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16 - Breast cancer: screening and prevention

from Part IV - Cancer prevention

Published online by Cambridge University Press:  21 August 2009

Jo Ann Rosenfeld
Affiliation:
East State Tennessee University
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
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Summary

Introduction

Breast cancer has the highest incidence and the third highest death rate for cancer in women in the USA. More than 200 000 women annually develop breast cancer in the USA. The incidence of breast cancer increased between 1973 and 1998 by 40%, perhaps caused by an increase in early-stage breast cancer detection. A woman in the USA has approximately a one in eight risk of developing breast cancer in her lifetime. The incidence of breast cancer increases with age, making screening more important in middle-aged women.

Unlike with lung cancer, screening programs and early detection for breast cancer have reduced its mortality. No studies have found a method to prevent breast cancer. Thus, early detection to reduce mortality is essential. The fact that early detection with mammography reduces mortality in women aged 50–69 years has been accepted and established. However, controversies about the efficacy of screening with different methods and in different populations have occurred; newer studies may be reported in the near future that may reduce or increase these disputes. Evaluation of previous investigations is, thus, important.

Presentation

The most common presentation of breast cancer is no symptoms. The first symptom is often a small, painless nodule or pain. Other symptoms include skin changes, dimpling, and nipple discharge.

Case: a 48-year-old woman comes to the office for an episode of acute bronchitis. After history and examination, you notice that there is no note of any breast cancer screening, including mammography, on her chart. You suggest a mammogram, but she says, “Hasn't that proven lately not to be accurate?”

Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
, pp. 275 - 286
Publisher: Cambridge University Press
Print publication year: 2004

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References

National Cancer Institute information pages: www.nci.nih.gov/cancerinfo/pdq/prevention/breast/healthprofessional/
Harvard University information site for patients and for determining risk: www.yourcancerrisk.harvard.edu/
Parker, S. L., Tong, T., Bolden, S. and Wingo, P. W.Cancer statistics, 1997. CA Cancer J. Clin. 1997; 47:5–27CrossRefGoogle ScholarPubMed
Howe, H. L., Wingo, P. A., Thun, M. J., et al.Annual report to the nation on the status of cancer (1973 to 1998), featuring cancers with recent increasing trends. J. Natl. Cancer Inst. 2001; 93:824–42CrossRefGoogle Scholar
Lawson, H., Henson, R., Bobo, J. K. and Kaeser, M. K.Implementing recommendations for the early detection of breast and cervical cancer among low income women. Morb. Mortal. Wkly Rep. 2000; 49:37–55Google ScholarPubMed
Blamey, R. W., Wilson, A. R. M. and Patnick, J.ABC of breast diseases: screening for breast cancer. Br. Med. J. 2000; 321:689–93CrossRefGoogle ScholarPubMed
International Agency for Research on Cancer Working Group on the Evaluation of Cancer Preventive Strategies. Efficacy of screening by breast self-examination. In: H. Vaionio and F. Bianchini (eds.). Breast Cancer Screening. Lyon: IARC Press; 2002. pp. 107–13
Semiglazov, V. R., Moisenyenko, V. M., Bavli, J. L., et al.The role of breast self-examination in early breast cancer detection. Eur. J. Epidemiol. 1992; 8:498–502CrossRefGoogle ScholarPubMed
Baxter, N. and the Canadian Task Force on Preventive Health Care. Preventive health care, 2001 update: should women be routinely taught breast self-examination to screen for breast cancer?Can. Med. Assoc. J. 2001; 164:1837–46Google ScholarPubMed
Barton, M., Harris, R. and Fletcher, S.Does this patient have breast cancer? The screening clinical breast examination: should it be done? How?J. Am. Med. Assoc. 1999; 282:1270–80CrossRefGoogle Scholar
Miller, A. B., To, T., Baines, C. J. and Wall, C.Canadian national breast screening study – 2: 13-year results of a randomized trial in women aged 50–59. J. Natl. Cancer Inst. 2000; 92:1490–99CrossRefGoogle ScholarPubMed
Alexander, F. E., Anderson, T. J., Brown, H. K., et al.The Edinburgh randomized trial of breast cancer screening: results after 10 years follow-up. Br. J. Cancer 1994; 70:542–8CrossRefGoogle Scholar
Shapiro, S., Venet, W., Strax, P., et al.Ten to fourteen year effect of screening on breast cancer mortality. J. Natl. Cancer Inst. 1982; 69:349–55Google ScholarPubMed
Brewster, A. and Davidson, N. Breast cancer screening. In: J. Rosenfeld (ed.). Handbook of Women's Health. Cambridge: Cambridge University Press; 2001. pp. 385–6
Blanks, R. G., Moss, S. M., McGahan, C. E., Quinn, J. and Babb, B. J.Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990–8: comparison of observed with predicted mortality. Br. Med. J. 2000; 321:665–9CrossRefGoogle ScholarPubMed
US Preventive Services Task Force. Guide to Clinical Preventive Services: Report of the US Preventive Services Task Force, 2nd edn. Baltimore, MD: Williams & Wilkins; 1996
Kerlikowske, K., Grad, D. and Barclay, J.Positive predictive value of screening mammography by age and family history of breast cancer. J. Am. Med. Assoc. 1993; 270:2444–50CrossRefGoogle ScholarPubMed
Elmore, J., Barton, M., Moceri, V., et al.Ten year risk of false positive screening mammograms and clinical breast examinations. N. Engl. J. Med. 1998; 338:1089–96CrossRefGoogle ScholarPubMed
American Cancer Society. Cancer Prevention and Early Detection Facts and Figures, 2002. Atlanta, GA: American Cancer Society; 2002
Blackman, D. K., Bennett, E. M. and Miller, D. S.Trends in self-reported use of mammograms (1989–1997) and Papanicolaou tests (1991–1997) – behavioral risk factor surveillance system. Morbid. Mortal. Wkly CDC Surveill. Summ. 1999; 48:1–22Google ScholarPubMed
Kerlikowske, K., Grady, D., Barclay, J., Sickles, E. A. and Ernster, V.Effect of age, breast density, and family history on the sensitivity of first screening mammography. J. Am. Med. Assoc. 1996; 276:33–8CrossRefGoogle ScholarPubMed
Miller, A. B., To, T., Baines, C. J. and Wall, C.The Canadian National Breast Screening Study-1: breast cancer mortality after 11 to 16 years of follow-up. A randomized screening trial of mammography in women age 40 to 49 years. Ann. Intern. Med. 2002; 137:305–12CrossRefGoogle ScholarPubMed
Miller, A. B., To, T., Baines, C. J. and Wall, C.Canadian National Breast Screening Study-2: 13-year results of a randomized trial in women aged 50–59 years. J. Natl. Cancer Inst. 2000; 92:1490–99CrossRefGoogle ScholarPubMed
Hendrick, R. E., Smith, R. A., Rutledge, J. H., III and Smart, C. R.Benefit of screening mammography in women aged 40–49: a new meta-analysis of randomized controlled trials. J. Natl. Cancer Inst. Monogr. 1997; 22:87–92CrossRefGoogle Scholar
Humphrey, L. L., Helfand, M., Chan, B. K. and Woolf, S. H.Breast cancer screening: a summary of the evidence for the U.S. Preventive Services Task Force. Ann. Intern. Med. 2002; 137:347–60CrossRefGoogle ScholarPubMed
Larson, L. G., Nystrom, L., Wall, S., et al.The Swedish randomized mammography screening trials: analysis of the effect on the breast cancer related excess mortality. J. Med. Screen. 1996; 3:129–32CrossRefGoogle Scholar
McCarthy, E. P., Burns, R. B., Freund, K. M., et al.Mammography use, breast cancer stage at diagnosis and survival among older women. J. Am. Geriatr. Soc. 2000; 48:2221–9CrossRefGoogle ScholarPubMed
Randolph, W. M., Goodwin, J. S., Mahnken, J. D. and Freeman, J. L.Regular mammography use is associated with elimination of age-related disparities in size and stage of breast cancer at diagnosis. Ann. Intern. Med. 2002; 137:783–90CrossRefGoogle ScholarPubMed
Uematsu, T., Sano, M., Homma, K., Shiina, M. and Kobayashi, S.Three-dimensional helical CT of the breast: accuracy for measuring extent of breast cancer candidates for breast conserving surgery. Breast Cancer Res. Treat. 2001; 65:249–57CrossRefGoogle ScholarPubMed
Gilhuijs, K. G., Deurloo, E. E., Muller, S. H., Peterse, J. L. and Schultz Kool, L. J.Breast MR imaging in women at increased lifetime risk of breast cancer: clinical system for computerized assessment of breast lesions initial results. Radiology 2002; 225:907–16CrossRefGoogle ScholarPubMed
Kolb, T. M., Lichy, J. and Newhouse, J. H.Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 2002; 225:165–75CrossRefGoogle ScholarPubMed
Brinton, L. A., Schairer, C., Hoover, R. N., et al.Menstrual factors and risk of breast cancer. Cancer Invest. 1988; 6:245–54CrossRefGoogle ScholarPubMed
Thune, I., Brenn, T. and Lund, E.Physical activity and the risk of breast cancer. N. Engl. J. Med. 1997; 336:1269–75CrossRefGoogle ScholarPubMed
Hirose, K., Tajima, K., Hamajima, N., et al.The effect of body size on breast cancer risk among Japanese women. Int. J. Cancer 1999; 80:349–553.0.CO;2-8>CrossRefGoogle ScholarPubMed
Schairer, C., Lubin, J., Troisis, R., et al.Menopausal estrogen and estrogen– progestin replacement therapy and breast cancer risk. J. Am. Med. Assoc. 2000; 283:485–91CrossRefGoogle ScholarPubMed
Colditz, F. A., Hankinson, S. E., Hunter, D. J., et al.The use of estrogens and progestins and the risk of breast cancer in post menopausal women. N. Engl. J. Med. 1995; 332:1589–93CrossRefGoogle Scholar
Kerlikowske, K., Carney, P. A., Geller, B., et al.Performance of screening mammography among women with and without a first-degree relative with breast cancer. Ann. Intern. Med. 2000; 133:855–63CrossRefGoogle ScholarPubMed
Easton, D. F., Bishop, D. T., Ford, D., et al.Genetic linkage analysis in familial breast and ovarian cancer: results from 215 familieis. Am. J. Hum. Genet. 1993; 52:678–701Google Scholar
Strueing, J. P., Hartge, P., Wacholder, S., et al.The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. N. Engl. J. Med. 1997; 336:1401–8CrossRefGoogle Scholar
Macmillan, R. D.Screening women with a family history of breast cancer. Results from the British Familial Breast Cancer group. Eur. J. Surg. Oncol. 2000; 26:149–52CrossRefGoogle ScholarPubMed
Fisher, B., Constatino, J. P., Wickerham, D. L., et al.Tamoxifen for prevention of breast cancer. Report of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J. Natl. Cancer Inst. 1998; 90:1371–88CrossRefGoogle ScholarPubMed
Cummings, S. R., Eckert, D., Kreuger, D. A., et al.The effect of raloxifene on risk of breast cancer in postmenopausal women. J. Am. Med. Assoc. 1999; 281:2189–97CrossRefGoogle ScholarPubMed

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