Chapter 9: Risk-based breast cancer screening strategies in women

Publication date: Available online 18 November 2019Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Elaine F. Harkness, Susan M. Astley, D Gareth EvansAbstractThe incidence of breast cancer continues to increase worldwide. Population-based screening is available in many countries but may not be the most efficient use of resources, thus interest in risk-based/stratified screening has grown significantly in recent years. An important part of risk-based screening is the incorporation of mammographic density and single nucleotide polymorphisms (SNPs) into risk prediction models to be combined with classical risk factors. In this article we discuss different measures of mammographic density and risk prediction models available. Risk-stratified screening options including supplemental or alternative screening modalities including digital breast tomosynthesis (DBT), automated ultrasound (ABUS) and magnetic resonance imaging (MRI) are discussed, as well as potential risk-based interventions (diet and lifestyle, chemoprevention and risk-reducing surgery). Furthermore we look at risk feedback in practice and the cost-effectiveness and acceptability of risk-based screening, highlighting some of the current challenges.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research

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Publication date: Available online 18 November 2019Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Elaine F. Harkness, Susan M. Astley, D.Gareth EvansAbstractThe incidence of breast cancer continues to increase worldwide. Population-based screening is available in many countries but may not be the most efficient use of resources, thus interest in risk-based/stratified screening has grown significantly in recent years. An important part of risk-based screening is the incorporation of mammographic density (MD) and single nucleotide polymorphisms (SNPs) into risk prediction models to be comb...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research
The objective of this study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) in detecting the secondary breast cancer among women with a personal history of the lesion. Materials and Methods We retrospectively reviewed breast MRI examinations performed between 2007 and 2011. A total of 798 women with a history of breast cancer were included in the study. Cancer detection rate, positive predictive value (PPV), recall rate, sensitivity, and specificity were assed. Cancer detection rate was stratified by interval after surgery of the primary breast cancer. Also, we derived 1 comparison group f...
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Breast Imaging Source Type: research
Abstract The detection of lymph node metastasis affects the management of patients with primary breast cancer significantly in terms of staging, treatment, and prognosis. The main goal for the radiologist is to determine and detect the presence of metastatic disease in nonpalpable axillary lymph nodes with a positive predictive value that is high enough to initially select patients for upfront axillary lymph node dissection. Features that are suggestive of axillary adenopathy may be seen with different imaging modalities, but ultrasound is the method of choice for evaluating axillary lymph nodes and for performing...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research
You’re staring at a letter from your mammography facility. Your breast exam was normal, great. But then you see a note on the bottom: you have high breast density, which could put you at higher risk for breast cancer in the future. Now what? “The finding of dense breasts on a mammogram can be stressful and confusing for patients,” says Dr. Toni Golen, acting editor in chief of Harvard Women’s Health Watch. It’s information that may concern them, but they don’t know what to do about it. What is breast density? Breasts are composed of: lobules, which produce milk ducts, tubes that carry m...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Breast Cancer Health Tests and procedures Women's Health Source Type: blogs
ConclusionsMRI is the best predictor of tumor size in breast cancer. Histologic type and tumor size are key parameters when estimating tumor size and should be taken into account when planning surgery. Patient age does not interfere with the interpretation of imaging tests.ResumenIntroducciónEl objetivo de este estudio fue evaluar qué prueba de imagen de las empleadas para medir el tamaño del cáncer de mama primario preoperatorio (mamografía, ecografía o resonancia magnética (RM)) se correlacionó mejor con el tamaño del tumor en la pieza quirúrgica posto...
Source: Cirugia Espanola - Category: Surgery Source Type: research
AbstractPurposeTo develop a multiparametric [18F]FDG positron emission tomography/magnetic resonance imaging (PET/MRI) model for breast cancer diagnosis incorporating imaging biomarkers of breast tumors and contralateral healthy breast tissue.MethodsIn this prospective study and retrospective data analysis, 141 patients (mean 57  years) with an imaging abnormality detected on mammography and/or ultrasound (BI-RADS 4/5) underwent combined multiparametric [18F]FDG PET/MRI with PET/computed tomography and multiparametric MRI of the breast at 3  T. Images were evaluated and the following were recorded: for the tumor,...
Source: European Journal of Nuclear Medicine and Molecular Imaging - Category: Nuclear Medicine Source Type: research
This study could be beneficial for: (i) Clinicians to receive second opinion from the CAD system for early diagnosis, and (ii) Researchers to analyze and enhance the existing state-of-art techniques used in CAD system, which may further reduce the gap of variability between intra and inter observer.Graphical abstract
Source: IRBM - Category: Biomedical Engineering Source Type: research
CONCLUSIONS: MRI is the best predictor of tumor size in breast cancer. Histologic type and tumor size are key parameters when estimating tumor size and should be taken into account when planning surgery. Patient age does not interfere with the interpretation of imaging tests. PMID: 31186117 [PubMed - as supplied by publisher]
Source: Cirugia eEspanola - Category: Surgery Authors: Tags: Cir Esp Source Type: research
AbstractBackgroundDense breast tissue increases breast cancer risk and lowers mammography sensitivity, but the value of supplemental imaging for dense breasts remains uncertain. Since 2009, 37 states and Washington DC have passed legislation requiring patient notification about breast density.ObjectiveExamine the effects of state breast density notification laws on use of supplemental breast imaging and breast biopsies.DesignDifference-in-differences analysis of supplemental imaging and biopsies before and after notification laws in 12 states enacting breast density notification laws from 2009 to 2014 and 12 matched contro...
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Conclusion: The texture analysis for breast DCE-MRI proposed in this study demonstrated potential utility in HER2 2+ status discrimination. Background Human epidermal growth factor receptor 2 (HER2) is an orphan tyrosine kinase receptor. It is reported that HER2 is overexpressed in 15–20% of breast cancers. Overexpression of HER2 in breast cancer correlates with shortened disease-free survival. Compared with HER2-negative patients, patients with HER2-positive breast cancers have a poor prognosis, a high probability of lymph node metastasis and a high risk of recurrence (1–3). However, previous studies h...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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