breast cancer

Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement

risk assessment

Information for patients about the new screening recommendations from the USPSTF. James W. Mold, MD, MPH

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We all want better ways to find breast cancer early and save lives from this disease. Breast cancer screening can detect cancer early, when it’s most treatable. This guide is meant to help you and your health care professional understand the benefits and risks of breast cancer screening, including what age to start screening and how often people should be screened. This guide is not for women who have a BRCA gene variant, a history of chest radiation, or a personal history of breast cancer. These women should talk to their health care professional about how best to stay healthy.

Author/s:

US Preventive Services Task Force

Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement

Alex Haga — Tue, 07 May 2024 21:01:58 +0000

Date Added:

May 7, 2024

Journal/Publication:

JAMA

Publisher:

JAMA

Publication Date:

April 30, 2024

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.5534

Keywords

cancer screening

Early Detection of Cancer

PMID (1):

38687503

MeSH

Magnetic Resonance Imaging

The USPSTF now recommends beginning biennial breast cancer screening at 40 rather than 50 in most women. James W. Mold, MD, MPH

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Importance: Among all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast cancer. Non-Hispanic White women have the highest incidence of breast cancer and non-Hispanic Black women have the highest mortality rate.

Objective: The USPSTF commissioned a systematic review to evaluate the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, modality, use of supplemental imaging, or personalization of screening for breast cancer on the incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer-specific or all-cause mortality, and collaborative modeling studies to complement the evidence from the review.

Population: Cisgender women and all other persons assigned female at birth aged 40 years or older at average risk of breast cancer.

Evidence assessment: The USPSTF concludes with moderate certainty that biennial screening mammography in women aged 40 to 74 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older and the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or magnetic resonance imaging (MRI), regardless of breast density.

Recommendation: The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).

Author/s:

US Preventive Services Task Force

American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline

Rowan Hutchins — Sun, 08 Oct 2023 05:00:00 +0000

Date Added:

October 8, 2023

Journal/Publication:

Publisher:

ACS

Publication Date:

December 7, 2015

URL:

American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.3322/caac.21319

Keywords

cancer survivors

Neoplasms

PMID (1):

26641959

MeSH

Survivors

Breast Cancer Survivorship Guidelines

Genetic Counseling

Guidelines for care of breast cancer survivors developed by the American Cancer Society and the American Society for Clinical Oncology. The Guideline recommendations are listed in Table 3. James W. Mold, MD, MPH

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The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made. CA Cancer J Clin 2016;43–73. © 2015 American Cancer Society.

Author/s:

Carolyn D. Runowicz MD, Corinne R. Leach PhD, MS, MPH, N. Lynn Henry MD, PhD, Karen S. Henry MSN

Breast Cancer Survivorship Guidelines

Rowan Hutchins — Sun, 08 Oct 2023 05:00:00 +0000

Date Added:

October 8, 2023

Journal/Publication:

Publisher:

ACS

Publication Date:

December 7, 2015

Issue:

Volume:

Pages:

URL:

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.3322/caac.21322

Keywords

cancer

cancer survivors

education of patients

PMID (1):

26642105

MeSH

Demystifying breast cancer

Patient Advocacy

Guideline recommendations for patients who have survived breast cancer from the ACA and ASCO. James W. Mold, MD, MPH

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What Is the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline?

The Breast Cancer Survivorship Care Guideline is advice from the American Cancer Society and the American Society of Clinical Oncology to help doctors, nurses, and other health care professionals provide care for breast cancer survivors who have finished cancer treatment. The cancer survivorship care guideline addresses issues that can occur in breast cancer survivors after their treatment.

Demystifying breast cancer

Aubrey Delammermore — Sat, 15 Jul 2023 05:00:00 +0000

Date Added:

July 15, 2023

Journal/Publication:

Canadian Family Physician

Publisher:

College of Family Physicians of Canada

Publication Date:

July 1, 2023

Issue:

Volume:

Pages:

473-476

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.46747/cfp.6907473

Keywords

PMID (1):

37451990

MeSH

patients

Combined Modality Therapy

Humans

female

A concise summary of the types of breast cancer and their treatment. James W. Mold, MD, MPH

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The first question a patient often asks their FP after receiving a diagnosis of breast cancer (BC) is “What will my treatment be?” This article will help FPs answer this complex question by reviewing multimodal therapy for BC, which is contingent on molecular subtype and stage.

Author/s:

Wilkinson, A. N.

Continuation of Annual Screening Mammography and Breast Cancer Mortality in Women Older Than 70 Years

Brian Desmarais — Tue, 25 Feb 2020 15:27:32 +0000

Date Added:

February 25, 2020

Journal/Publication:

Annals of Internal Medicine

Publication Date:

February 25, 2020

URL:

Continuation of Annual Screening Mammography and Breast Cancer Mortality in Women Older Than 70 Years

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.7326/M18-1199

Keywords

MeSH

Use of anastrozole for breast cancer prevention (IBIS-II): long-term results of a randomised controlled trial

Rare Diseases

Records

Evidence from a large cohort study that annual mammography beyond age 70 does not reduce breast cancer mortality. James W. Mold, MD, MPH

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BACKGROUND:

Randomized trials have shown that initiating breast cancer screening between ages 50 and 69 years and continuing it for 10 years decreases breast cancer mortality. However, no trials have studied whether or when women can safely stop screening mammography. An estimated 52% of women aged 75 years or older undergo screening mammography in the United States.

OBJECTIVE:

To estimate the effect of breast cancer screening on breast cancer mortality in Medicare beneficiaries aged 70 to 84 years.

DESIGN:

Large-scale, population-based, observational study of 2 screening strategies: continuing annual mammography, and stopping screening.

SETTING:

U.S. Medicare program, 2000 to 2008.

PARTICIPANTS:

1 058 013 beneficiaries aged 70 to 84 years who had a life expectancy of at least 10 years, had no previous breast cancer diagnosis, and underwent screening mammography.

MEASUREMENTS:

Eight-year breast cancer mortality, incidence, and treatments, plus the positive predictive value of screening mammography by age group.

RESULTS:

In women aged 70 to 74 years, the estimated difference in 8-year risk for breast cancer death between continuing and stopping screening was -1.0 (95% CI, -2.3 to 0.1) death per 1000 women (hazard ratio, 0.78 [CI, 0.63 to 0.95]) (a negative risk difference favors continuing). In those aged 75 to 84 years, the corresponding risk difference was 0.07 (CI, -0.93 to 1.3) death per 1000 women (hazard ratio, 1.00 [CI, 0.83 to 1.19]).

LIMITATIONS:

The available Medicare data permit only 8 years of follow-up after screening. As with any study using observational data, the estimates could be affected by residual confounding.

CONCLUSION:

Continuing annual breast cancer screening past age 75 years did not result in substantial reductions in 8-year breast cancer mortality compared with stopping screening.

PRIMARY FUNDING SOURCE:

National Institutes of Health.

Author/s:

García-Albéniz, X., Hernán, M.A., Logan, R.W., Price, M., Armstrong, K., Hsu, J.

Use of anastrozole for breast cancer prevention (IBIS-II): long-term results of a randomised controlled trial

John Bayhi — Fri, 10 Jan 2020 16:02:17 +0000

Date Added:

January 10, 2020

Journal/Publication:

Lancet

Publisher:

Elsevier Ltd.

Publication Date:

January 11, 2020

Issue:

10218

Volume:

395

Pages:

117-122

URL:

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/S0140-6736(19)32955-1

Keywords

Final Update Summary: Breast Cancer: Medication Use to Reduce Risk

anastrozole

female

PMID (1):

31839281

MeSH

cardiovascular diseases

Anastrozole (Arimidex) reduced the long term risk of breast cancer by 50% in women at risk with no major adverse side effects. Menopausal symptoms were increased, primarily during the first year of treatment. James W. Mold, MD, MPH.

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BACKGROUND:

Two large clinical trials have shown a reduced rate of breast cancer development in high-risk women in the initial 5 years of follow-up after use of aromatase inhibitors (MAP.3 and International Breast Cancer Intervention Study II [IBIS-II]). Here, we report blinded long-term follow-up results for the IBIS-II trial, which compared anastrozole with placebo, with the objective of determining the efficacy of anastrozole for preventing breast cancer (both invasive and ductal carcinoma in situ) in the post-treatment period.

METHODS:

IBIS-II is an international, randomised, double-blind, placebo-controlled trial. Postmenopausal women at increased risk of developing breast cancer were recruited and were randomly assigned (1:1) to either anastrozole (1 mg per day, oral) or matching placebo daily for 5 years. After treatment completion, women were followed on a yearly basis to collect data on breast cancer incidence, death, other cancers, and major adverse events (cardiovascular events and fractures). The primary outcome was all breast cancer.

FINDINGS:

3864 women were recruited between Feb 2, 2003, and Jan 31, 2012. 1920 women were randomly assigned to 5 years anastrozole and 1944 to placebo. After a median follow-up of 131 months (IQR 105-156), a 49% reduction in breast cancer was observed for anastrozole (85 vs 165 cases, hazard ratio [HR] 0·51, 95% CI 0·39-0·66, p<0·0001). The reduction was larger in the first 5 years (35 vs 89, 0·39, 0·27-0·58, p<0·0001), but still significant after 5 years (50 vs 76 new cases, 0·64, 0·45-0·91, p=0·014), and not significantly different from the first 5 years (p=0·087). Invasive oestrogen receptor-positive breast cancer was reduced by 54% (HR 0·46, 95% CI 0·33-0·65, p<0·0001), with a continued significant effect in the period after treatment. A 59% reduction in ductal carcinoma in situ was observed (0·41, 0·22-0·79, p=0·0081), especially in participants known to be oestrogen receptor-positive (0·22, 0·78-0·65, p<0·0001). No significant difference in deaths was observed overall (69 vs 70, HR 0·96, 95% CI 0·69-1·34, p=0·82) or for breast cancer (two anastrozole vs three placebo). A significant decrease in non-breast cancers was observed for anastrozole (147 vs 200, odds ratio 0·72, 95% CI 0·57-0·91, p=0·0042), owing primarily to non-melanoma skin cancer. No excess of fractures or cardiovascular disease was observed.

INTERPRETATION:

This analysis has identified a significant continuing reduction in breast cancer with anastrozole in the post-treatment follow-up period, with no evidence of new late side-effects. Further follow-up is needed to assess the effect on breast cancer mortality.

FUNDING:

Cancer Research UK, the National Health and Medical Research Council Australia, Breast Cancer Research Foundation, Sanofi Aventis, and AstraZeneca.

Author/s:

Cuzick, J, Sestak, I, Forbes, JF, Dowsett, M, Cawthorn, S, Mansel, RE, Loibl, S, Bonanni, B, Evans, DG, Howell, A, IBIS-II Investigators

Final Update Summary: Breast Cancer: Medication Use to Reduce Risk

John Bayhi — Wed, 04 Sep 2019 17:50:29 +0000

Date Added:

September 4, 2019

Journal/Publication:

US Preventative Services Task Force / JAMA

Publisher:

American Medical Association

Publication Date:

September 3, 2019

Issue:

322

Volume:

Pages:

857-867

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019.11885

Keywords

PMID (1):

31479144

MeSH

Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence

risk reduction behavior

biopsy

risk assessment

tamoxifen

Raloxifene Hydrochloride

aromatase inhibitors

It looks like all women need to be assessed for risk of breast cancer so that high-risk women can be offered medications to reduce risk. James W. Mold, MD, MPH

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IMPORTANCE:

Breast cancer is the most common nonskin cancer among women in the United States and the second leading cause of cancer death. The median age at diagnosis is 62 years, and an estimated 1 in 8 women will develop breast cancer at some point in their lifetime. African American women are more likely to die of breast cancer compared with women of other races.

OBJECTIVE:

To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on medications for risk reduction of primary breast cancer.

EVIDENCE REVIEW:

The USPSTF reviewed evidence on the accuracy of risk assessment methods to identify women who could benefit from risk-reducing medications for breast cancer, as well as evidence on the effectiveness, adverse effects, and subgroup variations of these medications. The USPSTF reviewed evidence from randomized trials, observational studies, and diagnostic accuracy studies of risk stratification models in women without preexisting breast cancer or ductal carcinoma in situ.

FINDINGS:

The USPSTF found convincing evidence that risk assessment tools can predict the number of cases of breast cancer expected to develop in a population. However, these risk assessment tools perform modestly at best in discriminating between individual women who will or will not develop breast cancer. The USPSTF found convincing evidence that risk-reducing medications (tamoxifen, raloxifene, or aromatase inhibitors) provide at least a moderate benefit in reducing risk for invasive estrogen receptor-positive breast cancer in postmenopausal women at increased risk for breast cancer. The USPSTF found that the benefits of taking tamoxifen, raloxifene, and aromatase inhibitors to reduce risk for breast cancer are no greater than small in women not at increased risk for the disease. The USPSTF found convincing evidence that tamoxifen and raloxifene and adequate evidence that aromatase inhibitors are associated with small to moderate harms. Overall, the USPSTF determined that the net benefit of taking medications to reduce risk of breast cancer is larger in women who have a greater risk for developing breast cancer.

CONCLUSIONS AND RECOMMENDATION:

The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects. (B recommendation) The USPSTF recommends against the routine use of risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, in women who are not at increased risk for breast cancer. (D recommendation) This recommendation applies to asymptomatic women 35 years and older, including women with previous benign breast lesions on biopsy (such as atypical ductal or lobular hyperplasia and lobular carcinoma in situ). This recommendation does not apply to women who have a current or previous diagnosis of breast cancer or ductal carcinoma in situ.

Author/s:

US Preventive Services Task Force, Owens, Douglas K., Davidson, Karina W., Krist, Alex H., Barry, Michael J., Cabana, M, Caughey, AB, Doubeni, Chyke A., Epling, John W. Jr., Kubik, M, Landefeld, CS, Mangione, Carol M., Pbert, L, Silverstein, Michael, Tseng, Chien-Wen, Wong, JB

Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence

John Bayhi — Sat, 31 Aug 2019 15:40:18 +0000

Date Added:

August 31, 2019

Journal/Publication:

The Lancet

Publisher:

Elsevier Ltd.

Publication Date:

August 29, 2019

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/S0140-6736(19)31709-X

Keywords

MeSH

The relevant information for advising individual patients is covered in the Summary Interpretation section and the last two paragraphs of the Discussion (end of paper).

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Summary

Background

Published findings on breast cancer risk associated with different types of menopausal hormone therapy (MHT) are inconsistent, with limited information on long-term effects. We bring together the epidemiological evidence, published and unpublished, on these associations, and review the relevant randomised evidence.

Methods

Principal analyses used individual participant data from all eligible prospective studies that had sought information on the type and timing of MHT use; the main analyses are of individuals with complete information on this. Studies were identified by searching many formal and informal sources regularly from Jan 1, 1992, to Jan 1, 2018. Current users were included up to 5 years (mean 1·4 years) after last-reported MHT use. Logistic regression yielded adjusted risk ratios (RRs) comparing particular groups of MHT users versus never users.

Findings

During prospective follow-up, 108 647 postmenopausal women developed breast cancer at mean age 65 years (SD 7); 55 575 (51%) had used MHT. Among women with complete information, mean MHT duration was 10 years (SD 6) in current users and 7 years (SD 6) in past users, and mean age was 50 years (SD 5) at menopause and 50 years (SD 6) at starting MHT. Every MHT type, except vaginal oestrogens, was associated with excess breast cancer risks, which increased steadily with duration of use and were greater for oestrogen-progestagen than oestrogen-only preparations. Among current users, these excess risks were definite even during years 1–4 (oestrogen-progestagen RR 1·60, 95% CI 1·52–1·69; oestrogen-only RR 1·17, 1·10–1·26), and were twice as great during years 5–14 (oestrogen-progestagen RR 2·08, 2·02–2·15; oestrogen-only RR 1·33, 1·28–1·37). The oestrogen-progestagen risks during years 5–14 were greater with daily than with less frequent progestagen use (RR 2·30, 2·21–2·40 vs 1·93, 1·84–2·01; heterogeneity p<0·0001). For a given preparation, the RRs during years 5–14 of current use were much greater for oestrogen-receptor-positive tumours than for oestrogen-receptor-negative tumours, were similar for women starting MHT at ages 40–44, 45–49, 50–54, and 55–59 years, and were attenuated by starting after age 60 years or by adiposity (with little risk from oestrogen-only MHT in women who were obese). After ceasing MHT, some excess risk persisted for more than 10 years; its magnitude depended on the duration of previous use, with little excess following less than 1 year of MHT use.

Interpretation

If these associations are largely causal, then for women of average weight in developed countries, 5 years of MHT, starting at age 50 years, would increase breast cancer incidence at ages 50–69 years by about one in every 50 users of oestrogen plus daily progestagen preparations; one in every 70 users of oestrogen plus intermittent progestagen preparations; and one in every 200 users of oestrogen-only preparations. The corresponding excesses from 10 years of MHT would be about twice as great.

Funding

Cancer Research UK and the Medical Research Council.

Author/s:

Collaborative Group on Hormonal Factors in Breast Cancer

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: US Preventive Services Task Force Recommendation Statement.

Brian Desmarais — Wed, 21 Aug 2019 19:42:45 +0000

Date Added:

August 21, 2019

Journal/Publication:

Journal of the American Medical Association

Publication Date:

August 20, 2019

URL:

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: US Preventive Services Task Force Recommendation Statement.

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019.10987

Keywords

MeSH

Discussions of Dense Breasts, Breast Cancer Risk, and Screening Choices in 2019

Genetic Counseling

I suspect you are already doing this, but since it is making a splash on the TV news programs, I thought you ought to see it. James W. Mold, MD, MPH

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IMPORTANCE:

Potentially harmful mutations of the breast cancer susceptibility 1 and 2 genes (BRCA1/2) are associated with increased riskfor breast, ovarian, fallopian tube, and peritoneal cancer. For women in the United States, breast cancer is the most common cancer after nonmelanoma skin cancer and the second leading cause of cancer death. In the general population, BRCA1/2 mutations occur in an estimated 1 in 300 to 500 women and account for 5% to 10% of breast cancer cases and 15% of ovarian cancer cases.

OBJECTIVE:

To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer.

EVIDENCE REVIEW:

The USPSTF reviewed the evidence on risk assessment, genetic counseling, and genetic testing for potentially harmful BRCA1/2 mutations in asymptomatic women who have never been diagnosed with BRCA-related cancer, as well as those with a previous diagnosis of breast, ovarian, tubal, or peritoneal cancer who have completed treatment and are considered cancer free. In addition, the USPSTF reviewed interventions to reduce the risk for breast, ovarian, tubal, or peritoneal cancer in women with potentially harmful BRCA1/2 mutations, including intensive cancer screening, medications, and risk-reducing surgery.

FINDINGS:

For women whose family or personal history is associated with an increased risk for harmful mutations in the BRCA1/2 genes, or who have an ancestry associated with BRCA1/2 gene mutations, there is adequate evidence that the benefits of risk assessment, genetic counseling, genetic testing, and interventions are moderate. For women whose personal or family history or ancestry is not associated with an increased risk for harmful mutations in the BRCA1/2 genes, there is adequate evidence that the benefits of risk assessment, genetic counseling, genetic testing, and interventions are small to none. Regardless of family or personal history, the USPSTF found adequate evidence that the overall harms of risk assessment, genetic counseling, genetic testing, and interventions are small to moderate.

CONCLUSIONS AND RECOMMENDATION:

The USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with BRCA1/2 gene mutations with an appropriate brief familial risk assessment tool. Women with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing. (B recommendation) The USPSTF recommends against routine risk assessment, genetic counseling, or genetic testing for women whose personal or family history or ancestry is not associated with potentially harmful BRCA1/2 gene mutations. (D recommendation).

Author/s:

US Preventive Services Task Force

Discussions of Dense Breasts, Breast Cancer Risk, and Screening Choices in 2019

Brian Desmarais — Wed, 05 Jun 2019 00:21:43 +0000

Date Added:

June 4, 2019

Journal/Publication:

JAMA

Publisher:

JAMA Network

Publication Date:

May 31, 2019

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019.6247

Keywords

mammography screening

Reproducibility of Results

MeSH

Breast Density

risk factors

Breast

Treatment of Nonmetastatic Breast Cancer

Radiologists

Adipose Tissue

This is a concise review of what we know now about breast density and cancer risk and how to help patients interpret mammographic reports. James W. Mold, MD, MPH

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Breast density, a radiologic term that describes the proportion of parenchymal relative to fatty tissue in mammograms, is a strong and prevalent risk factor. With increasing breast density, the risk of having a breast cancer masked or hidden on mammography increases, as does future breast cancer risk.1 Almost 50% of US women aged 40 to 74 years have dense breasts (an estimated 27.6 million women). The widespread incorporation of breast density information into screening mammography reports in 36 US states and suggestion to consider supplemental imaging has resulted in women raising questions about breast density and supplemental imaging with their clinicians.2 Thus, clinicians need to be knowledgeable of the clinical significance of breast density and how it may be useful when combined with breast cancer risk to inform screening discussions.

Author/s:

Kerlikowske, Karla", C.M., Miglioretti, D.L.

Treatment of Nonmetastatic Breast Cancer

Tracy Ashby — Mon, 15 Apr 2019 05:00:00 +0000

Date Added:

April 15, 2019

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

April 12, 2019

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019.3927

Keywords

mammography screening

early detection

PMID (1):

30977769

MeSH

Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians

A concise algorithmic summary of the current approach to treatment of invasive stage I to III breast cancer. James W. Mold, MD, MPH

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The treatment of breast cancer has evolved largely based on refinements in understanding of the biology of the disease and the variable risk for mortality among separate disease subtypes.1 Further, due to widespread use of screening mammography, there is a reduction in average breast tumor size at diagnosis. Breast cancer primarily affects women but also affects a smaller number of men. Because many clinicians provide medical care to patients with breast cancer, familiarity with contemporary treatments is important. In this JAMA Insights article, current practices and emerging trends in breast oncology are highlighted, including aspects of precision oncology and the recent deescalation of certain treatments to minimize long-term toxicities.

Author/s:

Ruddy, Kathryn J., Ganz, Patricia A.

Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians

Tracy Ashby — Tue, 09 Apr 2019 05:00:00 +0000

Date Added:

April 9, 2019

Journal/Publication:

Annals of Internal Medicine

Publisher:

American College of Physicians

Publication Date:

April 9, 2019

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M18-2147

Keywords

average-risk women

mammography screening

PMID (1):

30959525

MeSH