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MRI Identifies Tumors in Second Breast of Women

By MedImaging International staff writers
Posted on 06 Apr 2010

Postmenopausal women, including those over 70 years old, who have been newly diagnosed with cancer in one breast have higher cancer detection rates when the other breast is scanned for tumors with magnetic resonance imaging (MRI), compared to premenopausal women.

The investigators found that 3.8% of 425 women had breast cancer in the undiagnosed breast that had not been found with a clinical or mammographic examination; all were postmenopausal. In these women, detecting and treating cancer in both breasts at the same time may save costs, patient stress, and the potential toxicity that may come from having to treat cancer later in the second breast once it is discovered, the researchers reported in the March/April 2010 issue of the Breast Journal.

Of particular interest to the researchers is their finding that patients 70 and older had a higher prevalence of cancer detected in the second breast by MRI than did younger patients in the study. MRI detected a tumor in the second breast in 5.4% of 129 elderly women included in the study. "Our findings are not really surprising because we know that the risk of breast cancer increases as age increases,” stated the study's lead investigator, Johnny Ray Bernard Jr., M.D., a radiation oncologist from the Mayo Clinic in Jacksonville (FL, USA). "Elderly women in good health potentially benefit from earlier detection, and we believe that screening of the undiagnosed breast with MRI should be considered in all postmenopausal women diagnosed with a breast cancer.”

Since 2003, Mayo Clinic in Jacksonville has offered MRI scanning of both breasts in women with newly diagnosed breast cancer. In this study, Mayo researchers retrospectively reviewed the records of 425 women who underwent bilateral breast MRI between 2003 and 2007. The goal was to determine the prevalence of "contralateral” cancer detected by MRI, but not captured by mammogram or clinical breast exams. Contralateral refers to the opposite breast where cancer was not diagnosed.

The researchers concluded that postmenopausal status was the only statistically significant predictor of contralateral cancer detected by MRI. In 72 of the 425 women, MRI detected a suspicious lesion. A follow-up biopsy demonstrated that 16 (22%) of the 72 women had contralateral breast cancer (stage 0-1) that had not been detected with typical screening methods. Of the 16 women diagnosed with a contralateral cancer, seven were 70 or older.

The researchers undertook the study, they reported, because to their knowledge, no published studies in the medical literature that have examined the use of MRI to screen contralateral breasts in women diagnosed with breast cancer have included an analysis of women 70 and older.

It makes sense to look at women of this age, according to the investigators. Studies have shown that MRI of the breast has a higher cancer detection rate than clinical breast examination and mammography alone in women at high risk for developing breast cancer, according to Dr. Bernard. He added that women who have been diagnosed with breast cancer are at two-to-six times increased risk for developing a secondary, contralateral breast cancer, compared to women at average risk. "So the combination of older age and a personal breast cancer history possibly makes women aged 70 years or older with newly diagnosed breast cancer at even higher risk for developing a contralateral breast cancer,” he said.

Dr. Bernard acknowledged that the routine use of breast MRI in all patients with a history of breast cancer at initial diagnosis is controversial, as is its use in elderly patients. But he noted that the findings from this study may help clarify the debate because it suggests that postmenopausal patients have the highest prevalence of contralateral breast cancer identified only by MRI, and not by mammogram or physical examination. "This could impact healthcare costs by limiting screening MRI to those groups likely to have higher detection rates, such as postmenopausal women in our study, and also could reduce costs by having both cancers treated at the same time instead of undergoing potentially toxic and expensive treatments twice that is, once the contralateral cancer is finally detected by mammogram or physical exam,” Dr. Bernard noted.

The researchers also noted that there should be no age cutoff in use of MRI in these breast cancer patients. "We do feel that life span is underestimated in this older age group,” Dr. Bernard concluded.

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58 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

59 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

60 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

61 (149.01161193848): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (486.13548278809): SELECT fid FROM jos_deeppockets WHERE id=294728807 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294728807 AND published='1' LIMIT 1

63 (264.16778564453): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

64 (45.061111450195): select jos_twitters.link from jos_twitters where cat=10

65 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

66 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

67 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

68 (35.04753112793): SELECT fid FROM jos_deeppockets WHERE id=294728807 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294728807 AND published='1' LIMIT 1

69 (31.948089599609): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (332.83233642578): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294728807 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (216.96090698242): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294728807 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (46.014785766602): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (149.01161193848): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (46.968460083008): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294728807 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (31.948089599609): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294728807 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (35.04753112793): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (61.988830566406): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

105 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

106 (46.968460083008): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294728807 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (46.014785766602): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294728807 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

109 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

110 (46.014785766602): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294728807 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (437.97492980957): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294728807 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (519.99092102051): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (309.94415283203): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

115 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

116 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

117 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

118 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

119 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

120 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

121 (34.093856811523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

122 (278.94973754883): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 20070.07598877): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (!!!!! 4595.0412750244): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294728807 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294728807 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 16985.893249512): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 3934.8602294922): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (260.82992553711): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (201.94053649902): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (102.99682617188): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (138.99803161621): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (33.140182495117): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (111.81831359863): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (32.186508178711): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (378.84712219238): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (487.08915710449): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (229.1202545166): SELECT name FROM jos_deeppockets WHERE id=212

138 (31.948089599609): SELECT name FROM jos_deeppockets WHERE id=212

139 (!!!!! 2234.935760498): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (592.94700622559): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

142 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

143 (!!!!! 11786.937713623): TRUNCATE TABLE jos_trademed_module

144 (83.92333984375): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294728807 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (52.928924560547): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294728807 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (794.88754272461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

149 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

150 (!!!!! 1167.0589447021): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

152 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

153 (43.869018554688): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294728807 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294728807 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (31.948089599609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (30.040740966797): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

156 (30.994415283203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (140.19012451172): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

158 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728807 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728807 AND published='1' LIMIT 1

159 (64.849853515625): select jos_twitters.link from jos_twitters where cat=10

160 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

161 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

162 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

163 (277.99606323242): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1230.001449585): insert into jos_banners_delta values (14615,'2025-06-28 11:55:57','216.73.216.249','view'),(14202,'2025-06-28 11:55:57','216.73.216.249','view'),(14203,'2025-06-28 11:55:57','216.73.216.249','view')

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