Vacuum-assisted breast biopsy (VABB) guided by digital breast tomosynthesis (DBT) represents one of the best instruments to obtain a histological diagnosis of suspicious lesions with no ultrasound ...correlation or those which are visible only on DBT. After a review of the literature, we retrospectively analyzed the DBT-guided VABBs performed from 2019 to 2022 at our department. Descriptive statistics, Pearson's correlation and χ
test were used to compare distributions of age, breast density (BD) and early performance measures including histopathology. We used kappa statistics to evaluate the agreement between histological assessment and diagnosis. Finally, we compared our experience to the literature to provide indications for clinical practice. We included 85 women aged 41-84 years old. We identified 37 breast cancers (BC), 26 stage 0 and 11 stage IA. 67.5% of BC was diagnosed in women with high BD. The agreement between VABB and surgery was 0.92 (k value, 95% CI: 0.76-1.08). We found a statistically significant inverse correlation between age and BD. The post-procedural clip was correctly positioned in 88.2%. The post-procedural hematoma rate was 14.1%. No infection or hemorrhage were recorded. When executed correctly, DBT-guided VABB represents a safe and minimally invasive technique with high histopathological concordance, for detecting nonpalpable lesions without ultrasound correlation.
Aim: To evaluate the local impact of the coronavirus disease 2019 (COVID-19) pandemic on breast cancer (BC) care, with particular attention to the economical and psychological consequences of the ...possible delay of new diagnoses and treatments.
Methods: Three years’ activity (from 2019 to 2021) has been compared. The number of BCs diagnosed from the total amount of mammographic and ultrasound (US) examinations performed in women aged more than 40 years old has been considered. A Pearson’s chi-squared test was performed to verify differences between results. Statistical significance was set at P ≤ 0.01.
Results: A statistically significant difference was found in the number of BC diagnosed between screening and ambulatory care patients in both the 2019–2020 (χ2 = 24.93, P < 0.01) and 2019–2021 (χ2 = 29.93, P < 0.01) comparisons. No statistically significant difference was found in the data recorded between 2020 and 2021 (χ2 = 2.35, P > 0.01). By evaluating the specific age groups for each year, a statistically significant difference (P < 0.01) was found in the number of BC diagnosed in screening patients aged 50–69 years old in both 2019–2020 and 2019–2021 comparisons. The percentages of early BC diagnosed in 2019, 2020, and 2021 were 80.9%, 91.7%, and 89.8%, respectively. The adherence rates to screening in 2019, 2020, and 2021 were 67.5%, 45.2%, and 56.9%, respectively.
Conclusions: Results showed a reduction of new diagnoses in the screening range during the pandemic in comparison with the previous period. The high percentage of early BC would seem to have prevented worsening outcomes. Nevertheless, women who have not undergone screening could present a more advanced stage disease in the following years. Consequently, the evaluation of possible solutions to guarantee an essential level of care with the purpose to avoid worsening patients’ outcomes and the increase in healthcare costs is mandatory.
The assessment of breast density is one of the main goals of radiologists because the masking effect of dense fibroglandular tissue may affect the mammographic identification of lesions. The BI-RADS ...5th Edition has revised the mammographic breast density categories, focusing on a qualitative evaluation rather than a quantitative one. Our purpose is to compare the concordance of the automatic classification of breast density with the visual assessment according to the latest available classification.
A sample of 1075 digital breast tomosynthesis images from women aged between 40 and 86 years (58 ± 7.1) was retrospectively analyzed by three independent readers according to the BI-RADS 5th Edition. Automated breast density assessment was performed on digital breast tomosynthesis images with the Quantra software version 2.2.3. Interobserver agreement was assessed with kappa statistics. The distributions of breast density categories were compared and correlated with age.
The agreement on breast density categories was substantial to almost perfect between radiologists (κ = 0.63-0.83), moderate to substantial between radiologists and the Quantra software (κ = 0.44-0.78), and the consensus of radiologists and the Quantra software (κ = 0.60-0.77). Comparing the assessment for dense and non-dense breasts, the agreement was almost perfect in the screening age range without a statistically significant difference between concordant and discordant cases when compared by age.
The categorization proposed by the Quantra software has shown a good agreement with the radiological evaluations, even though it did not completely reflect the visual assessment. Thus, clinical decisions regarding supplemental screening should be based on the radiologist's perceived masking effect rather than the data produced exclusively by the Quantra software.
Purpose - This paper examines the current digital competences of Italian accountants and to what extent these competences are evident in their competence profiles.
Methodology - In this study, 6,442 ...profiles of accountants, extracted from the professional social network LinkedIn, were analysed using the technique for the analysis of textual data.
Findings - The results of the study reveal that the male users expose more often in their professional profiles the possession of information technology skills than female accountants. Moreover, the results highlight a limited development of data analytics skills, which are reported in only 13% of the LinkedIn profiles analysed. Furthermore, the findings also show that there is a gap between the digital competences held by accountants who belong to different geographical areas. The accountants living in northern Italy, in fact, report more digital competences in their LinkedIn profiles than those living in central and southern Italy.
Originality - This study stimulates the ongoing debate on the competence's changes of the accountants in the digital technology era.
Purpose
This paper aims to investigate the impact of family involvement in ownership and governance on the quality of internal auditing.
Design/methodology/approach
Leveraging a hand-collected data ...set of listed family firms from 2014 to 2020, this study uses regression analyses to investigate the impact of family ownership, family involvement on the board, family CEO and the generational stage of the family business on the quality of internal auditing.
Findings
The results provide evidence that family ownership is positively associated with the quality of internal auditing, while later generational stages of family businesses have the opposite effect. Additional analyses reveal that the presence of a sustainability board sub-committee moderates the relationship between generational stages of family businesses and the quality of internal auditing function.
Research limitations/implications
This paper does not consider country-institutional factors and other potentially family-related antecedents or governance factors that may affect the quality of internal auditing.
Practical implications
The results are informative for investors and non-family stakeholders interested in understanding under which conditions family-related factors influence the quality of internal auditing functions.
Originality/value
This study offers fresh evidence regarding the relationship between family-related factors and the quality of internal auditing and board sub-committees that moderate such a relationship in family businesses.
Abstract This study investigates the effects of green innovation (GI) on financial performance under both accounting and market‐based perspectives in European Union (EU) listed non‐financial firms. ...In addition, this study explores whether the R&D investments and the Environmental, Social and Governance (ESG) disclosure play a mediating role over the association between GI and accounting‐based and market‐based financial performance, respectively. Based on a sample of 526 firms over the period 2012–2022, we find that GI is negatively associated with accounting‐based financial performance and positively associated with market‐based financial performance. We further find that GI impacts on accounting‐based financial performance via the channel of R&D investments and on market‐based financial performance via the channel of ESG disclosure. This study provides useful contributions to prior research by encouraging the adoption of an integrated perspective when evaluating potential effects of GI. This study can also assist managers in better preparing for the challenges of implementing GI by leveraging the ESG disclosure. It also advices to investors to carefully assess the more complex impact of GI on financial performance of the firm within their capital allocation decision‐making process. In the same vein, it offers some insights to policy makers interested in facilitating the transition to a sustainable economy.
The purpose of this study is to examine the conceptual structure of the field of internal audit (IA) research to provide a comprehensive overview of the academic field. A bibliometric analysis was ...used to analyse 461 papers from 152 journals between 1991 and 2020 divided into the following two steps. The descriptive statistical analysis highlights the characteristics of the IA research community in terms of publications, productive authors, journals, and countries. Then, the co-word analysis adopting multiple correspondence analysis (MCA) has been performed to analyse the conceptual structure of the IA field. The main results of this study can be summarized as follows. The increase in the number of publications recorded in the past few years highlights a growing academic interest in the IA research. Four main topics are identified by the bibliometric analysis: 1) the oversight governance role of IA; 2) information technology in the IA; 3) internal auditor independence and competence; 4) reliance on the IA. This study contributes to the field by facilitating the identification of research areas and outlining the current state of IA research.
The purpose of the paper is to examine the development of the accountancy profession in Italy, with particular reference to its relationship with the State. The period under review goes from 1906 – ...the year in which Law no. 327 was enacted regulating the accountancy profession consistently throughout the nation – until 2005, when the professional bodies of the dottori commercialisti and the ragionieri merged. The study uses both primary and secondary sources. The primary sources are a selection of laws, decrees and regulations issued by the government over time. A second set of documents consulted is the summaries of parliamentary debates and the explicative notes to laws and regulations. The secondary sources include writings on the sociology of the professions, international publications on the relationship between State and profession and economic history treatises on the history of the accountancy profession. The sources are examined mainly using a qualitative–deductive methodology. Passing through the analysis of some relevant variables, the results of study highlight how the State have significantly influenced the development of the accountancy profession. At the same time, this study extends the observation to a poorly explored economic–social context.
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