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Breast Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Amy Case, Gwenllian Edwards, Catherine Pembroke
Women at intermediate or high risk according to the aforementioned factors are offered referral to a specialist risk service, comprising clinical genetics, breast oncology, and counsellors.34 Women with an increased risk of breast cancer should be “breast aware” and follow advice regarding self-examination provided to all women. Intermediate risk women aged from 40 to 49 should attend annual clinical breast examination and digital mammography.
Breast Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Gaural Patel, Lucy Kate Satherley, Animesh JK Patel, Georgina SA Phillips
Describe the history of the NHSBSP.It was introduced in 1988 following the Forrest report for 50–64 year olds (extended to 70 year olds in 2001).9An interval of 3 years was chosen to emulate the Swedish two-county trial and confirmed by UKCCCR trial.10Two-view digital mammography is currently being extended to the 47–73 age range (age extension trial recruiting 2009–2022).Can also provide annual MRI surveillance for women at high risk of developing familial breast cancer (NICE guideline 41).It costs £96 million a year.
Breast cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Mammography is a sensitive means of detecting carcinomas, often before the lump is palpable by the patient or clinician, thereby facilitating the detection of early breast cancers with a particularly good prognosis. In the United Kingdom, the National Breast Screening Programme screens all women aged 50–70 years with 3-yearly mammograms. This age range is being extended to 47–73 over the next few years. Women older than this can be screened on request. Such a programme should result in a mortality reduction of 20%–30%. There is at present no consensus as to what age premenopausal women should be included in a screening programme, as they tend to have dense breasts, which can obscure the radiological signs of early breast cancers; studies to date have indicated a much smaller impact on survival than in the >50 year age group. However, young women with a family history of breast cancer should be offered regular clinical assessments and mammographic screening at an earlier age. Digital mammography seems to lead to fewer false-positive results than traditional film-based mammography and is superior for young women with dense breasts. Ultrasonography is a poor substitute for mammography. In younger women with dense breasts, particularly those with BRCA gene mutations, magnetic resonance mammography is the optimum screening modality.
Breast cancer glycan biomarkers: their link to tumour cell metabolism and their perspectives in clinical practice
Published in Expert Review of Proteomics, 2021
Tomas Bertok, Veronika Pinkova Gajdosova, Aniko Bertokova, Natalia Svecova, Peter Kasak, Jan Tkac
Today, screening and early diagnostics rely on imaging methods, such as digital mammography, hand-held or automated sonography and magnetic resonance imaging [4]. Statistically, 1 woman in 8 is diagnosed with BCa in her lifetime. However, 5-year survival rates might be as high as 99% if BCa is diagnosed at an early stage, i.e. for in situ non-invasive carcinoma (~63% of all cases). BCa incidence is often highest in more developed countries (also due to awareness and screening programmes), while mortality is highest in developing countries [5,6]. BCa is closely associated with genetic (especially BRCA 1 and 2 genes mutations) and other (sex, age or race – with higher mortality rate and earlier occurrence in African-Americans) risk-factors [7,8]. After developing invasive (metastatic) BCa (~6% of cases at the time of diagnosis), lymph nodes in the adjacent area are often affected, although a metastasis near a head or a pancreas was also reported [9].
The role of artificial intelligence in breast cancer screening: how can it improve detection?
Published in Expert Review of Molecular Diagnostics, 2020
The European commission initiative on breast cancer issued a recommendation for screening (strong recommendation for screening versus non-screening in 50–69 years, conditional recommendation for screening in age group 45–49 and 70–74 years.) Also recommendations are issued that identify the 2 year interval as the most appropriate screening interval, double reading of mammograms is recommended over single reading of mammograms. Also a neutral recommendation was formulated about the use of tomosynthesis (3D)-mammography as a primary means of screening versus the commonly used 2D Full Field Digital Mammography. The reason for a neutral recommendation was that there is still a lack of studies and a controversial discussion about the effect of the proven additional detection rates 3D-mammography provides in contrast to the lack of decrease of interval cancers shown in studies and the possible amount of overdiagnosis (meaning detection of cancers that would not have threatened the womens life, even if not had been detected) [4]. This also applies to the additional use of AI algorithms in screening programs. The aim is to find the clinical relevant cancers in a stage where treatment can be more effective and less harmful and to reduce the rate of overdiagnosis and overtreatment.
Does metformin affect mammographic breast density in postmenopausal women with type 2 diabetes
Published in Gynecological Endocrinology, 2020
Mehmet Akif Ozturk, Serpil Ozturk, Muzeyyen Eryilmaz, Selin Cinar, Meltem Sertbas, Feyza Ak, Yasar Sertbas, Ali Ozdemir
Breast cancer is the most common type of cancer in women [1]. It is one of the detectable cancers in women. With the detection of breast cancer in early stages, morbidity and mortality rates decrease, and life expectancy is significantly prolonged. The most common and accepted screening method is yearly digital mammography in women aged 45–54 years with an average risk and every two years in women over 55 years old [2]. Both mammary mass and breast density can be evaluated during mammograms. Increased mammographic breast density (MBD) is known to be associated with an increased risk of developing breast cancer [3]. In a study evaluating many meta-analyses, type 2 diabetes mellitus (T2DM) was found to be associated with an increased incidence of breast cancer in women, as in many cancer types [4]. Metformin, a hepatic gluconeogenesis inhibiting agent, is an oral antidiabetic agent that has been used for many years as a first-line treatment in T2DM patients [5]. In addition to metformin’s antidiabetic effects, antiproliferative effects have also been observed [6]. It is thought that metformin can be used in future cancer prevention. In this study, we aimed to research the possible relationship between MBD and metformin use in postmenopausal women diagnosed with T2DM.