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Breast Cancer
NIH - Medical Encyclopedia Breast cancer
"There are several different types of breast cancer. Ductal carcinoma begins in the cells lining the ducts that bring milk to the nipple and accounts for more than 75% of breast cancers. Lobular carcinoma begins in the milk-secreting glands of the breast but is otherwise fairly similar in its behavior to ductal carcinoma. Other varieties of breast cancer can arise from the skin, fat, connective tissues, and other cells present in the breast. … Some women have what is known as HER2-positive breast cancer. HER2, short for human epidermal growth factor receptor-2, is a gene that helps control cell growth, division, and repair. When cells have too many copies of this gene, cell growth speeds up. It’s believed that HER2 plays a key role in turning healthy cells into cancerous ones. Some women with breast cancer have too much HER2, and are therefore considered HER2-positive. … Some families appear to have a genetic tendency for breast cancer. Two variant genes have been found that appear to account for this: BRCA1 and BRCA2. … The body's reduced ability to get rid of abnormal cells leads to damage that gradually accumulates. Women carrying mutated BRCA1 and/or BRCA2 genes start with pre-existing dysfunction of this system and have a "head start" in this damaging process. Hormones are important because they encourage cell growth. High levels of hormones during a woman's reproductive years, especially when they are not interrupted by the hormonal changes of pregnancy, appear to increase the chances that genetically damaged cells will grow and cause cancer."
Highlighted ArticleLifetime Alcohol Intake and Breast Cancer Risk (Annals of Epidemiology 2006)
"These data give added support that moderate alcohol consumption over the life course increases breast cancer risk, particularly among women with low BMI and those diagnosed with estrogen receptor positive tumors or with invasive rather than in situ disease."
Breast Cancer
Diagnosis, Imaging, and Screening
NEWS:
75 Years Is an Appropriate Upper Age Limit for Mammography
Biopsies best at detecting breast cancer
Biopsy Best for Breast Cancer Detection: It's superior to other tests, like MRIs, researchers find
One in 10 Mammograms Comes Back Abnormal "Cancer was ultimately diagnosed in 4.8 out of every 1,000 women."
Over-diagnosis in breast cancer screening.
MRI Helps Spot Breast Cancer in High-Risk Women
Newer Breast Scan May Spare Unnecessary Biopsies "A type of screening called magnetic resonance spectroscopy may reduce the need for biopsies of breast abnormalities by 58 percent, researchers report."
ARTICLES:
JOURNAL ARTICLES:
Arterial Calcifications Seen on Mammograms: Cardiovascular Risk Factors, Pregnancy, and Lactation. (Radiology. 2006) "Conclusion: Calcifications in arteries on mammograms are associated with increasing age, pregnancy, and lactation but not with various cardiovascular risk factors."
[Breast density: a biomarker to better understand and prevent breast cancer] (Bull Cancer. 2006) "Breast cancer risk is much higher among women with very dense breasts than among those with little or no breast density. Recently, we were among the first to show that women with high vitamin D or calcium intakes have less breast density than those with low intakes, especially among premenopausal women. … The increase in vitamin D and calcium intakes may prove to be a safe and inexpensive approach to breast cancer prevention; this possibility should be carefully examined as quickly as possible."
Computed tomography in detecting bone metastases of breast carcinoma. Is it better than plain x-ray? (Saudi Med J. 2006) "CONCLUSION: Our results suggest that 5mm slice CT is not superior than XR to detect metastatic bone lesions. Larger series comparing different slice thickness of CT are needed to clarify the issue."
Computerized analysis of tissue density effect on missed cancer detection in digital mammography. (Comput Med Imaging Graph. 2006) "The results demonstrate that breast density is an important factor affecting not only radiologist's reading but also CAD performance. In order to improve early detection of breast cancer, a special effort should be directed to the high dense breast cases in CAD system design."
Correlation of nipple aspiration and ductal lavage cytology with histopathologic findings for patients before scheduled breast biopsy examination. (Am J Surg. 2006)
Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. (AJR Am J Roentgenol. 2006)
Does the method of biopsy affect the incidence of sentinel lymph node metastases? (Breast J. 2006)
Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years' follow-up: a randomised controlled trial (The Lancet 2006)
FDG PET positive lymph nodes are highly predictive of metastasis in breast cancer. (Nucl Med Commun. 2006)
[Importance of sentinel lymph node biopsy in surgical therapy of in situ breast cancer.] (Magy Onkol. 2006) "CONCLUSION: On the basis of international data and our present results, routine SLN biopsy is not recommended in pure DCIS cases. If the final histology verifies an invasive or microinvasive tumour, or if mastectomy is to be performed, SLN mapping is suggested."
Long-term morbidity of patients with early breast cancer after sentinel lymph node biopsy compared to axillary lymph node dissection. (J Surg Oncol. 2006)
Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis. (Cancer. 2006)
Mammograms and Other Breast Imaging Procedures (2006)
Mammographic Density and Breast Cancer Risk in BRCA1 and BRCA2 Mutation Carriers (Cancer Research 2006)
MR imaging in the management of patients with breast cancer. (Semin Ultrasound CT MR. 2006)
MRI-guided breast interventions. (Semin Ultrasound CT MR. 2006)
Multicentric Breast Cancer: A New Indication for Sentinel Node Biopsy—A Multi-Institutional Validation Study (Journal of Clinical Oncology 2006)
Prospective Breast Cancer Risk Prediction Model for Women Undergoing Screening Mammography (Journal of the National Cancer Institute 2006) "Conclusion: Breast density is a strong additional risk factor for breast cancer, although it is unknown whether reduction in breast density would reduce risk. Our risk model may be able to identify women at high risk for breast cancer for preventive interventions or more intensive surveillance."
Randomized Multicenter Trial of Sentinel Node Biopsy Versus Standard Axillary Treatment in Operable Breast Cancer: The ALMANAC Trial (Journal of the National Cancer Institute 2006) "Conclusion: Sentinel lymph node biopsy is associated with reduced arm morbidity and better quality of life than standard axillary treatment and should be the treatment of choice for patients who have early-stage breast cancer with clinically negative nodes."
Rate of over-diagnosis of breast cancer 15 years after end of Malmö mammographic screening trial: follow-up study (BMJ 2006) "Over-diagnosis of breast cancer at screening may be defined as the detection of cases that would never have come to clinical attention without screening.1-3 The rate of this negative side effect of screening has been estimated at 5-50%. Conclusions on over-diagnosis of breast cancer in the Malmo mammographic screening trial can be drawn mainly for women aged 55-69 years at randomisation whose control groups were never screened. Fifteen years after the trial ended the rate of over-diagnosis of breast cancer was 10% in this age group."
Reduction in breast cancer mortality from organized service screening with mammography: 1. Further confirmation with extended data. (Cancer Epidemiol Biomarkers Prev. 2006)
Reduction in breast cancer mortality from the organised service screening with mammography: 2. Validation with alternative analytic methods. (Cancer Epidemiol Biomarkers Prev. 2006)
Screening for breast cancer with mammography. (Cochrane Database Syst Rev. 2006) "AUTHORS' CONCLUSIONS: Screening likely reduces breast cancer mortality. Based on all trials, the reduction is 20%, but as the effect is lower in the highest quality trials, a more reasonable estimate is a 15% relative risk reduction. Based on the risk level of women in these trials, the absolute risk reduction was 0.05%. Screening also leads to overdiagnosis and overtreatment, with an estimated 30% increase, or an absolute risk increase of 0.5%. This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged. In addition, 10 healthy women, who would not have been diagnosed if there had not been screening, will be diagnosed as breast cancer patients and will be treated unnecessarily. It is thus not clear whether screening does more good than harm. Women invited to screening should be fully informed of both benefits and harms."
Screening MRI for women at high risk for breast cancer. (Semin Ultrasound CT MR. 2006) "The benefits include increased cancer detection with MRI and significantly more cancers detected prior to nodal metastases. The risks include false-positive exams, which lead to additional imaging and/or benign biopsies."
[Sentinel lymph node biopsy in breast cancer.] (Tidsskr Nor Laegeforen. 2006) "INTERPRETATION:. SN biopsy has replaced routine axillary clearance as a routine operation in breast cancer. The method is safe when performed correctly, as metastases in the axilla after a negative SN rarely occur."
[Sentinel lymph node biopsy in breast cancer. Experience of the Rome Breast Cancer Study Group] (Chir Ital. 2006) " Sentinel lymph node biopsy improves staging in women with breast cancer because it is accurate and reproducible, and allows detection of micrometastases and isolated tumour cells that would otherwise be missed. Our multicentric study confirms that this is the preferred axillary staging procedure in women with breast cancer."
Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomised controlled study. (Lancet Oncol. 2006)
Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. (Ann Surg Oncol. 2006)
The benefits and limitations of sentinel lymph node biopsy. (Curr Treat Options Oncol. 2006)
The efficacy of breast MRI in predicting breast conservation therapy. (J Surg Oncol. 2006) "CONCLUSION: Breast MRI does change surgical management by detecting additional malignancies. Breast MRI is accurate in staging extent of disease in the breast in patients with HG tumors."
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