Publications by authors named "Andre Pfob"

Background: Understanding sample representativeness is key to interpreting findings from epidemiological research and applying these findings to broader populations. Though techniques for assessing sample representativeness are available, they rely on access to raw data detailing the population of interest which are often not readily available and may not be suitable for comparing large datasets. In reality, population-based data are often only available in an aggregated format.

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Purpose: Artificial Intelligence models based on medical (imaging) data are increasingly developed. However, the imaging software on which the original data is generated is frequently updated. The impact of updated imaging software on the performance of AI models is unclear.

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The pretherapeutic assessment of axillary lymph node status is crucial in staging early breast cancer patients, significantly influencing their further treatment and prognosis. According to current guidelines, patients with clinically unsuspicious axillary status regularly undergo a biopsy of sentinel lymph nodes (SLNs), whereby metastasis is detected in up to 20% of cases. In recent years, the use of shear wave elastography (SWE) has been studied as an additional ultrasound tool for the non-invasive assessment of tumors in the breast parenchyma and axillary lymph nodes.

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Article Synopsis
  • The study focuses on predicting the risk of severe toxicity from cancer treatments using machine learning algorithms, addressing a significant concern for patients.
  • Clinical data from 590 breast cancer patients was analyzed to develop and validate two algorithms, with enhancements in predictive accuracy achieved by incorporating treatment information alongside patient characteristics.
  • Results indicate that machine learning can effectively forecast treatment-related toxicity, offering a potential strategy to enhance treatment safety and management for cancer patients.
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Background: In recent years, the integration of artificial intelligence (AI) techniques into medical imaging has shown great potential to transform the diagnostic process. This review aims to provide a comprehensive overview of current state-of-the-art applications for AI in abdominal and pelvic ultrasound imaging.

Methods: We searched the PubMed, FDA, and ClinicalTrials.

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We aimed to evaluate the role of adjuvant chemotherapy and loco-regional therapy for stage IA (pT1, pN0) triple-negative breast cancer (TNBC) in a real-world setting. We identified patients with pT1, pN0 TNBC diagnosed between 2009 and 2021 within the Baden-Württemberg cancer registry (BWCR), Germany. Overall survival (OS) was assessed using Kaplan-Meier statistics and multivariate Cox regression models (adjusted for age, use of chemotherapy, local therapy (breast conserving therapy [breast conserving surgery + radiotherapy] vs.

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Article Synopsis
  • Preoperative evaluation of axillary lymph nodes is important for determining treatment options in early breast cancer, and this study explored the effectiveness of shear wave elastography (SWE) for staging these lymph nodes.
  • The research involved 100 patients, measuring the stiffness of axillary lymph nodes with SWE, and established a cutoff velocity of 2.66 m/s to differentiate between malignant and benign nodes with notable sensitivity and specificity.
  • The findings suggest that SWE can enhance the assessment of suspicious axillary lymph nodes, providing a valuable tool for improving biopsy decisions and treatment planning in breast cancer patients.
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Background: Targeted approaches such as targeted axillary dissection (TAD) or sentinel lymph node biopsy (SLNB) showed false-negative rates of < 10% compared with axillary lymph node dissection (ALND) in patients with nodal-positive breast cancer undergoing neoadjuvant systemic treatment (NAST). We aimed to evaluate real-world oncologic outcomes for different axillary staging techniques.

Methods: We identified nodal-positive breast cancer patients undergoing NAST from 2016 to 2021 from the state cancer registry of Baden-Wuerttemberg, Germany.

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Objectives: Patients with triple-negative breast cancer (TNBC) exhibit a fast tumor growth rate and poor survival outcomes. In this study, we aimed to develop and compare intelligent algorithms using ultrasound radiomics features in addition to clinical variables to identify patients with TNBC prior to histopathologic diagnosis.

Methods: We used single-center, retrospective data of patients who underwent ultrasound before histopathologic verification and subsequent neoadjuvant systemic treatment (NAST).

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Background: BODY-Q is a rigorously developed patient-reported outcome measure designed to measure outcomes of weight loss and body contouring patients. To allow interpretation and comparison of BODY-Q scores across studies, normative BODY-Q values were generated from the general population. The aim of this study was to examine the psychometric properties of BODY-Q in the normative population.

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Article Synopsis
  • Some breast cancer patients don’t fully respond to treatment, which makes it harder for them to recover.
  • Researchers looked at a special biopsy method called VAB to see if it could help detect these patients before surgery.
  • They found that VAB always showed if there was leftover cancer after treatment, while regular imaging methods weren't as reliable.
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Objectives: Shear wave elastography (SWE) is increasingly used in breast cancer diagnostics. However, large, prospective, multicenter data evaluating the reliability of SWE is missing. We evaluated the intra- and interobserver reliability of SWE in patients with breast lesions categorized as BIRADS 3 or 4.

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Purpose: Digitalization plays a critical role and is beginning to impact every part of the patient journey, from drug discovery and data collection to treatment and patient-reported outcomes. We aimed to evaluate the status quo and future directions of digital medicine in the specialty of gynecology and obstetrics in Germany.

Methods: An anonymous questionnaire was distributed via the German Society of Gynecology and Obstetrics newsletter in December 2022.

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Article Synopsis
  • The study evaluates the use of hospital information systems (HIS) in the fields of gynecology and obstetrics in Germany, focusing on how they manage patient care services.* -
  • An anonymous survey sent out in December 2022 garnered responses from 91 healthcare professionals, uncovering that many rely on a mixed system of digital and paper-based documentation, with an average of four different software systems in use.* -
  • Results indicate a significant dissatisfaction with current HIS due to their lack of interoperability and outdated technology, highlighting the need for modernization in order to improve patient care.*
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Objectives: Response assessment to neoadjuvant systemic treatment (NAST) to guide individualized treatment in breast cancer is a clinical research priority. We aimed to develop an intelligent algorithm using multi-modal pretreatment ultrasound and tomosynthesis radiomics features in addition to clinical variables to predict pathologic complete response (pCR) prior to the initiation of therapy.

Methods: We used retrospective data on patients who underwent ultrasound and tomosynthesis before starting NAST.

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Background: Breast cancer therapy improved significantly, allowing for different surgical approaches for the same disease stage, therefore offering patients different aesthetic outcomes with similar locoregional control. The purpose of the CINDERELLA trial is to evaluate an artificial-intelligence (AI) cloud-based platform (CINDERELLA platform) vs the standard approach for patient education prior to therapy.

Methods: A prospective randomized international multicentre trial comparing two methods for patient education prior to therapy.

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Clinical axillary lymph node management in early breast cancer has evolved from being merely an aspect of surgical management and now includes the entire multidisciplinary team. The second edition of the "Lucerne Toolbox", a multidisciplinary consortium of European cancer societies and patient representatives, addresses the challenges of clinical axillary lymph node management, from diagnosis to local therapy of the axilla. Five working packages were developed, following the patients' journey and addressing specific clinical scenarios.

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Background: We sought to predict clinically meaningful changes in physical, sexual, and psychosocial well-being for women undergoing cancer-related mastectomy and breast reconstruction 2 years after surgery using machine learning (ML) algorithms trained on clinical and patient-reported outcomes data.

Patients And Methods: We used data from women undergoing mastectomy and reconstruction at 11 study sites in North America to develop three distinct ML models. We used data of ten sites to predict clinically meaningful improvement or worsening by comparing pre-surgical scores with 2 year follow-up data measured by validated Breast-Q domains.

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Objectives: We sought to identify trajectories of patient-reported outcomes, specifically physical well-being of the chest (PWBC), in patients who underwent postmastectomy breast reconstruction, and further assessed its significant predictors, and its relationship with health-related quality of life (HRQOL).

Methods: We used data collected as part of the Mastectomy Reconstruction Outcomes Consortium study within a 2-year follow-up in 2012-2017, with 1422, 1218,1199, and 1417 repeated measures at assessment timepoints of 0,3,12, and 24 months, respectively. We performed latent class growth analysis (LCGA) in the implant group (IMPG) and autologous group (AUTOG) to identify longitudinal change trajectories, and then assessed its significant predictors, and its relationship with HRQOL by conducting multinomial logistic regression.

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Purpose: A previous study in our breast unit showed that the diagnostic accuracy of intraoperative specimen radiography and its potential to reduce second surgeries in a cohort of patients treated with neoadjuvant chemotherapy were low, which questions the routine use of Conventional specimen radiography (CSR) in this patient group. This is a follow-up study in a larger cohort to further evaluate these findings.

Methods: This retrospective study included 376 cases receiving breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NACT) of primary breast cancer.

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Background: Assessments of health-related quality of life (HRQoL) play an important role in transition to palliative care for women with metastatic breast cancer. We developed machine learning (ML) algorithms to analyse longitudinal HRQoL data and identify patients who may benefit from palliative care due to disease progression.

Methods: We recruited patients from two institutions and administered the EuroQoL Visual Analog Scale (EQ-VAS) via an online platform over a 6-month period.

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In this review, we evaluate the potential and recent advancements in using artificial intelligence techniques to de-escalate loco-regional breast cancer therapy, with a special focus on surgical treatment after neoadjuvant systemic treatment (NAST). The increasing use and efficacy of NAST make the optimal loco-regional management of patients with pathologic complete response (pCR) a clinically relevant knowledge gap. It is hypothesized that patients with pCR do not benefit from therapeutic surgery because all tumor has already been eradicated by NAST.

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Purpose: The Histolog® Scanner (SamanTree Medical SA, Lausanne, Switzerland) is a large field-of-view confocal laser scanning microscope designed to allow intraoperative margin assessment by the production of histological images ready for assessment in the operating room. We evaluated the feasibility and the performance of the Histolog® Scanner (HS) to correctly identify infiltrated margins in clinical practice of lumpectomy specimens. It was extrapolated if the utilization of the HS has the potential to reduce infiltrated margins and therefore reduce re-operation rates in patients undergoing breast conserving surgery (BCS) due to a primarily diagnosed breast cancer including ductal carcinoma in situ.

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