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Engineered Composites for 3D Mammary Tissue Systems
Published in Karen J.L. Burg, Didier Dréau, Timothy Burg, Engineering 3D Tissue Test Systems, 2017
Cheryl T. Gomillion, Chih-Chao Yang, Didier Dréau, Karen J. L. Burg
Numerous risk factors are associated with breast cancers, including gender, age, weight, family history, child-bearing history, environmental factors, such as smoking or radiation, and genetic predisposition, which affects the chances of a person developing breast cancer (Russo and Russo 2004; Tozeren et al. 2005). Genetic mutations inherited from a parent affect 10%–20% of breast cancer cases (Osborne and Boolbol 2014; Rice et al. 2000). The most commonly inherited mutations predisposing women to breast cancer are those of two tumor suppressor genes involved in DNA repair BRCA1 (Breast Cancer 1) and BRCA2, respectively. BRCA1 and BRCA2 are located on chromosome #17 and #13, respectively. The presence of an altered or mutated copy of either the BRCA1 or BRCA2 gene carries a 36%–85% lifetime risk for developing breast cancer (Yalcin 2013). The presence of these mutations and their associated risk for breast cancer is usually followed by either more careful monitoring of patient breast health, or in some rare, but high risk cases, by preventive radical mastectomy.
Toward a Standard of Medical Care: Why Medical Professionals Can Refuse to Prescribe Puberty Blockers
Published in The New Bioethics, 2023
Yet, in the medical profession, there is often inconclusive or conflicting research on which services are more likely to induce dysfunction; in other words, selecting the probability values in these decision problems is not always so easy. A historical example will help illustrate this point. Fisher (1973), in his systematic review of the research available on the effectiveness of various breast cancer treatments during the 1970s, demonstrates the state of uncertainty of medical care on offer in early cancer research. At the time, there had been at least two major studies that compared the effectiveness of radical mastectomy and less invasive procedures (tylectomy and simple mastectomy). One study conducted in Cambridge concluded that there was no difference in 10-year survival or recurrence rates for individuals with stage II cancer who underwent radical mastectomy or simple mastectomy (removal of the breast tissue). Another study conducted in London, however, concluded that those who underwent tylectomy (removal of the tumor) had a better 10-year survival rate and higher rate of recurrence than those who underwent a radical mastectomy. As a result, it is unclear which procedure is more likely to restore function and, therefore, which one is more likely to induce dysfunction; in other words, it is unclear what probability values should be assigned to each procedure’s bringing about a worse dysfunctional condition than the other.