Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view.

INTRODUCTION: Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. METHODS: Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. RESULTS: Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). CONCLUSION: This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals

Effects of GnRH administration on ovulation and fertility in ewes subjected to estrous synchronization

The objective of this study was to verify the effects of GnRH on ovulation and pregnancy of ewes subjected to a short-term synchronization of estrus. Santa Inês and crossbred Santa Inês/Dorper ewes received 60 mg MAP sponges during 6 days plus 300 IU eCG and 30 µg d-cloprostenol 24 h prior to sponge withdrawal (SW). Ewes were assigned to receive 0.9% NaCl solution (Tcontrol; n = 32) or 25 µg GnRH (licerelin, T GnRH; n = 34) 24 hours after SW. Each group was assigned to intrauterine insemination by laparoscopy (n = 25) or to natural mating (n = 41). Artificial insemination was performed with a single dose of fresh semen. For controlled mating, females were exposed to males 12, 24, 36 and 48 hours after SW. Ten females per treatment were subjected to transrectal ultrasound examination at 12-hour intervals (SW to 60 hours after). Estrous response (100.0% vs 95.2%), interval from SW to estrus (32.9±7.4 vs 29.8±6.9 hours), estrous length (37.4±9.0 vs 31.5±10.4 hours), pregnancy rates (57.0% vs 41.0%), ovulation rate (100.0% vs 90.0%), number of ovulations/ewe (1.1±0.3 vs 1.2±0.4), maximum follicular diameter (6.4±0.7 vs 6.1±0.6 mm), interval from SW to ovulation (59.1±3.5 vs 58.4±3.5 hours) did not differ between Tcontrol and T GnRH, respectively. Administration of GnRH 24 hours after SW does not improve ovulation or pregnancy rate in estrous synchronization in ewes