mammography screening

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:

Treatment of Nonmetastatic Breast Cancer

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019.3927

Keywords

breast cancer

mammography screening

early detection

PMID (1):

30977769

MeSH

breast neoplasms

mammography

early detection of cancer

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:

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

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M18-2147

Keywords

breast cancer

average-risk women

mammography screening

PMID (1):

30959525

MeSH

early detection of cancer

A nice summary of current rational recommendations regarding mammography screening in average-risk women at different ages. James W. Mold, MD, MPH

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Description:

The purpose of this guidance statement is to provide advice to clinicians on breast cancer screening in average-risk women based on a review of existing guidelines and the evidence they include.

Methods:

This guidance statement is derived from an appraisal of selected guidelines from around the world that address breast cancer screening, as well as their included evidence. All national guidelines published in English between 1 January 2013 and 15 November 2017 in the National Guideline Clearinghouse or Guidelines International Network library were included. In addition, the authors selected other guidelines commonly used in clinical practice. Web sites associated with all selected guidelines were checked for updates on 10 December 2018. The AGREE II (Appraisal of Guidelines for Research and Evaluation II) instrument was used to evaluate the quality of guidelines.

Target Audience and Patient Population:

The target audience is all clinicians, and the target patient population is all asymptomatic women with average risk for breast cancer.

Guidance Statement 1:

In average-risk women aged 40 to 49 years, clinicians should discuss whether to screen for breast cancer with mammography before age 50 years. Discussion should include the potential benefits and harms and a woman's preferences. The potential harms outweigh the benefits in most women aged 40 to 49 years.

Guidance Statement 2:

In average-risk women aged 50 to 74 years, clinicians should offer screening for breast cancer with biennial mammography.

Guidance Statement 3:

In average-risk women aged 75 years or older or in women with a life expectancy of 10 years or less, clinicians should discontinue screening for breast cancer.

Guidance Statement 4:

In average-risk women of all ages, clinicians should not use clinical breast examination to screen for breast cancer.

Author/s:

Qaseem, Amir, Lin, Jennifer S., Mustafa, Reem A., Horwitch, Carrie A., Wilt, Timothy J., Clinical Guidelines Committee of the American College of Physicians