Top PDF Breast cancer screening practices for women aged 35 to 49 and 70 and older

Breast cancer screening practices for women aged 35 to 49 and 70 and older

Breast cancer screening practices for women aged 35 to 49 and 70 and older

Breast cancer mortality rates have decreased substantially over the past 25 years thanks to improvements in treatment and screening programs, but much remains to be done. We must pay more attention to women 50 years of age and younger and women 70 years of age and older in good health, because breast cancer in these populations represents a substantial burden and concrete solutions are available to physicians. For young women who are at risk, we must provide instruction in BSE, perform CBE, prescribe screening mammography, and, where appropriate, refer for genetic counseling. For older women in good health, CBE and prescribing mammography are appropriate. To improve these practices, we must act upon physicians’ attitudes and skills and issue clearer recommendations.
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The influence of participation and regularity of participation in the breast cancer screening program on tumour characteristics

The influence of participation and regularity of participation in the breast cancer screening program on tumour characteristics

Unknown data were left out of the analysis. For some subgroups this meant that many women were left out of the analysis. This was especially the case for the receptor statuses for both women aged between 70 and 75 years and women older than 75 years. Some reasons for the missing data are the fact that for DCIS receptor statuses are not recorded in the CR (18), and not every woman has her tumour researched after diagnosis. This could influence the analysis. The results could be different if the unknown data were included in the analysis. There could be over- or underestimation of the results, especially for women older than 75 years, for whom most data are missing. It is imaginable that these women do not want to be treated anymore because of the psychological and physical burden, and therefore not want to be examined anymore. It can be possible that these women participated in screening before they were 75 years old, and are diagnosed later in a late stage of the disease, but it is unclear what the exact stage is because they are not examined. In that case, there can be overestimation of for example the effect of participation to screening on tumour stage or lymph node involvement. It can also be that those women who participated in screening have an early stage tumour and in that case there would be underestimation of the effects of screening.
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Modeling of Sic Power Semiconductor Devices For Switching Converter Applications

Modeling of Sic Power Semiconductor Devices For Switching Converter Applications

Death rates for breast cancer have steadily decreased in women due to earlier detection, such as mammography, and improved treatments (4-9). Mammography is the single most effective method of early detection for breast cancer. It can identify the cancer at an early stage, when treatment is more effective (1). The American Cancer Society screening guidelines recommend that average-risk women aged 40 and older receive mammography screening on an annual basis (1). About 38%-54% of women do not maintain annual adherence to screening mammograms (10, 11), and only 49% having received screening when using a biennial schedule (11). Annual mammography with adequate follow-up is estimated to result in reductions in mortality ranging from 25% to 44% (6, 7, 12-15). Mammography is a highly accurate screening tool, but like most medical tests, it does not have perfect sensitivity and specificity. Generally, reported positive predictive values ranges from 78% to 90% (1, 16, 17). One drawback of mammography is the false positive results. One large study found that over a 10-year period of annual mammogram screenings, the chance of having a false positive result was close to 50% (18).
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Should women under 50 be screened for breast cancer?

Should women under 50 be screened for breast cancer?

The financial costs of mammography include those of screening mammography, and further assessment and treatment costs, as well as organisational costs for organised programmes. Screening will also impact on treatment costs. The frequency of screening will affect the cost across a given age range, and most comparisons of cost-effectiveness have assumed a shorter screening interval (12 – 18 months) below 50 years. However, the results of such comparisons will vary according to the estimate of effectiveness used. De Haes et al (1991) concluded that it would be more cost- effective to shorten the screening interval for women aged 50 – 70 years than to include 2 yearly screening for women aged 40 – 49 years, based on the 8% mortality reduction then observed in the Swedish Two Counties Study in women under 50 years. An analysis in 1995 by Lindfors and Rosenquist (1995), using a baseline estimate of mortality reduction for women aged 40 – 49 years of 4% with biennial and 23% with annual mammography, found that including women aged 40 – 49 years increased the marginal cost per life year saved, but by less than some alternative strategies. Salzmann et al (1997) assumed a 16% reduction in breast cancer mortality starting at 50 years for women who begin screening at 40 years and found that the cost-effectiveness of mammography in women aged 40 – 49 years was about five times that in older women.
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<p>Knowledge and practices on breast cancer detection and associated challenges among women aged 35 years and above in Tanzania: a case in Morogoro Rural District</p>

<p>Knowledge and practices on breast cancer detection and associated challenges among women aged 35 years and above in Tanzania: a case in Morogoro Rural District</p>

Background: Breast cancer is the leading cause of cancer-related deaths among women globally including Tanzania. However, timely access to diagnosis remains a challenge due to lack of specialized facilities. Most patients presents with advanced stages of the disease making management impossible. This leads to an increase in breast cancer-related mortality. Little is known about knowledge and practices on breast cancer screening in Tanzania. This study described knowledge and practices on breast-cancer detection and associated chal- lenges among women aged 35 years and above in Morogoro rural District in Tanzania. Methods: This descriptive cross-sectional study was conducted in Lubungo, Newland and Fulwe villages at Mikese ward in Morogoro rural District from June and July 2017. A standardized questionnaire was used to obtain information from 130 study participants regarding breast cancer knowledge and practices. Data were analyzed using (SPSS) software version 23 and descriptive statistics were summarized in frequencies and percentages. Results: One hundred and thirty women were studied, all participants have heard of breast cancer; 71.5% knew the effects of breast cancer; 37.7% knew about the signs and symptoms. The most frequently reported cause and risk factor of breast cancer were putting money under brassiere (30.8%) and fat diet (17.7%) respectively. The participants (73.8%) have never heard of breast self-examination (BSE) as an early detection method of breast cancer hence do not practice it. Lack of knowledge on early signs and symptoms of breast cancer was reported as the main challenge for breast cancer screening (73.8%). The frequently reported source of information about this disease was television/radio programs (83.1%). Conclusion: Most of the women have heard of breast cancer but they lack adequate knowledge on its risk factors, causes, symptoms and effects. The majority of the women do not practice BSE due to lack of knowledge. Efforts to improve women ’ s knowledge on breast cancer is warranted.
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Management of early breast cancer in older women: from screening to treatment

Management of early breast cancer in older women: from screening to treatment

Although only few data that include women aged over 70–75 years are available, adjuvant hormonal therapy is a ref- erence treatment for postmenopausal women with hormone- receptor-positive breast cancer. The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) meta-analysis, which included 3,700 women, confirmed that tamoxifen reduced the relapse rate by 28% and mortality by 21% in women aged 70 years or more. Nevertheless, it is important to note that among the patients included, there were only 726 women aged above 70 years who received tamoxifen over 2 years, with a reduction of annual risk of relapse of 42% ± 8%, and 186 patients who received it during 5 years, reducing the annual risk of relapse by 54% ± 13%. 37 The reduction of
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Factors associated with breast cancer screening awareness and practices of women in Addis Ababa, Ethiopia

Factors associated with breast cancer screening awareness and practices of women in Addis Ababa, Ethiopia

Recruitment of study participants was done based on sampling focused on health centers where women get ma- ternal and child health care services. Out of the ten sub-cities four sub-cities were selected randomly. Then 10 health centers were taken from four sub-cities by a simple random sampling method where the study was conducted. The study participants were aged between 20 and 49 years and were recruited proportionally from each of the health centers using the information from patient flow, 1 month prior to the data collection. At the time of data collection all the voluntary women who came to the maternal and child health care service were interviewed consecutively according to their order of arrival until the required sam- ple size was obtained. Data collection was conducted by experienced and trained nurses.
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Systematic reviews as a “lens of evidence”: determinants of benefits and harms of breast cancer screening

Systematic reviews as a “lens of evidence”: determinants of benefits and harms of breast cancer screening

Similarly to the reviews on younger populations, systematic reviews report inconsistent BCM reduction among women older than 69 years (Fig. 3d, Appendix 4). 8,11,12,16,20,30,49 A review by Galit et al. (2007) concluded on lower BCM among women aged 75–84 years who underwent screening compared to those who did not, 8 whereas other reviews concluded on no clear ben- efit for women older than 70 years. 11,12 Regular mammography has been associated with smaller and earlier-stage tumours among women older than 74 years, which could also be clini- cally insignificant. 8 The reviews on BCS benefits and harms among women older than 69 years were based on limited evi- dence on BCM reduction from RCTs and harms specific to this age group, and did not report all- cancer or all-cause mortality.
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“Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases”

“Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases”

built in order to identify those factors independently asso- ciated with MF/MC cancers. Actuarial (Kaplan–Meier) breast-cancer-specific survival (BCSS) was calculated from the date of surgery. For the analysis of the events during follow-up, recurrence of disease was classified as local (breast or chest wall), regional (axillary, supraclavicular or internal mammary lymph nodes) and distant. We evalu- ated the prognostic significance of MF and MC breast can- cers with respect to BCSS by means of a log-rank test. In order to compare such prognostic significance to that of the other clinical and pathological factors, a multivariate analysis was performed by means of Cox regression ana- lysis; the model of regression included those factors that were significantly related to prognosis in univariate ana- lysis. For statistical comparison, a p-value <0.05 was con- sidered significant.
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Oestrogen receptor negative early operable primary breast cancer in older women—biological characteristics and long term clinical outcome

Oestrogen receptor negative early operable primary breast cancer in older women—biological characteristics and long term clinical outcome

A UK-based audit of management protocols in older women with early operable primary breast cancer reported that 40% of them were treated by non-operative therapy[5]. This fact has impacted on how ER-negative primary breast cancer in older women could be studied. Most of the available studies only include patients treated by surgery (often using surgical spec- imens for studying biological features), introducing a potential bias towards a comparatively fitter older population. If we were to encompass all older women with ER-negative tumours regardless of primary treatment, we have to study their biological features using tumour tissue obtained from diagnostic needle core biopsies. The limitations of such approach include the small quantity and quality of the specimen, and method used to process the tissue (eg fresh fro- zen or formalin fixed paraffin embedded tissues).
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Translation and Psychometric Testing Persian Version of Breast Cancer Screening Belief Questionnaire (BCSBQ) in Iranian Women

Translation and Psychometric Testing Persian Version of Breast Cancer Screening Belief Questionnaire (BCSBQ) in Iranian Women

2) The instrument was a 13-item BCSBQ, which had three domains as follows: Health check-up (4 items), Knowledge and perceptions about breast cancer (4 items), and Mammographic screening practices (5 items). In this questionnaire, each item had choices based on a 5- point Likert spectrum from “completely agree” to "completely disagree", which allocated to themselves scores from 1 to 5. After obtaining written permission from the developer of the instrument; Dr. Kwok, the original English version of the questionnaire was translated into Persian through a backward-forward translation procedure, by two people who had good command over written medical texts, and who were experienced in the translation of questionnaires. Next, the Persian version was reviewed and evaluated for the consistency of each item with its corresponding item in the English version. Then, the Persian version of the instrument was again translated into into English, by two bilingual expert translators (a specialist in healthcare and a general translator), and the two English versions were compared. After review and making necessary corrections, a single English version of the questionnaire was obtained and sent to the original designer for final approval of the instrument (Figure 1).
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Expression of glucosylceramide synthase in invasive ductal breast cancer may be correlated with high estrogen receptor status and low HER-2 status

Expression of glucosylceramide synthase in invasive ductal breast cancer may be correlated with high estrogen receptor status and low HER-2 status

Paraffin-embedded tumor samples were prepared from 196 patients with invasive ductal breast carcinoma, 25 patients with ductal carcinoma in-situ (DCIS), 11 patients with atypical ductal hyperplasia (ADH), 25 pa- tients with usual ductal hyperplasia (UDH) and five pa- tients with accessory breast. Histopathologic variables, including tumor size, lymph node metastasis, histologic subtype, and histologic grade, were determined by reviewing pathology reports and hematoxylin and eosin stained (H&E) sections. Patient and tumor characteris- tics are summarized in Tables 1 and 2. Forty of the ductal breast carcinoma patients received clinical follow- up at a median of 63 months (range, 15–68 months).
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Gonorrhea infection in women: prevalence, effects, screening, and management

Gonorrhea infection in women: prevalence, effects, screening, and management

widespread screening is recommended by the US Preventive Services Task Force and the CDC. Routine genital screening for N. gonorrhoeae is recommended annually for all sexu- ally active women at risk for infection, including women aged , 25 years and older women with one or more of the following risks: a previous gonorrhea infection, the presence of other STIs, new or multiple sex partners, inconsistent con- dom use, commercial sex work, drug use, or human immuno- deficiency virus infection with sexual activity. 18 Pharyngeal

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Decision-analytic modeling to evaluate the long-term effectiveness and cost-effectiveness of HPV-DNA testing in primary cervical cancer screening in Germany

Decision-analytic modeling to evaluate the long-term effectiveness and cost-effectiveness of HPV-DNA testing in primary cervical cancer screening in Germany

In der Basisfallanalyse erzielen die verschiedenen unter- suchten Screeningstrategien im Vergleich zu keinem Screening einen durchschnittlichen Gewinn an Lebenser- wartung zwischen 56 und 91 Lebenstagen pro Frau und reduzieren das Zervixkrebsrisiko relativ um durchschnitt- lich 53% bis 97% sowie das Zervixkrebsmortalitätsrisiko um durchschnittlich 61% bis 99%. Im Vergleich zum jährlichen Pap-Screening erzielen die HPV-Screeningstra- tegien im 2-Jahres-Intervall eine ähnliche Effektivität (1% bis 1,5% geringere relative Reduktion des Lebenszeitrisi- kos für Zervixkrebs). Unter den HPV-Screeningstrategien im 2-Jahres-Intervall erreichte das HPV-Screening ab ei- nem Alter von 30 Jahren mit Pap-Triage für HPV-positive befundete Frauen (und zwei-jährlichem Pap-Test im Alter von 20 bis 29 Jahren) die höchste Langzeit-Effektivität, gefolgt von zweijährlichem Screening mit einer Kombina- tion von HPV- und Pap-Test ab dem Alter von 30 Jahren (und jährlichem Pap-Test im Alter von 20 bis 29 Jahren) sowie einem Screening mit HPV-Test allein ab dem Alter von 30 Jahren (und jährlichem oder zweijährlichem Pap- Test im Alter von 20 bis 29 Jahren). Die Rangfolge bleibt auch für Screeningintervalle von drei oder fünf Jahren dieselbe. Allerdings ist die Reduktion des Zervixkrebsrisi- kos bei den HPV-Screeningstrategien mit 3- oder 5-Jahres- Intervall im Vergleich zum jährlichen Pap-Screening um 7,8% bis 8,6% bzw. 20,5% bis 21,4% niedriger. HPV- Screening im 3-Jahres-Intervall ist jedoch effektiver als Pap-Screening im 2-Jahres-Intervall und HPV-Screening im 5-Jahres-Intervall ist effektiver als Pap-Screening im 3-Jahres-Intervall.
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Current strategies for the prevention of breast cancer

Current strategies for the prevention of breast cancer

There was no difference between the effects of tamoxifen and raloxifene on the incidence of breast cancer. There were 163 cases of IBC in the women assigned to the tamoxifen group, compared to 168 cases in the raloxifene group. The rate per 1,000 woman-years was 4.3 in the tamoxifen group and 4.4 in the raloxifene group (RR = 1.02; 95% CI: 0.82 to 1.28). The pathological characteristics of the tumors showed no difference between the treatment groups regard- ing the distribution by tumor size, nodal status, or ER level. The incidence of noninvasive breast cancer was lower in the tamoxifen group (1.51 per 1,000 women) compared to the raloxifene group (2.11 per 1000 women); however, this difference did not reach statistical significance. There were 57 cases of noninvasive breast cancer among women assigned to the tamoxifen arm and 80 cases among those assigned to raloxifene (RR = 1.40; 95% CI: 0.98 to 2.00). There were fewer cases of uterine malignancies in the raloxifene group (23 cases) compared to the tamoxifen group (36 cases), although this difference was also not statistically significant. Annual incidence rates were 1.99 per 1,000 women and 1.25 per 1,000 women in the tamoxifen and raloxifene groups, respectively (RR = 0.62; 95% CI: 0.35 to 1.08). It is important to note that approximately 50% of patients in either group had had a hysterectomy prior to enrollment in the trial. The incidence of uterine hyperplasia with or without atypia was significantly less in the raloxifene group. The number of hysterectomies performed for nonmalignant indications was statistically fewer in the raloxifene group (244 tamoxifen versus 111 raloxifene; RR = 0.29; 95% CI: 0.30 to 0.50). In addition, no statistically significant difference in the incidence of other malignancies, such as colorectal, lung, leukemia/hematopoietic, or other cancers, were observed between the two treatment groups.
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Comparative study of breast cancer in Mexican and Mexican American women

Comparative study of breast cancer in Mexican and Mexican American women

samples were sent to M.D. Anderson Cancer Center for the construction of tissue microarrays (TMAs) (Figure 1). The markers being evaluated in the TMAs were selected to characterize basal and luminal subtypes (ER, PR, and HER2, Ki67, epidermal growth factor receptor (EGFR) and basal cytokeratins [CK5 or 6, CK14 and CK17]) for subset delineation by immunohistochemistry as described by Nielsen et al. [33]. Prior to initiation of the ELLA recruitment, special trainings were conducted at Ventana Medical Systems (Tucson, Arizona) that in- cluded all Mexico pathologists involved in the study. To assure uniformity of tumor marker measures of diagno- stic value across community and international laborato- ries, ER, PR, HER2, and Ki67 analyses were repeated on all tumor samples at Ventana Medical Systems with auto- mation and intra- and inter-batch control. We do not present clinical characteristics or marker data due to their premature nature as data derived from Mexico will need to undergo quality control verification.
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What Are the Recommended Timing and Screening Modalities for Women at Higher Risk of Developing Breast Cancer? A Clin-IQ

What Are the Recommended Timing and Screening Modalities for Women at Higher Risk of Developing Breast Cancer? A Clin-IQ

Abstract Early detection of breast cancer is desirable to prevent progression to advanced disease. This subject has been one of significant study and debate for women at normal risk, and recommendations continue to evolve. However, with regard to women at high risk, the recommendations from various health care professional organizations, including the U.S. Preventive Services Task Force, are different and also inconsistent concerning when to begin screening and which modalities should be used. We review several randomized controlled trials and consensus opinions regarding when to begin screening for breast cancer and how to best screen women at high risk. Specifically, we address women with known personal history of breast cancer, prior mantle radiation or specific family history (including genetic family history) of breast cancer. The purpose of this inquiry is to present current evidence and suggest a clinical pathway regarding the screening of women at high risk for breast cancer. (J Patient-Centered Res Rev. 2015;2:38-42.)
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Triple negative breast cancer and PTEN (phosphatase and tensin homologue)loss are predictors of BRCA1 germline mutations in women with early onset and familial breast cancer, but not in women with isolated late onset breast cancer

Triple negative breast cancer and PTEN (phosphatase and tensin homologue)loss are predictors of BRCA1 germline mutations in women with early onset and familial breast cancer, but not in women with isolated late onset breast cancer

From January 2003 to February 2012, 1,454 breast cancer patients were recruited into the MyBrCa study. Germline DNA samples were screened for BRCA1 and BRCA2 mutations for all women with (a) early-onset breast can- cer ( ≤ 35 years of age) (35 with and 96 without family his- tory of breast and ovarian cancer); (b) family history of breast or ovarian cancer in first- and second-degree rela- tives (193 women); or (c) isolated triple-negative breast cancer diagnosed at between 36 and 50 years old in the absence of family history (47 women). In addition, of the 432 women who were diagnosed aged 36 to 50 years with non-TNBC, 60 women with the highest risk were ana- lyzed (bilateral breast cancer, breast and ovarian cancer in the index patient, family history of breast and ovarian cancer in third-degree or isolated breast cancer (≤45 years of age)). Mutation detection for germline BRCA1 and BRCA2 mutations was conducted by using direct DNA sequencing and multiple ligation-dependent probe amplification (MLPA), as previously described [12,13].
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Analysis of three strategies to increase screening coverage for cervical cancer in the general population of women aged 60 to 70 years: the CRICERVA study

Analysis of three strategies to increase screening coverage for cervical cancer in the general population of women aged 60 to 70 years: the CRICERVA study

There were some limitations when interpreting our data. One limitation is that private medical care is rarely regis- tered in the public health system although it is recom- mended therefore the information on the private medical practice was obtained through personal interviews but was not verified. Another limitation is that the control group was interviewed via telephone and the response rate was significantly lower compared to the intervention groups. This difference could affect the comparison of screening coverage prior to intervention. Moreover it could be spec- ulated that individual randomization could have been a better option to control for co-factors affecting screen- ing uptake. However, the geographical areas selected for randomization were chosen to avoid ‘contamination’ be- tween our intervention groups by clearly separating them geographically. Finally, it was surprising that the introduction of a telephone call did not substantially in- crease coverage. Although we had several trained call operators a reluctance to answer the phone or to accept a short conversation seems to be a major obstacle, due to the overuse of this communication pathway by com- mercial purposes.
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A study to evaluate the effectiveness of structured teaching programme on knowledge regarding cervical cancer among women in selected Village of Villupuram District

A study to evaluate the effectiveness of structured teaching programme on knowledge regarding cervical cancer among women in selected Village of Villupuram District

John (2012) conducted study to determine the effectiveness of two self instructional modules on knowledge of women regarding cervical Cancer. Its detection and control in Pune city evaluate approach used with quasi experiment pretest, post test design were given pap test and the women in the second group were given self instructional module. The findings of the study revealed that the women in North groups gained significantly in the post test for group one the value obtained was 10.27 and for group two the value obtained was 8.60. Dhamija S., Sehgat A Luthera U.K Sehgat K., (2013) et al conducted a study that an attempt has been made to study the knowledge of Cervical Cancer in the community. The survey under taken is a part of knowledge at practice study prior to invitation of cytological screening total women interviewed by knowledge attitude practice survey were 1411 selected through 2 stage stratified Random sampling subjects for the present analysis. The study brought younger women had between awareness knowledge about Cervical Cancer and related information screening 50% never performed 77.8% presented with gynecological complaints.
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