Download or read book Breast Abnormalities Identification of Indicators that Facilitate Use of Health Services for Diagnosis and Treatment of Breast Cancer written by Ruth Ann DeBoard and published by . This book was released on 2010 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: Problem: There is a lack of knowledge about women who are screened for breast cancer, have an abnormal finding on mammogram, and then do not return in a timely manner for diagnostics and treatment. Lack of follow- up likely constitutes delayed treatment and poorer outcomes. Delays may result in later entry into the health system with advanced disease, more extensive and expensive care, burdening resources. Late stage breast cancer likely results in poorer health outcomes or early death. Purpose and Aims: The purpose of this research is to describe contextual characteristics at the health delivery level as well as individual characteristics of women with abnormal mammography, and their association with use of follow- up health services. Particularly, this research examines the differences between women who are early and late responders after an abnormal mammogram. Population: The participants were a convenience sample of 380 women who participated in mobile breast cancer screening. A subset of women with inconclusive or abnormal mammogram findings was the focus of analysis. Methods: This research utilized a descriptive design with quantitative data collection through participant survey at mobile mammogram screening events in multiple urban and rural Arizona sites. Participants requiring further health care were followed by chart review. Analysis of correlations with the outcome variable: time to first follow- up appointment for recommended health care in women with abnormal mammograms was conducted. Findings: Data indicated the time to the first follow- up appointment ranged from 1- 110 days with follow- up for 77.4% of participants within 60 days, 6.5% within 60-90 days, and 16.1% without follow- up after 90 days. Significant relationships between contextual and individual characteristics and follow- up were found. Categories included organizational health system characteristics of geographic location, clinical breast exam and shared case management; individual characteristics of beliefs including value of health care; finance including out of pocket costs and perceptions of financial assistance; perceived needs including breast symptoms; and satisfaction with the last health visit and mammograms in general. Implications: Recognition of barriers to follow- up after breast cancer screening is important for development of interventions to improve outcomes and has implications for screening and treatment management programs, community health centers and private practice. Health disparity related to screening without adequate options for access to health care is ethically untenable. Nurses are well positioned to reduce barriers to health care.
Download or read book Image guided Diagnosis and Treatment of Breast Cancer written by United States. Public Health Service. Office on Women's Health and published by . This book was released on 1998 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Saving Women s Lives written by National Research Council and published by National Academies Press. This book was released on 2005-03-18 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: The outlook for women with breast cancer has improved in recent years. Due to the combination of improved treatments and the benefits of mammography screening, breast cancer mortality has decreased steadily since 1989. Yet breast cancer remains a major problem, second only to lung cancer as a leading cause of death from cancer for women. To date, no means to prevent breast cancer has been discovered and experience has shown that treatments are most effective when a cancer is detected early, before it has spread to other tissues. These two facts suggest that the most effective way to continue reducing the death toll from breast cancer is improved early detection and diagnosis. Building on the 2001 report Mammography and Beyond, this new book not only examines ways to improve implementation and use of new and current breast cancer detection technologies but also evaluates the need to develop tools that identify women who would benefit most from early detection screening. Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis encourages more research that integrates the development, validation, and analysis of the types of technologies in clinical practice that promote improved risk identification techniques. In this way, methods and technologies that improve detection and diagnosis can be more effectively developed and implemented.
Download or read book Identifying Typologies of Breast Cancer Patients Based on Multiple Individual and Contextual Factors for Timely Treatment Initiation written by Sharon Baik and published by . This book was released on 2018 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rationale: Breast cancer is the most commonly diagnosed cancer, excluding skin cancers, and is the second leading cause of cancer death among women in the United States. Despite advancements in screening, early detection, and cancer treatments, not all women have benefited equally. Racial and ethnic minorities, particularly African American women, and those of low income have higher breast cancer mortality rates compared to the general population. Previous research has identified a number of demographic (e.g., race/ethnicity, age, health insurance, income), medical (e.g., comorbidities with other illnesses, family medical history), environmental (e.g., geographic area), and health system (e.g., type of cancer-related services available) factors associated with breast cancer disparities. However, these factors have largely been examined individually, and no study has comprehensively evaluated how multiple individual and contextual factors impact breast cancer outcomes. Therefore, this dissertation project had two primary aims: 1) to identify distinct subgroups of breast cancer patients based on demographic, medical, environmental, and health system factors that have been shown to influence timeliness of breast cancer care, and 2) to examine differences among emergent classes in timely initiation of breast cancer treatment. Design: The proposed study used archival data from the control arm of the Patient Navigation Research Project (PNRP), a five-year 10-site clinical trial of adult patients from medically underserved populations with an abnormal cancer screening or a new diagnosis of breast, cervical, colorectal, or prostate cancer. For this study, the sample included 198 patients with newly diagnosed Stage I-III breast cancer who received usual standard of care (control arm) from four PNRP sites, and who received a treatment for breast cancer (e.g., surgery, chemotherapy, radiation, hormonal therapy). Control participants were primarily recruited via medical record abstraction for which informed consent was waived. Exploratory Latent Class Analysis (LCA) was used to identify subgroups of breast cancer patients based on demographic (race/ethnicity, age at diagnosis, health insurance status, annual household income), medical (comorbidities [Charlson Comorbidity Index], family history of cancer), environmental (geographic residence [urban vs. rural], and health system (cancer-related services available onsite) factors associated with timeliness of breast cancer care. For the second aim, the study conducted logistic regression analyses to examine if class membership significantly predicted timely breast cancer treatment initiation, defined as initiation of any treatment for breast cancer (e.g., surgery, chemotherapy, radiation, hormonal therapy) within 30 or 60 days of diagnosis, controlling for type of breast cancer treatment. Results: Three classes of breast cancer patients were identified with varying patterns of patient demographic, medical, and health system characteristics. The first class was distinguished by its high endorsement of indicators associated with timely breast cancer care; patients in this class were most likely to be White, have private health insurance, and have a family history of cancer. The second class was characterized by individual and contextual factors associated with treatment delays, including having public health insurance, not having a family history of cancer, and receiving care at a facility with the least amount of breast cancer services available onsite. The third class represented breast cancer patients with the oldest average age at diagnosis and the greatest number of medical comorbidities. Binomial logistic regression analyses demonstrated that the emergent classes did not significantly differ in the likelihood of initiating breast cancer treatment within 30 days or 60 days from breast cancer diagnosis, controlling for type of treatment. Conclusions: The present study used LCA to derive classes of breast cancer patients based on simultaneous evaluation of demographic, medical, environmental, and health system factors associated with timely breast cancer care. However, the emergent classes did not significantly differ in terms of timely initiation of breast cancer treatment following definitive diagnosis of breast cancer. The relatively small and homogenous study sample may have obscured differences in timeliness of breast cancer treatment initiation. Future studies should utilize LCA with larger, more diverse samples of breast cancer patients to identify distinct classes with unique combinations of individual and contextual characteristics that influence timeliness of breast cancer care. Identification of distinct typologies of breast cancer patients provides a deeper understanding of how the combination of factors synergistically impacts breast cancer outcomes and can help target interventions to specific subgroups of patients that are most likely to experience delays in breast cancer care.
Download or read book Saving Women s Lives written by National Research Council and published by National Academies Press. This book was released on 2004-12-18 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this report The Breast Cancer Research Foundation (BCRF) and the Institute of Medicine (IOM) present a one-day symposium that was held at the IOM to further disseminate the conclusions and recommendations of the joint IOM and National Research Council report, Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis. The committee assembled for this event was asked to share insights and consider ways in which the objectives of the report could be achieved from the standpoint of what women need to know, the best models of screening programs, manpower, risk stratification, basic research, and payment. This symposium seeks to provide continuing food for thought and ideas for actions in support of breast cancer detection and diagnosis and saving women's lives.
Download or read book Understanding Breast Changes written by and published by . This book was released on 1997 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Breast Cancer written by and published by . This book was released on 1981 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Improving Diagnosis in Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2015-12-29 with total page 473 pages. Available in PDF, EPUB and Kindle. Book excerpt: Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Download or read book Noninvasive Diagnostic Tests for Breast Abnormalities Update of a 2006 Review written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-04-11 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast cancer is one of the most common malignancies of women, with approximately 200,000 new cases diagnosed every year in the U.S. Some breast cancers are identified by physical examination (either self-examination or an examination performed by a physician). Population-wide screening programs that use x-ray mammography to examine asymptomatic women for early signs of breast cancer are also in common use. If a suspicious area is seen on x-ray mammography, women are usually recalled for further examination. The results of these examinations are used to make decisions about further management: return to normal screening/return for short-interval followup/refer for biopsy. In current standard practice the examinations conducted after recall usually consist of diagnostic mammography and possibly ultrasound. More and more often women are being sent for additional imaging during recall workup. Extensive diagnostic ultrasound examinations and MRI are currently the most commonly chosen additional imaging added to the workup, but other imaging technologies are offered by some practitioners. It is important to triage recalled women into the correct management pathway. Women with readily treatable early-stage cancers who get mistakenly triaged into “return to normal screening” may experience a significant delay in diagnosis and treatment of the cancer. However, the majority of women who are recalled for further assessment after a screening mammography do not have cancer, and significant numbers of healthy women are referred for biopsy or short-interval followup after recall and diagnostic mammography. A number of noninvasive imaging technologies have been developed and proposed to be useful as part of the workup after recall. This evidence review focuses on additional noninvasive imaging studies that can be conducted (in addition to standard workup) after discovery of a possible abnormality on screening mammography or physical examination. These studies are intended to guide patient management decisions. In other words, these imaging studies are not intended to provide a final diagnosis as to the nature of the breast lesion; rather, they are intended to provide additional information about the nature of the lesions such that women can be more appropriately triaged into the correct management pathway. It is important to evaluate the evidence to see if women do or do not benefit from the addition of these imaging modalities to the standard workup after recall on breast cancer screening. This systematic review was commissioned by the Agency for Healthcare Research and Quality (AHRQ) to address the following Key Questions: Key Question 1. What is the accuracy (expressed as sensitivity, specificity, predictive values, and likelihood ratios) of noninvasive tests for diagnosis of breast cancer in women referred for further evaluation after identification of a possible breast abnormality on routine screening (mammography and/or clinical or self-detection of a palpable lesion)? The noninvasive tests to be evaluated are: Ultrasound (conventional B-mode, color Doppler, power Doppler, tissue harmonics, and tomography), Magnetic resonance imaging (MRI) with breast-specific coils and gadolinium-based contrast agents, with or without computer-aided diagnosis (CADx), Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) as the tracer, with or without concurrent computed tomography (CT) scans 8, Scintimammography (SMM) with technetium-99m sestamibi (MIBI) as the tracer, including Breast Specific Gamma Imaging (BSGI). Key Question 2. Are there demographic (e.g., age) and clinical risk factors (e.g., morphologic characteristics of the lesion) that affect the accuracy of the tests considered in Key Question 1? Key Question 3. Are there other factors and considerations (e.g., safety, care setting, patient preferences, ease of access to care) that may affect the accuracy or acceptability of the tests considered in Key Questions 1 and 2?
Download or read book Developing Technologies for Early Detection of Breast Cancer written by National Research Council and published by National Academies Press. This book was released on 2000-07-06 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: In November 1999, the Institute of Medicine, in consultation with the Commission on Life Sciences, the Commission on Physical Sciences, Mathematics, and Applications, and the Board on Science, Technology and Economic Policy launched a one year study on technologies for early detection of breast cancer. The committee was asked to examine technologies under development for early breast cancer detection, and to scrutinize the process of medical technology development, adoption, and dissemination. The committee is gathering information on these topics for its report in a number of ways, including two public workshops that bring in outside expertise. The first workshop on "Developing Technologies for Early Breast Cancer Detection" was held in Washington DC in February 2000. The content of the presentations at the workshop is summarized here. A second workshop, which will focus on the process of technology development and adoption, will be held in Washington, DC on June 19-20. A formal report on these topics, including conclusions and recommendations, will be prepared by the committee upon completion of the one-year study.
Download or read book Contrast Enhanced Mammography written by Marc Lobbes and published by Springer. This book was released on 2019-04-29 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is a comprehensive guide to contrast-enhanced mammography (CEM), a novel advanced mammography technique using dual-energy mammography in combination with intravenous contrast administration in order to increase the diagnostic performance of digital mammography. Readers will find helpful information on the principles of CEM and indications for the technique. Detailed attention is devoted to image interpretation, with presentation of case examples and highlighting of pitfalls and artifacts. Other topics to be addressed include the establishment of a CEM program, the comparative merits of CEM and MRI, and the roles of CEM in screening populations and monitoring of response to neoadjuvant chemotherapy. CEM became commercially available in 2011 and is increasingly being used in clinical practice owing to its superiority over full-field digital mammography. This book will be an ideal source of knowledge and guidance for all who wish to start using the technique or to learn more about it.
Download or read book Improving Breast Imaging Quality Standards written by National Research Council and published by National Academies Press. This book was released on 2005-09-27 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mammography is an important tool for detecting breast cancer at an early stage. When coupled with appropriate treatment, early detection can reduce breast cancer mortality. At the request of Congress, the Food and Drug Administration (FDA) commissioned a study to examine the current practice of mammography and breast cancer detection, with a focus on the FDA's oversight via the Mammography Quality Standards Act (MQSA), to identify areas in need of improvement. Enacted in 1993, MQSA provides a general framework for ensuring national quality standards in facilities performing screening mammography, requires that each mammography facility be accredited and certified, and mandates that facilities will undergo annual inspections. This book recommends strategies for achieving continued progress in assuring mammography quality, including changes to MQSA regulation, as well as approaches that do not fall within the purview of MQSA. Specifically, this book provides recommendations aimed at improving mammography interpretation; revising MQSA regulations, inspections, and enforcement; ensuring an adequate workforce for breast cancer screening and diagnosis; and improving breast imaging quality beyond mammography.
Download or read book Fulfilling the Potential of Cancer Prevention and Early Detection written by National Research Council and published by National Academies Press. This book was released on 2003-05-07 with total page 564 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
Download or read book The Coordinated Diagnostic and Evaluation Program written by Julia Fridland and published by . This book was released on 2009 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Digital Breast Tomosynthesis written by Alberto Tagliafico and published by Springer. This book was released on 2016-05-03 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive description of the screening and clinical applications of digital breast tomosynthesis (DBT) and offers straightforward, clear guidance on use of the technique. Informative clinical cases are presented to illustrate how to take advantage of DBT in clinical practice. The importance of DBT as a diagnostic tool for both screening and diagnosis is increasing rapidly. DBT improves upon mammography by depicting breast tissue on a video clip made of cross‐sectional images reconstructed in correspondence with their mammographic planes of acquisition. DBT results in markedly reduced summation of overlapping breast tissue and offers the potential to improve mammographic breast cancer surveillance and diagnosis. This book will be an excellent practical teaching guide for beginners and a useful reference for more experienced radiologists.
Download or read book Breast Disease written by Adnan Aydiner and published by Springer. This book was released on 2015-11-02 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: This first of two volumes provides and in-depth account of breast disease characteristics, imaging and diagnosis. Covering from breast anatomy and tumor biology to benign and malignant lesions this is an indispensable companion for breast specialists, medical oncologists, radiologists and pathologists. The book is organised in themed parts exploring topics such as epidemiology, risk factors, genetic biomarkers, pathological evaluation of tumors and biopsy techniques. With a high number of colored illustrations and edited by highly experienced clinicians, this work enables readers to gain an interdisciplinary perspective on breast diseases. Contributions from an international team of experts present invaluable insight into pathological and epidemiological aspects of breast disease. Covering both theoretical and practical aspects of breast cancer this is a highly informative and carefully presented book which will appeal to an international audience of breast cancer practitioners.
Download or read book Early Detection of Breast Cancer written by John Kenneth Gohagan and published by . This book was released on 1982 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt:
