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Are 3D mammograms better than standard imaging? A diverse study aims to find out_我的网站

一 |     日喀则上午9点突发地震，可中午12点刚过，解放军就火速赶到灾区。    Are 3D mammograms better than standard 2D imaging for catching advanced cancers?A clinical trial is recruiting thousands of volunteers — including a large number of Black women who face disparities in breast cancer death rates — to try to find out.People like Carole Stovall, a psychologist in Washington, D.C., have signed up for the study to help answer the question.“We all need a mammogram anyway, so why not do it with a study that allows the scientists to understand more and move closer to finding better treatments and ways of maybe even preventing it?” Stovall said.The underrepresentation of women and minorities in research is a long-simmering issue affecting health problems including Alzheimer’s disease, stroke and COVID-19. Trials without diversity lead to gaps in understanding of how new treatments work for all people. “Until we get more Black women into clinical trials, we can’t change the science. And we need better science for Black bodies,” said Ricki Fairley, a breast cancer survivor and advocate who is working on the issue.Black women are 40% more likely to die from breast cancer than white women and tend to be diagnosed younger. But it’s not clear whether 3D mammography is better for them, said Dr. Worta McCaskill-Stevens of the National Cancer Institute.“Are there populations for whom this might be important to have early diagnosis?" asked McCaskill-Stevens. "Or is it harmful,” causing too many false alarms or unneeded follow-up tests and treatments?McCaskill-Stevens, who is Black, leads NCI’s efforts to boost access to cancer research in minority and rural communities. She has joined the study herself.The newer 3D technique has been around for a decade, but there’s never been conclusive evidence that it's better than 2D at detecting advanced cancers. The screening technique combines multiple pictures of the breast taken from different angles to create a 3D-like image. Both 3D and 2D mammograms compress the breast and use low doses of radiation.Prior studies suggest that 3D finds more cancers than 2D, but catching more cancers doesn’t necessarily mean more lives saved. Some cancers missed by standard screening may not progress or need treatment. Previous studies did not randomly assign patients to a screening method, the gold standard for research.The notion “that if it’s new, it’s shiny, then it’s better,” isn’t necessarily true, McCaskill-Stevens said. “Until we have the evidence to support that, then we need well-designed randomized trials.”The trial has enrolled nearly 93,000 women so far with a goal of 128,000. The NCI-funded study is now running in Canada, South Korea, Peru, Argentina, Italy and 32 U.S. states. A site in Thailand will soon begin enrolling patients.“We added more international sites to enhance the trial’s diversity, particularly for Hispanic and Asian women,” said Dr. Etta Pisano, who leads the study. Overall, 42% of participants are Hispanic. As recruiting continues, enrolling Black women and other women of color will “absolutely” continue as a priority, Pisano said.Participants are randomly assigned to either 2D or 3D mammograms and are followed for several years. The number of advanced cancers detected by the two methods will be compared.At the U.S. study sites, 21% of study participants are Black women — that's higher than a typical cancer treatment study, in which 9% of participants are Black, McCaskill-Stevens said.The University of North Carolina has signed up more Black women than any other study site. Nearly a quarter of the nearly 3,000 women enrolled at UNC’s two locations are Black.“Women in North Carolina want to take part in something that’s bigger than them,” said Dr. Cherie Kuzmiak, who leads the UNC arm of the study. “They want this active role in helping determine the future of health care for women.”In Washington, D.C., word of mouth has led to successful recruiting. A chance encounter at her hair salon persuaded Stovall to join the research. While waiting for a hair appointment, she met Georgetown University cancer researcher Lucile Adams-Campbell. The two, both Black, started chatting.“She explained how important it was to get women of color into the program,” said Stovall, who jumped at the chance to catch up on her mammograms after the COVID-19 pandemic delayed screening for her and thousands of others.For Stovall, there was a personal reason to join the research. Her sister recently completed treatment for triple negative breast cancer, an aggressive type that affects Black women at higher rates than white women. Women ages 45 to 74 without a personal history of breast cancer are eligible for the study, which launched in 2017. Many women also are providing blood and cheek swab samples for a database that will be mined for insights.“It’s a dream that people had since the beginning of screening that we wouldn’t fit everybody into the same box,” Pisano said. The study's findings could “reduce disparities if we’re successful, assuming people have access to care.”Stovall, 72, had a brief scare when her mammogram, the traditional 2D type, showed something suspicious. A biopsy ruled out cancer.“I was extremely relieved,” Stovall said. “Everybody I know has heard from me about the need for them to go get a mammogram.”___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.。

二 | 打头阵的是200多人的成建制特遣队，他们带着各种救灾装备和大量物资来到受灾群众身边。同时，无人机在空中侦察，给地面部队提供精准情报，就像给部队装上了“千里眼”。下午，西部战区的运 -20运输机运来战区前沿指挥所，在定日机场落地后，一个覆盖整个灾区的完备指挥体系迅速搭建起来。除了这是救灾不是作战，解放军这次行动完美展示了对高原边境地区的快速反应能力，边境对面的印军看了，或许会有自己的思考。从央视画面能看到，解放军先遣部队通过陆地开进，率先到达地震的山谷。之前无人机已经在空中侦察，绘制了最新地形图，给部队指路。直 -20直升机把特种小队空运到车开不进去的地方。

三 | 2008年汶川地震到现在区区16年，从解放军的救灾水平能看出我们军队的机动能力进步有多大！2008年汶川地震，当时的救援行动却面临诸多艰难险阻。

四 | 地震致使交通全面瘫痪，道路垮塌、桥梁断裂，大型救援装备难以运输。徒步挺进的官兵，背负沉重物资，在余震不断、崎岖难行的山路上艰难跋涉。空中救援同样面临困境，直升机数量有限，复杂的气象和地形条件，严重制约了救援物资的投放与人员转运效率。16年过去，解放军的机动能力实现了质的飞跃。运 -20等大型运输机发挥了关键作用，在短时间内将大量的人员、紧缺物资，精准投送至灾区。在地面，新型全地形车、高机动性越野装备等大量列装，这些装备能够在各种复杂地形中畅行无阻，快速将救灾人员和物资送达偏远区域。

五 | 空中方面，直升机不仅数量增多，性能也大幅提升，特别是在高原性能上的优化，实现精准的物资投送与伤员转运。

六 | 就在地震前几天，央视还播了解放军在高原搞无人化、智能化后勤补给演练，机器狗、无人小车、无人机都用上了，以后高海拔地区补给和保障难的问题，算是解决了。这样一来，解放军能用比印军少很多的兵力，有效控制同样大的边境地区。有无人机、无人平台、直升机和运输机帮忙，解放军合成部队能第一时间出现在防区任何地方，而且装备齐、弹药足，一到就能投入战斗，不用等后续部队。

七 | 再看印军，他们直升机在高海拔飞不了多久，之前阿帕奇武装直升机发动机熄火，只能拆了用卡车运下山。在无人平台运补给、边境路况保障、兵力快速调动这些方面，印军落后太多。没办法，印军只能在边境长期保持5万、10万甚至20万兵力，可这么多人吃喝拉撒，消耗巨大，就像个填不满的坑。这就是去年年底印度急着和咱们就西段边境对峙问题和解的原因。

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Published on:07:05:13