Artificial Intelligence Shows Promise in Detecting Missed Interval Breast Cancer on Screening Mammograms

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Mon, 08/25/2025 - 15:49

TOPLINE:

An artificial intelligence (AI) system flagged high-risk areas on mammograms for potentially missed interval breast cancers (IBCs), which radiologists had also retrospectively identified as abnormal. Moreover, the AI detected a substantial number of IBCs that manual review had overlooked.

METHODOLOGY:

  • Researchers conducted a retrospective analysis of 119 IBC screening mammograms of women (mean age, 57.3 years) with a high breast density (Breast Imaging Reporting and Data System [BI-RADS] c/d, 63.0%) using data retrieved from Cancer Registries of Eastern Switzerland and Grisons-Glarus databases.
  • A recorded tumour was classified as IBC when an invasive or in situ BC was diagnosed within 24 months after a normal screening mammogram.
  • Three radiologists retrospectively assessed the mammograms for visible signs of BC, which were then classified as either potentially missed IBCs or IBCs without retrospective abnormalities on the basis of consensus conference recommendations of radiologists.
  • An AI system generated two scores (a scale of 0 to 100): a case score reflecting the likelihood that the mammogram currently harbours cancer and a risk score estimating the probability of a BC diagnosis within 2 years.

TAKEAWAY:

  • Radiologists classified 68.9% of IBCs as those having no retrospective abnormalities and assigned significantly higher BI-RADS scores to the remaining 31.1% of potentially missed IBCs (P < .05).
  • Potentially missed IBCs received significantly higher AI case scores (mean, 54.1 vs 23.1; P < .05) and were assigned to a higher risk category (48.7% vs 14.6%; P < .05) than IBCs without retrospective abnormalities.
  • Of all IBC cases, 46.2% received an AI case score > 25, 25.2% scored > 50, and 13.4% scored > 75.
  • Potentially missed IBCs scored widely between low and high risk and case scores, whereas IBCs without retrospective abnormalities scored low case and risk scores. Specifically, 73.0% of potentially missed IBCs vs 34.1% of IBCs without retrospective abnormalities had case scores > 25, 51.4% vs 13.4% had case scores > 50, and 29.7% vs 6.1% had case scores > 75.

IN PRACTICE:

“Our research highlights that an AI system can identify BC signs in relevant portions of IBC screening mammograms and thus potentially reduce the number of IBCs in an MSP [mammography screening program] that currently does not utilize an AI system,” the authors of the study concluded, adding that “it can identify some IBCs that are not visible to humans (IBCs without retrospective abnormalities).”

SOURCE:

This study was led by Jonas Subelack, Chair of Health Economics, Policy and Management, School of Medicine, University of St. Gallen, St. Gallen, Switzerland. It was published online in European Radiology.

LIMITATIONS:

The retrospective study design inherently limited causal conclusions. Without access to diagnostic mammograms or the detailed position of BC, researchers could not evaluate whether AI-marked lesions corresponded to later detected BCs.

DISCLOSURES:

This research was funded by the Cancer League of Eastern Switzerland. One author reported receiving consulting and speaker fees from iCAD.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. 

A version of this article first appeared on Medscape.com.

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TOPLINE:

An artificial intelligence (AI) system flagged high-risk areas on mammograms for potentially missed interval breast cancers (IBCs), which radiologists had also retrospectively identified as abnormal. Moreover, the AI detected a substantial number of IBCs that manual review had overlooked.

METHODOLOGY:

  • Researchers conducted a retrospective analysis of 119 IBC screening mammograms of women (mean age, 57.3 years) with a high breast density (Breast Imaging Reporting and Data System [BI-RADS] c/d, 63.0%) using data retrieved from Cancer Registries of Eastern Switzerland and Grisons-Glarus databases.
  • A recorded tumour was classified as IBC when an invasive or in situ BC was diagnosed within 24 months after a normal screening mammogram.
  • Three radiologists retrospectively assessed the mammograms for visible signs of BC, which were then classified as either potentially missed IBCs or IBCs without retrospective abnormalities on the basis of consensus conference recommendations of radiologists.
  • An AI system generated two scores (a scale of 0 to 100): a case score reflecting the likelihood that the mammogram currently harbours cancer and a risk score estimating the probability of a BC diagnosis within 2 years.

TAKEAWAY:

  • Radiologists classified 68.9% of IBCs as those having no retrospective abnormalities and assigned significantly higher BI-RADS scores to the remaining 31.1% of potentially missed IBCs (P < .05).
  • Potentially missed IBCs received significantly higher AI case scores (mean, 54.1 vs 23.1; P < .05) and were assigned to a higher risk category (48.7% vs 14.6%; P < .05) than IBCs without retrospective abnormalities.
  • Of all IBC cases, 46.2% received an AI case score > 25, 25.2% scored > 50, and 13.4% scored > 75.
  • Potentially missed IBCs scored widely between low and high risk and case scores, whereas IBCs without retrospective abnormalities scored low case and risk scores. Specifically, 73.0% of potentially missed IBCs vs 34.1% of IBCs without retrospective abnormalities had case scores > 25, 51.4% vs 13.4% had case scores > 50, and 29.7% vs 6.1% had case scores > 75.

IN PRACTICE:

“Our research highlights that an AI system can identify BC signs in relevant portions of IBC screening mammograms and thus potentially reduce the number of IBCs in an MSP [mammography screening program] that currently does not utilize an AI system,” the authors of the study concluded, adding that “it can identify some IBCs that are not visible to humans (IBCs without retrospective abnormalities).”

SOURCE:

This study was led by Jonas Subelack, Chair of Health Economics, Policy and Management, School of Medicine, University of St. Gallen, St. Gallen, Switzerland. It was published online in European Radiology.

LIMITATIONS:

The retrospective study design inherently limited causal conclusions. Without access to diagnostic mammograms or the detailed position of BC, researchers could not evaluate whether AI-marked lesions corresponded to later detected BCs.

DISCLOSURES:

This research was funded by the Cancer League of Eastern Switzerland. One author reported receiving consulting and speaker fees from iCAD.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. 

A version of this article first appeared on Medscape.com.

TOPLINE:

An artificial intelligence (AI) system flagged high-risk areas on mammograms for potentially missed interval breast cancers (IBCs), which radiologists had also retrospectively identified as abnormal. Moreover, the AI detected a substantial number of IBCs that manual review had overlooked.

METHODOLOGY:

  • Researchers conducted a retrospective analysis of 119 IBC screening mammograms of women (mean age, 57.3 years) with a high breast density (Breast Imaging Reporting and Data System [BI-RADS] c/d, 63.0%) using data retrieved from Cancer Registries of Eastern Switzerland and Grisons-Glarus databases.
  • A recorded tumour was classified as IBC when an invasive or in situ BC was diagnosed within 24 months after a normal screening mammogram.
  • Three radiologists retrospectively assessed the mammograms for visible signs of BC, which were then classified as either potentially missed IBCs or IBCs without retrospective abnormalities on the basis of consensus conference recommendations of radiologists.
  • An AI system generated two scores (a scale of 0 to 100): a case score reflecting the likelihood that the mammogram currently harbours cancer and a risk score estimating the probability of a BC diagnosis within 2 years.

TAKEAWAY:

  • Radiologists classified 68.9% of IBCs as those having no retrospective abnormalities and assigned significantly higher BI-RADS scores to the remaining 31.1% of potentially missed IBCs (P < .05).
  • Potentially missed IBCs received significantly higher AI case scores (mean, 54.1 vs 23.1; P < .05) and were assigned to a higher risk category (48.7% vs 14.6%; P < .05) than IBCs without retrospective abnormalities.
  • Of all IBC cases, 46.2% received an AI case score > 25, 25.2% scored > 50, and 13.4% scored > 75.
  • Potentially missed IBCs scored widely between low and high risk and case scores, whereas IBCs without retrospective abnormalities scored low case and risk scores. Specifically, 73.0% of potentially missed IBCs vs 34.1% of IBCs without retrospective abnormalities had case scores > 25, 51.4% vs 13.4% had case scores > 50, and 29.7% vs 6.1% had case scores > 75.

IN PRACTICE:

“Our research highlights that an AI system can identify BC signs in relevant portions of IBC screening mammograms and thus potentially reduce the number of IBCs in an MSP [mammography screening program] that currently does not utilize an AI system,” the authors of the study concluded, adding that “it can identify some IBCs that are not visible to humans (IBCs without retrospective abnormalities).”

SOURCE:

This study was led by Jonas Subelack, Chair of Health Economics, Policy and Management, School of Medicine, University of St. Gallen, St. Gallen, Switzerland. It was published online in European Radiology.

LIMITATIONS:

The retrospective study design inherently limited causal conclusions. Without access to diagnostic mammograms or the detailed position of BC, researchers could not evaluate whether AI-marked lesions corresponded to later detected BCs.

DISCLOSURES:

This research was funded by the Cancer League of Eastern Switzerland. One author reported receiving consulting and speaker fees from iCAD.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. 

A version of this article first appeared on Medscape.com.

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Tue, 08/19/2025 - 14:23

Does Ethnicity Affect Skin Cancer Risk?

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Does Ethnicity Affect Skin Cancer Risk?

TOPLINE:

The incidence of skin cancer in England varied by ethnicity: White individuals had higher rates of melanoma, cutaneous squamous cell carcinoma, and basal cell carcinoma than Asian or Black individuals. In contrast, acral lentiginous melanoma was most common among Black individuals, whereas cutaneous T-cell lymphoma and Kaposi sarcoma were highest among those in the "Other" ethnic group.

METHODOLOGY:

  • Researchers analysed all cases of cutaneous melanoma (melanoma and acral lentiginous melanoma), basal cell carcinoma, cutaneous squamous cell carcinoma, cutaneous T-cell lymphoma, and Kaposi sarcoma using data from the NHS National Disease Registration Service cancer registry between 2013 and 2020.
  • Data collection incorporated ethnicity information from multiple health care datasets, including Clinical Outcomes and Services Dataset, Patient Administration System, Radiotherapy Dataset, Diagnostic Imaging Dataset, and Hospital Episode Statistics.
  • A population analysis categorised patients into 7 standardised ethnic groups (on the basis of Office for National Statistics classifications): White, Asian, Chinese, Black, mixed, other, and unknown groups, with ethnicity data being self-reported by patients.
  • Outcomes included European age-standardised rates calculated using the 2013 European Standard Population and reported per 100,000 person-years (PYs).

TAKEAWAY:

  • White Individuals had 13-fold higher rates of cutaneous squamous cell carcinoma (61.75 per 100,000 PYs), 26-fold and 27-fold higher rates of basal cell carcinoma (153.69 per 100,000 PYs), and 33-fold and 16-fold higher rates of cutaneous melanoma (27.29 per 100,000 PYs) than Asian and Black individuals, respectively.
  • Black individuals had the highest incidence of acral lentiginous melanoma (0.85 per 100,000 PYs), and those in the other ethnic group had the highest incidence of cutaneous T-cell lymphoma (1.74 per 100,000 PYs) and Kaposi sarcoma (1.57 per 100,000 PYs).
  • The presentation of early-stage melanoma was low among Asian (53.5%), Black (62.4%), mixed (62.5%), and other (76.4%) ethnic groups compared to that among White ethnicities (79.8%).
  • Acral lentiginous melanomas were less likely to get urgent suspected cancer pathway referrals than overall melanoma (40.1% vs 44.6%; P < .001) and more likely to be diagnosed late than overall melanoma (stage I/II at diagnosis; 72% vs 80%; P < .0001).

IN PRACTICE:

"The findings emphasise the need for better, targeted ethnicity data collection strategies to address incidence, outcomes and health care equity for not just skin cancer but all health conditions in underserved populations," the authors wrote. "While projects like the Global Burden of Disease have improved global health care reporting, continuous audit and improvement of collected data are essential to provide better care across people of all ethnicities."

SOURCE:

This study was led by Shehnaz Ahmed, British Association of Dermatologists, London, England. It was published online on September 10, 2025, in the British Journal of Dermatology.

LIMITATIONS:

Census data collection after every 10 years could have contributed to inaccurate population estimates and incidence rates. Small sample sizes in certain ethnic groups could have led to potential confounders, requiring a cautious interpretation of relative incidence. The NHS data included only self-reported ethnicity data with no available details of skin phototypes, skin tones, or racial ancestry. This study lacked granular ethnicity census data and stage data for basal cell carcinoma, cutaneous small cell carcinoma, and Kaposi sarcoma.

DISCLOSURES:

This research was supported through a partnership between the British Association of Dermatologists and NHS England's National Disease Registration Service. Two authors reported being employees of the British Association of Dermatologists.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

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TOPLINE:

The incidence of skin cancer in England varied by ethnicity: White individuals had higher rates of melanoma, cutaneous squamous cell carcinoma, and basal cell carcinoma than Asian or Black individuals. In contrast, acral lentiginous melanoma was most common among Black individuals, whereas cutaneous T-cell lymphoma and Kaposi sarcoma were highest among those in the "Other" ethnic group.

METHODOLOGY:

  • Researchers analysed all cases of cutaneous melanoma (melanoma and acral lentiginous melanoma), basal cell carcinoma, cutaneous squamous cell carcinoma, cutaneous T-cell lymphoma, and Kaposi sarcoma using data from the NHS National Disease Registration Service cancer registry between 2013 and 2020.
  • Data collection incorporated ethnicity information from multiple health care datasets, including Clinical Outcomes and Services Dataset, Patient Administration System, Radiotherapy Dataset, Diagnostic Imaging Dataset, and Hospital Episode Statistics.
  • A population analysis categorised patients into 7 standardised ethnic groups (on the basis of Office for National Statistics classifications): White, Asian, Chinese, Black, mixed, other, and unknown groups, with ethnicity data being self-reported by patients.
  • Outcomes included European age-standardised rates calculated using the 2013 European Standard Population and reported per 100,000 person-years (PYs).

TAKEAWAY:

  • White Individuals had 13-fold higher rates of cutaneous squamous cell carcinoma (61.75 per 100,000 PYs), 26-fold and 27-fold higher rates of basal cell carcinoma (153.69 per 100,000 PYs), and 33-fold and 16-fold higher rates of cutaneous melanoma (27.29 per 100,000 PYs) than Asian and Black individuals, respectively.
  • Black individuals had the highest incidence of acral lentiginous melanoma (0.85 per 100,000 PYs), and those in the other ethnic group had the highest incidence of cutaneous T-cell lymphoma (1.74 per 100,000 PYs) and Kaposi sarcoma (1.57 per 100,000 PYs).
  • The presentation of early-stage melanoma was low among Asian (53.5%), Black (62.4%), mixed (62.5%), and other (76.4%) ethnic groups compared to that among White ethnicities (79.8%).
  • Acral lentiginous melanomas were less likely to get urgent suspected cancer pathway referrals than overall melanoma (40.1% vs 44.6%; P < .001) and more likely to be diagnosed late than overall melanoma (stage I/II at diagnosis; 72% vs 80%; P < .0001).

IN PRACTICE:

"The findings emphasise the need for better, targeted ethnicity data collection strategies to address incidence, outcomes and health care equity for not just skin cancer but all health conditions in underserved populations," the authors wrote. "While projects like the Global Burden of Disease have improved global health care reporting, continuous audit and improvement of collected data are essential to provide better care across people of all ethnicities."

SOURCE:

This study was led by Shehnaz Ahmed, British Association of Dermatologists, London, England. It was published online on September 10, 2025, in the British Journal of Dermatology.

LIMITATIONS:

Census data collection after every 10 years could have contributed to inaccurate population estimates and incidence rates. Small sample sizes in certain ethnic groups could have led to potential confounders, requiring a cautious interpretation of relative incidence. The NHS data included only self-reported ethnicity data with no available details of skin phototypes, skin tones, or racial ancestry. This study lacked granular ethnicity census data and stage data for basal cell carcinoma, cutaneous small cell carcinoma, and Kaposi sarcoma.

DISCLOSURES:

This research was supported through a partnership between the British Association of Dermatologists and NHS England's National Disease Registration Service. Two authors reported being employees of the British Association of Dermatologists.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

The incidence of skin cancer in England varied by ethnicity: White individuals had higher rates of melanoma, cutaneous squamous cell carcinoma, and basal cell carcinoma than Asian or Black individuals. In contrast, acral lentiginous melanoma was most common among Black individuals, whereas cutaneous T-cell lymphoma and Kaposi sarcoma were highest among those in the "Other" ethnic group.

METHODOLOGY:

  • Researchers analysed all cases of cutaneous melanoma (melanoma and acral lentiginous melanoma), basal cell carcinoma, cutaneous squamous cell carcinoma, cutaneous T-cell lymphoma, and Kaposi sarcoma using data from the NHS National Disease Registration Service cancer registry between 2013 and 2020.
  • Data collection incorporated ethnicity information from multiple health care datasets, including Clinical Outcomes and Services Dataset, Patient Administration System, Radiotherapy Dataset, Diagnostic Imaging Dataset, and Hospital Episode Statistics.
  • A population analysis categorised patients into 7 standardised ethnic groups (on the basis of Office for National Statistics classifications): White, Asian, Chinese, Black, mixed, other, and unknown groups, with ethnicity data being self-reported by patients.
  • Outcomes included European age-standardised rates calculated using the 2013 European Standard Population and reported per 100,000 person-years (PYs).

TAKEAWAY:

  • White Individuals had 13-fold higher rates of cutaneous squamous cell carcinoma (61.75 per 100,000 PYs), 26-fold and 27-fold higher rates of basal cell carcinoma (153.69 per 100,000 PYs), and 33-fold and 16-fold higher rates of cutaneous melanoma (27.29 per 100,000 PYs) than Asian and Black individuals, respectively.
  • Black individuals had the highest incidence of acral lentiginous melanoma (0.85 per 100,000 PYs), and those in the other ethnic group had the highest incidence of cutaneous T-cell lymphoma (1.74 per 100,000 PYs) and Kaposi sarcoma (1.57 per 100,000 PYs).
  • The presentation of early-stage melanoma was low among Asian (53.5%), Black (62.4%), mixed (62.5%), and other (76.4%) ethnic groups compared to that among White ethnicities (79.8%).
  • Acral lentiginous melanomas were less likely to get urgent suspected cancer pathway referrals than overall melanoma (40.1% vs 44.6%; P < .001) and more likely to be diagnosed late than overall melanoma (stage I/II at diagnosis; 72% vs 80%; P < .0001).

IN PRACTICE:

"The findings emphasise the need for better, targeted ethnicity data collection strategies to address incidence, outcomes and health care equity for not just skin cancer but all health conditions in underserved populations," the authors wrote. "While projects like the Global Burden of Disease have improved global health care reporting, continuous audit and improvement of collected data are essential to provide better care across people of all ethnicities."

SOURCE:

This study was led by Shehnaz Ahmed, British Association of Dermatologists, London, England. It was published online on September 10, 2025, in the British Journal of Dermatology.

LIMITATIONS:

Census data collection after every 10 years could have contributed to inaccurate population estimates and incidence rates. Small sample sizes in certain ethnic groups could have led to potential confounders, requiring a cautious interpretation of relative incidence. The NHS data included only self-reported ethnicity data with no available details of skin phototypes, skin tones, or racial ancestry. This study lacked granular ethnicity census data and stage data for basal cell carcinoma, cutaneous small cell carcinoma, and Kaposi sarcoma.

DISCLOSURES:

This research was supported through a partnership between the British Association of Dermatologists and NHS England's National Disease Registration Service. Two authors reported being employees of the British Association of Dermatologists.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

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Does Ethnicity Affect Skin Cancer Risk?

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Thu, 09/18/2025 - 11:05

Weekend Warrior and Regular Physical Activity Patterns Are Associated With Reduced Lung Cancer Risk

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TOPLINE:

Compared with inactive patterns, weekend warrior (moderate-to-vigorous physical activity [MVPA] condensed into 1-2 days per week) and regular physical activity patterns were found to be equally effective at reducing the risk for lung cancer. Neither pattern showed significant associations with the overall risk for cancer or specific risks for prostate, breast, and colorectal cancers.

METHODOLOGY:

  • This analysis included 80,896 participants (mean age, 55.5 years; 56% women) with valid accelerometer data collected between June 2013 and December 2015.
  • Participants were classified into three groups: 32,213 active weekend warriors (≥ 150 minutes of weekly MVPA with ≥ 50% achieved in 1-2 days), 22,162 active regular participants (≥ 150 minutes of MVPA but not meeting a weekend warrior pattern), and 26,521 inactive participants (< 150 minutes of MVPA).
  • Researchers tracked associations between physical activity patterns and incident cases of all types of cancer plus specific cases of prostate, breast, colorectal, and lung cancer over a median follow-up duration of 6 years.

TAKEAWAY:

  • Compared with inactive patterns, active weekend warrior patterns showed a significant inverse association with the risk for lung cancer (hazard ratio [HR], 0.77; 95% CI, 0.61-0.98).
  • Active regular activity patterns demonstrated similar protective effects against lung cancer as inactive patterns (HR, 0.73; 95% CI, 0.56-0.96).
  • Neither of the physical activity patterns showed any significant association with the overall risk for cancer or specific risks for prostate, breast, and colorectal cancers.

IN PRACTICE:

"Physical activity condensed into one to two days per week compared with a more balanced weekly distribution was associated with similar risk reductions of incident lung cancer, while neither pattern was associated with reduced overall, prostate, breast, and colorectal cancers," the authors of the study wrote.

SOURCE:

This study was led by Rubén López-Bueno, Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain. It was published online on September 06, 2025, in Annals of Medicine.

A version of this article first appeared on Medscape.com.

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TOPLINE:

Compared with inactive patterns, weekend warrior (moderate-to-vigorous physical activity [MVPA] condensed into 1-2 days per week) and regular physical activity patterns were found to be equally effective at reducing the risk for lung cancer. Neither pattern showed significant associations with the overall risk for cancer or specific risks for prostate, breast, and colorectal cancers.

METHODOLOGY:

  • This analysis included 80,896 participants (mean age, 55.5 years; 56% women) with valid accelerometer data collected between June 2013 and December 2015.
  • Participants were classified into three groups: 32,213 active weekend warriors (≥ 150 minutes of weekly MVPA with ≥ 50% achieved in 1-2 days), 22,162 active regular participants (≥ 150 minutes of MVPA but not meeting a weekend warrior pattern), and 26,521 inactive participants (< 150 minutes of MVPA).
  • Researchers tracked associations between physical activity patterns and incident cases of all types of cancer plus specific cases of prostate, breast, colorectal, and lung cancer over a median follow-up duration of 6 years.

TAKEAWAY:

  • Compared with inactive patterns, active weekend warrior patterns showed a significant inverse association with the risk for lung cancer (hazard ratio [HR], 0.77; 95% CI, 0.61-0.98).
  • Active regular activity patterns demonstrated similar protective effects against lung cancer as inactive patterns (HR, 0.73; 95% CI, 0.56-0.96).
  • Neither of the physical activity patterns showed any significant association with the overall risk for cancer or specific risks for prostate, breast, and colorectal cancers.

IN PRACTICE:

"Physical activity condensed into one to two days per week compared with a more balanced weekly distribution was associated with similar risk reductions of incident lung cancer, while neither pattern was associated with reduced overall, prostate, breast, and colorectal cancers," the authors of the study wrote.

SOURCE:

This study was led by Rubén López-Bueno, Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain. It was published online on September 06, 2025, in Annals of Medicine.

A version of this article first appeared on Medscape.com.

TOPLINE:

Compared with inactive patterns, weekend warrior (moderate-to-vigorous physical activity [MVPA] condensed into 1-2 days per week) and regular physical activity patterns were found to be equally effective at reducing the risk for lung cancer. Neither pattern showed significant associations with the overall risk for cancer or specific risks for prostate, breast, and colorectal cancers.

METHODOLOGY:

  • This analysis included 80,896 participants (mean age, 55.5 years; 56% women) with valid accelerometer data collected between June 2013 and December 2015.
  • Participants were classified into three groups: 32,213 active weekend warriors (≥ 150 minutes of weekly MVPA with ≥ 50% achieved in 1-2 days), 22,162 active regular participants (≥ 150 minutes of MVPA but not meeting a weekend warrior pattern), and 26,521 inactive participants (< 150 minutes of MVPA).
  • Researchers tracked associations between physical activity patterns and incident cases of all types of cancer plus specific cases of prostate, breast, colorectal, and lung cancer over a median follow-up duration of 6 years.

TAKEAWAY:

  • Compared with inactive patterns, active weekend warrior patterns showed a significant inverse association with the risk for lung cancer (hazard ratio [HR], 0.77; 95% CI, 0.61-0.98).
  • Active regular activity patterns demonstrated similar protective effects against lung cancer as inactive patterns (HR, 0.73; 95% CI, 0.56-0.96).
  • Neither of the physical activity patterns showed any significant association with the overall risk for cancer or specific risks for prostate, breast, and colorectal cancers.

IN PRACTICE:

"Physical activity condensed into one to two days per week compared with a more balanced weekly distribution was associated with similar risk reductions of incident lung cancer, while neither pattern was associated with reduced overall, prostate, breast, and colorectal cancers," the authors of the study wrote.

SOURCE:

This study was led by Rubén López-Bueno, Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain. It was published online on September 06, 2025, in Annals of Medicine.

A version of this article first appeared on Medscape.com.

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Older Patients With Breast Cancer Face Inconsistent Bone Health Management Across Centres

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TOPLINE:

Bone health management for older women with breast cancer receiving aromatase inhibitors (AIs) varied substantially across 5 UK hospitals. Despite the higher risk for fractures, women aged > 80 years were less likely to receive DEXA scans or bisphosphonates, highlighting the urgent need for standardised bone monitoring and treatment in frail older patients.

METHODOLOGY:

  • This secondary analysis of the multicentre Age Gap study included 529 women (age ≥ 70 years) with oestrogen receptor-positive early breast cancer who received AIs, either as primary or adjuvant treatment, at five hospitals in the UK.
  • Researchers collected comprehensive data including the type of endocrine therapy, DEXA scan results, bisphosphonate usage, calcium and vitamin D supplementation, and the incidence of fractures during or after AI therapy.
  • Frailty was assessed using a modified Rockwood Frailty Index, with scores being calculated across 75 variables to categorise patients as robust (< 0.08), prefrail (0.08-0.25), or frail (> 0.25).

TAKEAWAY:

  • Overall, 67% of patients had baseline DEXA scans. Of these, 42% were osteopenic and 18% osteoporotic. Scans were more common in 70- to 79-year-olds than in those aged ≥ 80 years and in women undergoing surgery than in those undergoing primary endocrine therapy, with marked variation across centres (P < .001 for all).
  • Among patients receiving AI therapy, 43% were prescribed bisphosphonates, especially those who had surgery (hazard ratio [HR], 1.36; P = .04) and those aged 70-79 years (HR, 1.31; P = .02); 33% had vitamin D plus calcium along with bisphosphonates.
  • During follow-up, 23% of patients had fractures, with significant variation across centres (P = .02), and 38% of these patients had received prior bisphosphonates.
  • Although 94% of patients were frail or prefrail, frailty did not correlate with baseline hip (P = .10) or spine (P = .89) T scores. Bisphosphonates plus AIs were prescribed in 70% of nonfrail participants vs 43% of prefrail and 47% of frail participants (P = .02).

IN PRACTICE:

“Patient’s age and general health influence bone health decision making, with older and frailer patients often receiving non-standard care. Despite national and international recommendations, there is still wide variation in bone health management, highlighting the need for further education and standardised bone health care in older women with breast cancer,” the authors wrote.

SOURCE:

This study was led by Elisavet Theodoulou, University of Sheffield, Sheffield, England. It was published online, in the Journal of Geriatric Oncology.

LIMITATIONS:

The study’s inclusion of only 5 hospital sites limited the ability to draw broader conclusions about bone health management practices across a wider range of centres. Additionally, the interpretation of the results was complicated by the introduction of adjuvant bisphosphonates during the study period, making the cohort unstable in terms of bisphosphonate usage indications.

DISCLOSURES:

The Age Gap study was supported by the National Institute for Health and Care Research Programme Grants for Applied Research. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

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TOPLINE:

Bone health management for older women with breast cancer receiving aromatase inhibitors (AIs) varied substantially across 5 UK hospitals. Despite the higher risk for fractures, women aged > 80 years were less likely to receive DEXA scans or bisphosphonates, highlighting the urgent need for standardised bone monitoring and treatment in frail older patients.

METHODOLOGY:

  • This secondary analysis of the multicentre Age Gap study included 529 women (age ≥ 70 years) with oestrogen receptor-positive early breast cancer who received AIs, either as primary or adjuvant treatment, at five hospitals in the UK.
  • Researchers collected comprehensive data including the type of endocrine therapy, DEXA scan results, bisphosphonate usage, calcium and vitamin D supplementation, and the incidence of fractures during or after AI therapy.
  • Frailty was assessed using a modified Rockwood Frailty Index, with scores being calculated across 75 variables to categorise patients as robust (< 0.08), prefrail (0.08-0.25), or frail (> 0.25).

TAKEAWAY:

  • Overall, 67% of patients had baseline DEXA scans. Of these, 42% were osteopenic and 18% osteoporotic. Scans were more common in 70- to 79-year-olds than in those aged ≥ 80 years and in women undergoing surgery than in those undergoing primary endocrine therapy, with marked variation across centres (P < .001 for all).
  • Among patients receiving AI therapy, 43% were prescribed bisphosphonates, especially those who had surgery (hazard ratio [HR], 1.36; P = .04) and those aged 70-79 years (HR, 1.31; P = .02); 33% had vitamin D plus calcium along with bisphosphonates.
  • During follow-up, 23% of patients had fractures, with significant variation across centres (P = .02), and 38% of these patients had received prior bisphosphonates.
  • Although 94% of patients were frail or prefrail, frailty did not correlate with baseline hip (P = .10) or spine (P = .89) T scores. Bisphosphonates plus AIs were prescribed in 70% of nonfrail participants vs 43% of prefrail and 47% of frail participants (P = .02).

IN PRACTICE:

“Patient’s age and general health influence bone health decision making, with older and frailer patients often receiving non-standard care. Despite national and international recommendations, there is still wide variation in bone health management, highlighting the need for further education and standardised bone health care in older women with breast cancer,” the authors wrote.

SOURCE:

This study was led by Elisavet Theodoulou, University of Sheffield, Sheffield, England. It was published online, in the Journal of Geriatric Oncology.

LIMITATIONS:

The study’s inclusion of only 5 hospital sites limited the ability to draw broader conclusions about bone health management practices across a wider range of centres. Additionally, the interpretation of the results was complicated by the introduction of adjuvant bisphosphonates during the study period, making the cohort unstable in terms of bisphosphonate usage indications.

DISCLOSURES:

The Age Gap study was supported by the National Institute for Health and Care Research Programme Grants for Applied Research. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

Bone health management for older women with breast cancer receiving aromatase inhibitors (AIs) varied substantially across 5 UK hospitals. Despite the higher risk for fractures, women aged > 80 years were less likely to receive DEXA scans or bisphosphonates, highlighting the urgent need for standardised bone monitoring and treatment in frail older patients.

METHODOLOGY:

  • This secondary analysis of the multicentre Age Gap study included 529 women (age ≥ 70 years) with oestrogen receptor-positive early breast cancer who received AIs, either as primary or adjuvant treatment, at five hospitals in the UK.
  • Researchers collected comprehensive data including the type of endocrine therapy, DEXA scan results, bisphosphonate usage, calcium and vitamin D supplementation, and the incidence of fractures during or after AI therapy.
  • Frailty was assessed using a modified Rockwood Frailty Index, with scores being calculated across 75 variables to categorise patients as robust (< 0.08), prefrail (0.08-0.25), or frail (> 0.25).

TAKEAWAY:

  • Overall, 67% of patients had baseline DEXA scans. Of these, 42% were osteopenic and 18% osteoporotic. Scans were more common in 70- to 79-year-olds than in those aged ≥ 80 years and in women undergoing surgery than in those undergoing primary endocrine therapy, with marked variation across centres (P < .001 for all).
  • Among patients receiving AI therapy, 43% were prescribed bisphosphonates, especially those who had surgery (hazard ratio [HR], 1.36; P = .04) and those aged 70-79 years (HR, 1.31; P = .02); 33% had vitamin D plus calcium along with bisphosphonates.
  • During follow-up, 23% of patients had fractures, with significant variation across centres (P = .02), and 38% of these patients had received prior bisphosphonates.
  • Although 94% of patients were frail or prefrail, frailty did not correlate with baseline hip (P = .10) or spine (P = .89) T scores. Bisphosphonates plus AIs were prescribed in 70% of nonfrail participants vs 43% of prefrail and 47% of frail participants (P = .02).

IN PRACTICE:

“Patient’s age and general health influence bone health decision making, with older and frailer patients often receiving non-standard care. Despite national and international recommendations, there is still wide variation in bone health management, highlighting the need for further education and standardised bone health care in older women with breast cancer,” the authors wrote.

SOURCE:

This study was led by Elisavet Theodoulou, University of Sheffield, Sheffield, England. It was published online, in the Journal of Geriatric Oncology.

LIMITATIONS:

The study’s inclusion of only 5 hospital sites limited the ability to draw broader conclusions about bone health management practices across a wider range of centres. Additionally, the interpretation of the results was complicated by the introduction of adjuvant bisphosphonates during the study period, making the cohort unstable in terms of bisphosphonate usage indications.

DISCLOSURES:

The Age Gap study was supported by the National Institute for Health and Care Research Programme Grants for Applied Research. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

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