with this technique has improved considerably and CB is now considered to be the standard. The preoperative diagnosis rate of screen-detected carcinoma has been improving with increasing use of CB. Correspondingly, the use of FNAC is in decline and a number of screening units in the UK have abandoned it completely (Britton et al, 1997).At the Bedfordshire and Hertfordshire Breast Screening Unit, CB was introduced in the assessment of screen-detected breast lesions in 1997, but we continued to perform FNAC in addition in the majority of patients with suspicious lesions. The aim of this study was to assess the performance of FNAC and CB in the preoperative diagnosis of screen-detected breast carcinoma. MATERIALS AND METHODSData were prospectively collected on all women who attended the Bedfordshire and Hertfordshire Breast Screening Unit, England. We reviewed a 4-year period from April 1999 to March 2003. This period was chosen to ensure that operators had gained sufficient expertise in the use of CB, which was introduced in 1997. We selected, for detailed analysis, the women who had ...

Objective Empowerment is critical for cancer patients to make informed choices, to manage medication, and to navigate through the oncological care system. Cancer peer support provides patients with information, emotional relief and may promote empowerment. This paper provides a systematic review of the literature examining the impact of cancer peer support interventions on psychological empowerment. Methods PubMed, Web of Science, CINAHL, Cochrane Library, PsycINFO and PSYNDEX databases were systematically searched from inception until December 2020. We included quantitative studies, published in English or German, which examined peer‐led cancer support interventions and their impact on the three components of psychological empowerment (intrapersonal, interactional and behavioural) among participating cancer patients. Results Database searches and screening of relevant reference lists identified 2336 potentially relevant articles. A total of 29 studies were included in the review. Active coping, self‐efficacy and knowledge were the most prominent dimensions of empowerment in these studies. The majority of studies revealed that peer support led to a small to medium, significant increase in psychological empowerment, and was associated with further patient‐reported benefits. Conclusions The existing evidence suggests a weak to moderate, positive association between cancer peer support and the three components of psychological empowerment among cancer patients. Peer support groups should be seen as an important element in cancer care and clinical practice and, thus, be more systematically involved in cancer care.

The aim of the study was to investigate the relationship between specific known dietary patterns and the prevalence of periodontal disease in a northern population-based cohort study. We evaluated data from 6209 participants of the Hamburg City Health Study (HCHS). The HCHS is a prospective cohort study and is registered at ClinicalTrial.gov (NCT03934957). Dietary intake was assessed with the food frequency questionnaire (FFQ2). Periodontal examination included probing depth, gingival recession, plaque index, and bleeding on probing. Descriptive analyses were stratified by periodontitis severity. Ordinal logistic regression models were used to determine the association. Ordinal regression analyses revealed a significant association between higher adherence to the DASH diet/Mediterranean diet and lower odds to be affected by periodontal diseases in an unadjusted model (OR: 0.92; 95% CI: 0.87, 0.97; p < 0.001/OR: 0.93; 95% CI: 0.91, 0.96; p < 0.001) and an adjusted model (age, sex, diabetes) (OR: 0.94; 95% CI: 0.89, 1.00; p < 0.0365/OR: 0.97; 95% CI: 0.94, 1.00; p < 0.0359). The current cross-sectional study identified a significant association between higher adherence to the DASH and Mediterranean diets and lower odds to be affected by periodontal diseases (irrespective of disease severity). Future randomized controlled trials are needed to evaluate to which extent macro- and micronutrition can affect periodontitis initiation/progression.

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