Breast Cancer Screening Flashcards
Breast cancer is the most commonly diagnosed noncutaneous cancer in women in the united states second to
Lung cancer
Breast cancer accounts for what percentage of all new cases of cancer diagnosed in women
27%
Breast cancer screening traditionally included which three elements?
- Breast imaging (primarily mammogram)
- Clinical breast examination
- Patient self-screening (self breast screening or self breast awareness)
Probability of developing invasive breast cancer in the next 10 years if current age is 20
0.06% or 1 in 1,760
Probability of developing invasive breast cancer in the next 10 years if current age is 40
1.44% or 1 in 69
Probability of developing invasive breast cancer in the next 10 years if current age is 50
2.39% or 1 in 42
Tumors detected at an early stage that are small and confined are more likely to be successfully treated with a
98% 5 year survival for localized disease
A typical ductal adenocarcinoma with constant doubling time of 100 days would have been present for more than 11 years before it grew to a palpable size of
2cm
Mammography screening could potentially identify a mass measuring 1mm-1cm during it’s preclinical phase, or
3 years before it becomes palpable
What is sojourn time
The time interval when cancer may be detected by screening before it becomes symptomatic
Sojourn time dependent on what?
Type of cancer. The
More biologically aggressive tumors typically have shorter sojourn times. The greatest predictor of sojourn time is age
What is used in evaluating inconclusive mammographic findings, in evaluating young patients and other women with dense breast tissue, in guiding tissue core needle biopsy and other biopsy techniques, and in differentiating a cyst from a solid mass
Ultrasonography
Ultrasonography may be an option for additional screening in women at high risk who are candidates for MRI screening butcannot receive MRI because of
Gadolinium contrast allergy, claustrophobia , or other barriers
MRI can be useful adjunct but
Cost, duration of exam, and injection of contrast material prohibit it as a routine technique
American cancer society recommends MRI screening for women with 20% or greater lifetime risk of developing breast cancer with what?
- Known brca1 or brca2 gene mutation
- First degree relative with brca1 or brca2 gene mutation and not tested
Themselves - Lifetime risk of breast cancer of 20% or greater according to risk assessment tools based mainly On family history
- Hx of radiationto the chest between 10-30 y.o
- Li faumeni syndrome, Bowden syndrome, bannayan Riley ruvalcaba syndrome