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Hendrick RE, Monticciolo DL. Mammography Screening Should Begin at Age 40 Years. JOURNAL OF BREAST IMAGING 2024; 6:116-123. [PMID: 38280219 DOI: 10.1093/jbi/wbad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Indexed: 01/29/2024]
Abstract
The 2023 U.S. Preventive Services Task Force draft recommendation statement on screening for breast cancer recommends lowering the starting age for biennial screening with mammography to age 40 years from 50 years, the age of screening initiation that the Task Force had previously recommended since 2009. A recent Perspective article in the New England Journal of Medicine by Woloshin et al contends that this change will provide no additional benefit and is unjustified. This article reviews the main ideas presented by Woloshin et al and provides substantial evidence not considered by those authors in support of screening mammography in U.S. women starting at age 40 years.
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Affiliation(s)
- R Edward Hendrick
- Department of Radiology, University of Colorado Anschutz School of Medicine, Aurora, CO, USA
| | - Debra L Monticciolo
- Dartmouth Geisel School of Medicine, Lebanon, NH, USA
- Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
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2
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Selvam M, Sundaram S. Breast self-examination practices among young rural women and its associated knowledge and attitudes in Tirunelveli District, Tamil Nadu. J Cancer Res Ther 2024; 20:62-70. [PMID: 38554300 DOI: 10.4103/jcrt.jcrt_713_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/29/2022] [Indexed: 04/01/2024]
Abstract
CONTEXT Breast self-examination (BSE) is a simple and cost-effective screening procedure in downstaging breast tumors. AIM To assess the BSE practices and its associated knowledge and attitudes of rural women from Tirunelveli District, Tamil Nadu during the COVID-19 pandemic. SETTINGS AND DESIGN A descriptive cross-sectional survey design was employed, and snowball sampling was used to recruit the sample of rural women from Tirunelveli. MATERIALS AND METHODS Women ages 18-60 willing to take part were included. Data were collected online through a self-developed questionnaire. STATISTICAL ANALYSIS Responses were analyzed using SPSS Version 20. Descriptive statistical analysis was used to present the general details and responses of the rural women through percentages. Using the appropriate tests, the mean differences of the BSE attitudes based on the personal variables were computed using one-way ANOVA. RESULTS A total of 433 rural women (Mean age: 29.20 ± 9.35 years) from Tirunelveli responded to the online Knowledge, Attitude and Practice (KAP) questionnaire. Regular health checkups were undergone by 27.48% of women and 9.24% underwent breast cancer (BC) screening in the past. While 68.36% had heard of BC, 61% knew it could be detected in the early stages. Insufficient knowledge regarding BSE techniques was evident among the women. Knowledge about BC was highest among those earning more than 20,001 INR, women aged 36-45, widowed/separated/divorced women, and diploma graduates. Overall, BSE and BC knowledge score was low, with correspondingly low attitudes and practices. CONCLUSION Findings showed the KAP among rural Tirunelveli women to be low.
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Affiliation(s)
- Mahalakshmi Selvam
- Department of Applied Psychology, Rajiv Gandhi National Institute for Youth Development, Sriperumpudur, Kanchipuram, Tamil Nadu, India
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3
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Mubarik S, Malik SS, Yanran Z, Hak E, Nawsherwan, Wang F, Yu C. Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus. BMC Med 2023; 21:299. [PMID: 37653535 PMCID: PMC10472654 DOI: 10.1186/s12916-023-03004-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/25/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Numerous studies over the past four decades have revealed that breast cancer screening (BCS) significantly reduces breast cancer (BC) mortality. However, in BRICS-plus countries, the association between BCS and BC case fatality and disability are unknown. This study examines the association of different BCS approaches with age-standardized mortality, case-fatality, and disability-adjusted life years (DALYs) rates, as well as with other biological and sociodemographic risk variables, across BRICS-plus from a national and economic perspective. METHODS In this ecological study applying mixed-effect multilevel regression models, a country-specific dataset was analyzed by combining data from the Global Burden of Disease study 2019 on female age-standardized BC mortality, incidence, and DALYs rates with information on national/regional BCS availability (against no such program or only a pilot program) and BCS type (only self-breast examination (SBE) and/or clinical breast examination (CBE) [SBE/CBE] versus SBE/CBE with mammographic screening availability [MM and/or SBE/CBE] versus SBE/CBE/mammographic with digital mammography and/or ultrasound (US) [DMM/US and/or previous tests] in BRICS-plus countries. RESULTS Compared to self/clinical breast examinations (SBE/CBE) across BRICS-plus, more complex BCS program availability was the most significant predictor of decreased mortality [MM and/or SBE/CBE: - 2.64, p < 0.001; DMM/US and/or previous tests: - 1.40, p < 0.001]. In the BRICS-plus, CVD presence, high BMI, second-hand smoke, and active smoking all contributed to an increase in BC mortality and DALY rate. High-income and middle-income regions in BRICS-plus had significantly lower age-standardized BC mortality, case-fatality, and DALYs rates than low-income regions when nationwide BC screening programs were implemented. CONCLUSIONS The availability of mammography (digital or traditional) and BCS is associated with breast cancer burden in BRICS-plus countries, with regional variations. In light of high-quality evidence from previous causal studies, these findings further support the preventive role of mammography screening for BCS at the national level. Intervening on BCS related risk factors may further reduce the disease burden associated with BC.
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Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, Wuhan, 430071, Hubei, China
- PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Saima Shakil Malik
- Center for Biotechnology & Genomic Medicine (CBGM) Medical College of Georgia Augusta University, 1462 Laney Walker Blvd, Augusta, GA, 30912-4810, USA
| | - Zhang Yanran
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, Wuhan, 430071, Hubei, China
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Eelko Hak
- PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Nawsherwan
- Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361000, China
| | - Fang Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, Wuhan, 430071, Hubei, China.
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Liu Y, Gordon AS, Eleff M, Barron JJ, Chi WC. The Association Between Mammography Screening Frequency and Breast Cancer Treatment and Outcomes: A Retrospective Cohort Study. JOURNAL OF BREAST IMAGING 2023; 5:21-29. [PMID: 38416960 DOI: 10.1093/jbi/wbac071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Indexed: 03/01/2024]
Abstract
OBJECTIVE Guidelines for optimal frequency of screening mammography vary by professional society. Sparse evidence exists on the association between screening frequency and breast cancer treatment options. The main objective was to examine differences in cancer treatment rendered for U.S. women with different numbers of screenings prior to breast cancer diagnosis. Cancer stage at diagnosis and health care cost were assessed in secondary analyses. METHODS This IRB-exempt retrospective study used administrative claims data to identify women aged 44 or older with various numbers of mammographic screenings ≥11 months apart, during the four years prior to incident breast cancer diagnosis from January 2010 to December 2018. Outcomes were assessed over the six months following diagnosis. Generalized linear regression models were used to compare women with differing numbers of mammograms, adjusting for patient characteristics. RESULTS Claims data review identified 25 492 women who met inclusion criteria. There was a stepwise improvement in each of these screening categories such that women with four screenings, compared to women with only one screening, experienced higher rates of lumpectomy (70% vs 55%) and radiation therapy (48% vs 36%), lower rates of mastectomy (27% vs 34%) and chemotherapy (28% vs 36%), less stage 3 or 4 cancer at diagnosis (15% vs 29%), and lower health care costs within six months postdiagnosis (P < 0.001). Results were similar in a subgroup limited to women aged 44 to 49 at diagnosis. CONCLUSION Potential benefits of more frequent screening include less aggressive treatment and lower health care costs among women who develop breast cancer.
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Affiliation(s)
- Ying Liu
- Elevance Health, Public Policy Institute, Indianapolis, IN, USA
| | - Aliza S Gordon
- Elevance Health, Public Policy Institute, Indianapolis, IN, USA
| | - Michael Eleff
- Elevance Health, Integrated Health Program, Indianapolis, IN, USA
| | - John J Barron
- HealthCore, Inc, Business Development, Wilmington, DE, USA
| | - Winnie C Chi
- Elevance Health, Domain Strategy and Planning, Indianapolis, IN, USA
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Monticciolo DL, Malak SF, Friedewald SM, Eby PR, Newell MS, Moy L, Destounis S, Leung JWT, Hendrick RE, Smetherman D. Breast Cancer Screening Recommendations Inclusive of All Women at Average Risk: Update from the ACR and Society of Breast Imaging. J Am Coll Radiol 2021; 18:1280-1288. [PMID: 34154984 DOI: 10.1016/j.jacr.2021.04.021] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/25/2022]
Abstract
Breast cancer remains the most common nonskin cancer, the second leading cause of cancer deaths, and the leading cause of premature death in US women. Mammography screening has been proven effective in reducing breast cancer deaths in women age 40 years and older. A mortality reduction of 40% is possible with regular screening. Treatment advances cannot overcome the disadvantage of being diagnosed with an advanced-stage tumor. The ACR and Society of Breast Imaging recommend annual mammography screening beginning at age 40, which provides the greatest mortality reduction, diagnosis at earlier stage, better surgical options, and more effective chemotherapy. Annual screening results in more screening-detected tumors, tumors of smaller sizes, and fewer interval cancers than longer screening intervals. Screened women in their 40s are more likely to have early-stage disease, negative lymph nodes, and smaller tumors than unscreened women. Delaying screening until age 45 or 50 will result in an unnecessary loss of life to breast cancer and adversely affects minority women in particular. Screening should continue past age 74 years, without an upper age limit unless severe comorbidities limit life expectancy. Benefits of screening should be considered along with the possibilities of recall for additional imaging and benign biopsy and the less tangible risks of anxiety and overdiagnosis. Although recall and biopsy recommendations are higher with more frequent screening, so are life-years gained and breast cancer deaths averted. Women who wish to maximize benefit will choose annual screening starting at age 40 years and will not stop screening prematurely.
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Affiliation(s)
- Debra L Monticciolo
- Vice-chair for Research, Department of Radiology, and Section Chief, Breast Imaging, Texas A&M University Health Sciences, Baylor Scott & White Healthcare-Central Texas, Temple, Texas.
| | | | - Sarah M Friedewald
- Chief of Breast and Women's Imaging; Vice Chair of Operations, Department of Radiology; Medical Director, Lynn Sage Comprehensive Breast Center, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Peter R Eby
- Chief of Breast Imaging, Radiology Representative to the Cancer Committee, Virginia Mason Medical Center, Seattle, Washington
| | - Mary S Newell
- Associate Division Director; Associate Director of Breast Center, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Linda Moy
- Laura and Isaac Perlutter Cancer Center, NYU School of Medicine, New York City, New York
| | - Stamatia Destounis
- Chair of Clinical Research and Medical Outcomes Department, Elizabeth Wende Breast Care, Rochester, New York
| | - Jessica W T Leung
- Deputy Chair of Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - R Edward Hendrick
- Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado
| | - Dana Smetherman
- Department Chair and Associate Medical Director of the Medical Specialties, Department of Radiology, Ochsner Medical Center, New Orleans, Louisiana
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6
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Alshammari SA, Alhazmi AM, Alenazi HA, Alshammari HS, Alshahrani AM. Mammography uptake among the female staff of King Saud University. J Family Med Prim Care 2020; 9:221-228. [PMID: 32110594 PMCID: PMC7014892 DOI: 10.4103/jfmpc.jfmpc_706_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/07/2019] [Accepted: 12/05/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Breast cancer is having a major impact on women's health worldwide. Early detection is the best defense against the associated morbidity and mortality of the disease. Objectives: To assess the level of mammography uptake among working Saudi women and identify the obstacles and barriers that negatively affect it. In addition, to identify the most effective sources of breast-cancer-related information and early detection screening. Method: We conducted a cross-sectional study of women employees of King Saud University aged 40 years and above on March–May 2015 using a self-report questionnaire. Results: A total of 229 participants were recruited from the female staff of King Saud University. Of the participants, 34% were aged 41 years or above, approximately 66% were married, 53.3% had a bachelor's degree, and 61.1% worked as administrators; further, 64.6% had a history of breastfeeding. The rate of mammography uptake was 51.5%. Univariate logistic regression indicated that age, education, and being single predict the rate of mammography uptake. However, multivariate logistic regression indicated that earlier age significantly predicts a higher risk of a low rate of mammography uptake. The main obstacle negatively affecting mammography uptake was ineligible criteria (21.8%). The main sources of information regarding breast cancer were awareness campaigns and television and radio (45.4% and 43.7%, respectively). Conclusion: The participants' rate of mammography uptake, awareness of mammograms, the risk factors, and signs of breast cancer were low. To improve breast-cancer mortality rates in Saudi Arabia, earlier detection of breast cancer through increasing awareness of mammograms is of paramount importance.
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Affiliation(s)
- Sulaiman Abdullah Alshammari
- Health Promotion and Health Education Research Chair, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Mohsen Alhazmi
- Health Promotion and Health Education Research Chair, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Robinson KA, Gray RJ, Tanna A, Kosiorek HE, Butterfield RJ, Palmieri JM, McDonough MAT, Rebecca AM, Patel BK. Patient-Awareness Survey: Do Breast Implants Affect the Acquisition and Accuracy of Screening Mammography? JOURNAL OF BREAST IMAGING 2019; 1:297-302. [PMID: 38424806 DOI: 10.1093/jbi/wbz062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/25/2019] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Breast implant augmentation is the most common cosmetic surgical procedure performed in the United States. The purpose of this study was to determine if patients with breast augmentation surgery are aware of the effect of breast implants on the mammographic detection of cancer. METHODS An institutional review board exempt patient awareness survey was distributed at a single breast imaging facility to women undergoing screening mammography. Comparative statistical analyses were performed between patients with and without breast implants. RESULTS The respondents were divided into three groups: no prior breast surgery (74%; 524/711), breast surgery with implants (21%; 152/711), and breast surgery without implants (5%; 35/711). Patients with breast implants were more aware that implants decrease the amount of breast tissue seen on a mammogram (75%; 105/141) and that implants result in the need for more mammogram views (70%; 103/147), as compared with patients with no surgery (46%; 221/484 and 31%; 147/478, respectively) (P < 0.001). More women with breast implants reported learning from breast imaging staff rather than from their surgeon that implants decrease the amount of breast tissue seen on a mammogram (46%; 49/106 vs. 38%; 40/106). Of 137 respondents, 35% (n = 48) reported that the effect of implants on their mammogram was discussed preoperatively. Of those who did not recall a preoperative discussion, 42% (16/38) indicated this knowledge would have factored into their decision to get breast implants. CONCLUSION This study highlights an opportunity for providers to engage in more education and shared decision-making with patients considering breast augmentation surgery to ensure preoperative counseling includes discussion of the effect of implants on mammography.
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Affiliation(s)
| | - Richard J Gray
- Mayo Clinic Hospital, Department of Research Biostatistics, Phoenix, AZ
| | - Aneri Tanna
- Mayo Clinic Hospital, Department of Radiology, Phoenix, AZ
| | - Heidi E Kosiorek
- Mayo Clinic Hospital, Department of Research Biostatistics, Phoenix, AZ
| | | | | | | | - Alanna M Rebecca
- Mayo Clinic Hospital, Department of Plastic Surgery, Phoenix, AZ
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8
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Lipschitz S. Screening mammography with special reference to guidelines in South Africa. SA J Radiol 2019; 22:1370. [PMID: 31754518 PMCID: PMC6837783 DOI: 10.4102/sajr.v22i2.1370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 07/27/2018] [Indexed: 11/01/2022] Open
Abstract
Screening mammography is known to reduce mortality from breast cancer. Controversy regarding screening has led to much confusion in the medical fraternity. The purpose of this review is to point out the 'pros and cons' of screening. The benefits and perceived harms of screening will be discussed using evidence-based literature from the past 30 years. The literature was obtained from various journals sourced from the Internet. General findings are that screening mammography from the age of 40 saves lives, but that the problem of overdiagnosis and overtreatment of certain breast cancers overrides the benefit of screening. The article also covers the debate on what age to begin screening. Screening in the South African context is discussed. Screening in the future will need to be more selective of patients and of which cancers to treat less aggressively, if at all.
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Affiliation(s)
- Shirley Lipschitz
- Dr Shirley Lipschitz and Associates, Sunninghill, Sandton, South Africa
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Margolis DJA, Hu JC. Vying for Standardization of Bladder Cancer MRI Interpretation and Reporting: VI-RADS. Radiology 2019; 291:675-676. [DOI: 10.1148/radiol.2019190648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Daniel J. A. Margolis
- From the Departments of Radiology (D.J.A.M.) and Urology (J.C.H.), Weill Cornell Medical College/New York-Presbyterian Hospital, 525 E 68th St, Box 141, New York, NY 10021
| | - Jim C. Hu
- From the Departments of Radiology (D.J.A.M.) and Urology (J.C.H.), Weill Cornell Medical College/New York-Presbyterian Hospital, 525 E 68th St, Box 141, New York, NY 10021
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10
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Patel SB. Estimated Mortality of Breast Cancer Patients Based on Stage at Diagnosis and National Screening Guideline Categorization. J Am Coll Radiol 2018; 15:1206-1213. [DOI: 10.1016/j.jacr.2018.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/04/2018] [Accepted: 04/09/2018] [Indexed: 01/28/2023]
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Gao Y, Heller SL, Moy L. Male Breast Cancer in the Age of Genetic Testing: An Opportunity for Early Detection, Tailored Therapy, and Surveillance. Radiographics 2018; 38:1289-1311. [PMID: 30074858 DOI: 10.1148/rg.2018180013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In detection, treatment, and follow-up, male breast cancer has historically lagged behind female breast cancer. On the whole, breast cancer is less common among men than among women, limiting utility of screening, yet the incidence of male breast cancer is rising, and there are men at high risk for breast cancer. While women at high risk for breast cancer are well characterized, with clearly established guidelines for screening, supplemental screening, risk prevention, counseling, and advocacy, men at high risk for breast cancer are poorly identified and represent a blind spot in public health. Today, more standardized genetic counseling and wider availability of genetic testing are allowing identification of high-risk male relatives of women with breast cancer, as well as men with genetic mutations predisposing to breast cancer. This could provide a new opportunity to update our approach to male breast cancer. This article reviews male breast cancer demographics, risk factors, tumor biology, and oncogenetics; recognizes how male breast cancer differs from its female counterpart; highlights its diagnostic challenges; discusses the implications of the widening clinical use of multigene panel testing; outlines current National Comprehensive Cancer Network guidelines (version 1, 2018) for high-risk men; and explores the possible utility of targeted screening and surveillance. Understanding the current state of male breast cancer management and its challenges is important to shape future considerations for care. Shifting the paradigm of male breast cancer detection toward targeted precision medicine may be the answer to improving clinical outcomes of this uncommon disease. ©RSNA, 2018.
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Affiliation(s)
- Yiming Gao
- From the Department of Radiology, New York University Langone Medical Center, 160 E 34th St, New York, NY 10016 (Y.G., S.L.H., L.M.); and the Center for Advanced Imaging Innovation and Research, New York University School of Medicine, New York, NY (L.M.)
| | - Samantha L Heller
- From the Department of Radiology, New York University Langone Medical Center, 160 E 34th St, New York, NY 10016 (Y.G., S.L.H., L.M.); and the Center for Advanced Imaging Innovation and Research, New York University School of Medicine, New York, NY (L.M.)
| | - Linda Moy
- From the Department of Radiology, New York University Langone Medical Center, 160 E 34th St, New York, NY 10016 (Y.G., S.L.H., L.M.); and the Center for Advanced Imaging Innovation and Research, New York University School of Medicine, New York, NY (L.M.)
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12
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Age to Begin and Intervals for Breast Cancer Screening: Balancing Benefits and Harms. AJR Am J Roentgenol 2018; 210:279-284. [DOI: 10.2214/ajr.17.18730] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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13
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Sant'Ana RSD, Mattos JSDC, Silva ASD, Mello LMD, Nunes AA. Associated factors with mammographic changes in women undergoing breast cancer screening. EINSTEIN-SAO PAULO 2016; 14:324-329. [PMID: 27759819 PMCID: PMC5234742 DOI: 10.1590/s1679-45082016ao3708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 05/15/2016] [Indexed: 12/24/2022] Open
Abstract
Objective: To evaluate association of sociodemographic, anthropometric, and epidemiological factors with result of mammogram in women undergoing breast cancer screening. Methods: This is a cross-sectional study with data obtained through interviews, anthropometric measurements, and mammography of 600 women aged 40 to 69 years at the Preventive Medicine Department of Hospital de Câncer de Barretos, Brazil, in 2014. The results of these examinations in the BI-RADS categories 1 and 2 were grouped and classified in this study as normal mammogram outcome, and those of BI-RADS categories 3, 4A, 4B, 4C, and 5 were grouped and classified as altered mammogram outcome. The statistical analysis included the Student's t-test to compare means, as well as odds ratios (OR), with their corresponding 95% confidence intervals (95%CI), to verify an association by means of the multivariate analysis. Results: Of 600 women evaluated, 45% belonged to the age group of 40–49 years-old and 60.2% were classified as BI-RADS category 2. The multivariate analysis showed that women with blood hypertension (OR: 2.64; 95%CI: 1.07–6.49; p<0.05) were more likely to present changes in the mammography, while physical activity was associated with lower chances (OR: 0.30; 95%CI: 0.11–0.81; p<0.05). Conclusion: Hypertensive women undergoing screening mammography are more likely to present mammographic changes, whereas women practicing physical activity have lower chances (70%) of presenting changes in the breast compared with sedentary individuals.
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Affiliation(s)
| | | | | | - Luanes Marques de Mello
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Chan SWW, Cheung C, Chan A, Cheung PSY. Surgical options for Chinese patients with early invasive breast cancer: Data from the Hong Kong Breast Cancer Registry. Asian J Surg 2016; 40:444-452. [PMID: 27209473 DOI: 10.1016/j.asjsur.2016.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 01/28/2016] [Accepted: 02/01/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Breast conserving surgery (BCS) is preferred for suitable candidates, while mastectomy (MTX) with reconstruction (MTX + R) is considered a better option for patients requiring MTX. In Hong Kong, the rates of BCS and breast reconstruction are relatively low. This paper aims to study the surgical options and their predictors among Hong Kong breast cancer patients. METHODS Data is retrieved from the Hong Kong Breast Cancer Registry (HKBCR) from 2007 to 2013. A total of 4519 Stage I-II breast cancer patients who had surgical treatments were included in this retrospective study. RESULTS Our multivariate logistic regression shows that people who were younger (age < 40 years: OR, 1.5; 95% CI, 1.1-2.1; p = 0.010), more educated (undergraduate/postgraduate: OR, 2.8; 95% CI, 1.7-4.4; p < 0.0001), never married (OR, 1.5; 95% CI, 1.1-1.9; p = 0.002), had regular mammography screening (OR, 1.5; 95% CI, 1.3-1.8; p < 0.0001), had screen-detected cancers (OR, 1.3; 95% CI, 1.0-1.6; p = 0.031), and who underwent surgery at a private medical service facility (OR, 1.8; 95% CI, 1.6-2.2; p < 0.0001) were more likely to receive BCS. In addition, people who were younger (age < 40 years: OR, 15.9; 95% CI, 6.5-39.2; p < 0.0001), more educated (undergraduate/postgraduate: OR, 26.8; 95% CI, 3.6-201.4; p = 0.001), had regular mammography screening (OR, 1.6; 95% CI, 1.1-2.3; p = 0.008), had screen-detected cancers (OR, 2.1; 95% CI, 1.4-3.3; p = 0.001), and had smaller tumor (≤ 2.0 cm: OR, 0.39; 95% CI, 0.20-0.76; p = 0.005) were more likely to have reconstruction after MTX. CONCLUSION Chinese patients have lower BCS and breast reconstruction rate. Besides cultural difference, patient-related factors such as age, education, marital status, mammography screening, the use of private medical facilities, and clinical characteristics including smaller tumor size and peripherally located tumor were significant predictors for type of surgical treatments in Chinese women with early breast cancer.
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Affiliation(s)
- Sharon W W Chan
- Kowloon East Cluster Breast Centre, Department of Surgery, United Christian Hospital, Hong Kong, China.
| | | | - Amy Chan
- Hong Kong Breast Cancer Foundation, Hong Kong, China
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Public Interest in Imaging-Based Cancer Screening Examinations in the United States: Analysis Using a Web-Based Search Tool. AJR Am J Roentgenol 2016; 206:113-8. [PMID: 26700342 DOI: 10.2214/ajr.15.14840] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study was to identify geographic and temporal patterns related to the frequencies of online searches within the United States for information on imaging-based cancer screening tests. MATERIALS AND METHODS Google Trends, a web-based tool for identifying the frequency of online searches, was used to determine, on both a monthly and a geographic basis, the relative frequency of searches for imaging-based cancer screening tests in the United States from 2004 through 2014. Findings were evaluated qualitatively. RESULTS Searches for "mammography" decreased slightly overall, although they peaked in October (Breast Cancer Awareness Month) in most years and spiked in November 2009 (when the updated U.S. Preventive Services Task Force screening mammography guidelines were released). The frequency of searches for "tomosynthesis" increased rapidly from 2009 through 2014. On the other hand, the frequency of searches for "lung cancer screening" decreased slightly from 2006 through 2010, increased rapidly from 2011 through 2014, and exhibited a spike in November 2010 (when the results of the National Lung Screening Trial were released). Searches for "virtual colonoscopy" decreased substantially from 2004 through 2010, remained stable from 2011 through 2014, and spiked in months coinciding with the publication of the results of large relevant clinical trials and a press release announcing that the president of the United States was undergoing virtual colonoscopy. The frequency of searches for "prostate MRI" was stable from 2006 through 2010 and increased rapidly from 2011 through 2014. Searches for "prostate MRI biopsy" increased rapidly in 2013 and 2014. These searches occurred predominantly in densely populated areas (e.g., searches for "lung cancer screening," "prostate MRI," and "tomosynthesis" were highest in New York City). CONCLUSION Online search patterns indicate geographic and short- and long-term temporal variation in the interest in cancer screening examinations among the U.S. population. These trends may indicate pending shifts in the use of these examinations.
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Hendriks GAGM, Holländer B, Menssen J, Milkowski A, Hansen HHG, de Korte CL. Automated 3D ultrasound elastography of the breast: a phantom validation study. Phys Med Biol 2016; 61:2665-79. [DOI: 10.1088/0031-9155/61/7/2665] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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CEA in breast ductal secretions as a promising biomarker for the diagnosis of breast cancer: a systematic review and meta-analysis. Breast Cancer 2016; 23:813-819. [PMID: 26898373 DOI: 10.1007/s12282-016-0680-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 02/14/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Other studies have shown that levels of carcinoembryonic antigen (CEA) in breast ductal secretions (BDS) differ significantly between breast cancer (BC) patients and healthy individuals, providing direct evidence for CEA in BDS as a promising biomarker for BC. This meta-analysis was designed to assess the potential diagnostic value of CEA in BDS. METHODS Relevant articles were retrieved from Embase, Pubmed, and the Cochrane Library. Sensitivity, specificity, and diagnostic odds ratio (DOR) of CEA in BDS for diagnosing BC were pooled using random effects models. SROC and the area under the curve (AUC) were used to estimate overall diagnostic performance. RESULTS This meta-analysis comprised five studies with a total of 340 BC patients and 448 healthy controls. For CEA in BDS, the pooled sensitivity, specificity, and DOR to diagnose BC were 58 % [95 % confidence interval (CI): 52-63 %], 87 % (95 % CI: 84-90 %), and 7.07 (95 % CI: 3.10-16.12), respectively. Moreover, the AUC of CEA in the diagnosis of BC was 0.8570. CONCLUSIONS CEA in BDS is a promising biomarker in the diagnosis of BC and should be evaluated as a standard screening tool upon verification of our results in a larger study population.
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Kim Z, Min SY, Yoon CS, Jung KW, Ko BS, Kang E, Nam SJ, Lee S, Hur MH. The Basic Facts of Korean Breast Cancer in 2012: Results from a Nationwide Survey and Breast Cancer Registry Database. J Breast Cancer 2015; 18:103-11. [PMID: 26155285 PMCID: PMC4490258 DOI: 10.4048/jbc.2015.18.2.103] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/10/2015] [Indexed: 12/29/2022] Open
Abstract
The Korean Breast Cancer Society has constructed a nationwide breast cancer database through utilization of an online registration program. We have reported the basic facts about breast cancer in Korea in 2012, and analyzed the changing patterns in the clinical characteristics and management of breast cancer in Korea over the last 10 years. Data on patients newly diagnosed with breast cancer were collected for the year 2012 from 97 hospitals and clinics nationwide using a questionnaire survey, and from the online registry database. A total of 17,792 patients were newly diagnosed with breast cancer in 2012. The crude incidence rate of female breast cancer, including invasive cancer and in situ cancer, was 70.7 cases per 100,000 women. The median age at diagnosis was 51 years, and the proportion of postmenopausal women was higher than that of premenopausal women among those diagnosed with breast cancer. The proportion of cases of early breast cancer increased continuously, and breast-conserving surgery was performed in more cases than total mastectomy in that same year. The total number of breast reconstruction surgeries increased approximately 3-fold over last 10 years. The 5-year overall survival rate for all stages of breast cancer patients was extremely high. The clinical characteristics of breast cancer have changed in ways that resulted in high overall survival over the past 10 years in Korea, and the surgical management of the disease has changed accordingly. Analysis of nationwide registry data will contribute to a better understanding of the characteristics of breast cancer in Korea.
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Affiliation(s)
- Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sun Young Min
- Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Chan Seok Yoon
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Beom Seok Ko
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seokwon Lee
- Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Min Hee Hur
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
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Abstract
After some decades of contention, one can almost despair and conclude that (paraphrasing) "the mammography debate you will have with you always." Against that sentiment, in this review I argue, after reflecting on some of the major themes of this long-standing debate, that we must begin to move beyond the narrow borders of claim and counterclaim to seek consensus on what the balance of methodologically sound and critically appraised evidence demonstrates, and also to find overlooked underlying convergences; after acknowledging the reality of some residual and non-trivial harms from mammography, to promote effective strategies for harm mitigation; and to encourage deployment of new screening modalities that will render many of the issues and concerns in the debate obsolete. To these ends, I provide a sketch of what this looking forward and beyond the current debate might look like, leveraging advantages from abbreviated breast magnetic resonance imaging technologies (such as the ultrafast and twist protocols) and from digital breast tomosynthesis-also known as three-dimensional mammography. I also locate the debate within the broader context of mammography in the real world as it plays out not for the disputants, but for the stakeholders themselves: the screening-eligible patients and the physicians in the front lines who are charged with enabling both the acts of screening and the facts of screening at their maximally objective and patient-accessible levels to facilitate informed decisions.
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Affiliation(s)
- C Kaniklidis
- No Surrender Breast Cancer Foundation, Locust Valley, NY, U.S.A
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