Download or read book Comparative Effectiveness of Medications To Reduce Risk of Primary Breast Cancer in Women written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Comparative Effectiveness of Medications to Reduce Risk of Primary Breast Cancer in Women written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-05-14 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast cancer is the most frequently diagnosed noncutaneous cancer and the second leading cause of cancer death after lung cancer among women in the United States. In 2008, an estimated 182,460 cases of invasive breast cancer and 67,770 cases of in situ breast cancer were diagnosed, and 40,480 women died of breast cancer in the United States. Recent clinical trials have demonstrated the efficacy of three medications—tamoxifen citrate, raloxifene, and tibolone—to reduce the risk of invasive breast cancer in women without pre-existing cancer. This therapy is sometimes referred to as “chemoprevention” in the literature, although this is not a fully accurate representation of the intervention. Tamoxifen and raloxifene are approved by the U.S. Food and Drug Administration for this indication and tibolone is not. Raloxifene is approved for use by postmenopausal women only. Current clinical recommendations, including those from the U.S. Preventive Services Task Force issued in 2002, support tamoxifen use for primary breast cancer prevention in women considered at high risk for breast cancer by the Gail model or other criteria and low risk for adverse events. However, use of risk-reducing medications for breast cancer is believed to be low in the United States. The purpose of this review is to evaluate the comparative effectiveness of tamoxifen citrate, raloxifene, and tibolone to reduce the risk of primary breast cancer; assess the nature and magnitude of harms; and examine how benefits and harms vary by age, breast cancer risk status, and other factors. The review was originally entitled “Comparative Effectiveness of Chemotherapy Agents in the Prevention of Primary Breast Cancer in Women.” Peer review comments suggested that the terms “chemotherapy” and “prevention” were misnomers. The term “medications to reduce risk” is a better representation of the intervention and therefore, all references to “chemoprevention” are edited, including the key questions and report title. The review also examines issues related to clinical effectiveness, such as patient choice, concordance, adherence, and persistence of use, and evaluates methods to appropriately select patients for risk-reducing medications for clinical applications. The target population includes women without pre-existing breast cancer, noninvasive breast cancer, or precursor conditions who are not known carriers of breast cancer susceptibility mutations (BRCA1, BRCA2, or others). Key questions addressed include: Key Question 1. In adult women without pre-existing breast cancer, what is the comparative effectiveness of selective estrogen receptor modulators (SERMs) tamoxifen citrate and raloxifene, and the selective tissue estrogenic activity regulator (STEAR) tibolone, when used to reduce risk for primary breast cancer on improving short-term and long-term outcomes including invasive breast cancer, noninvasive breast cancer, including ductal carcinoma in situ (DCIS), breast cancer mortality, all-cause mortality, and osteoporotic fractures? Key Question 2. What is the evidence for harms of tamoxifen citrate, raloxifene, and tibolone when used to reduce risk for primary breast cancer? Key Question 3. How do outcomes for tamoxifen citrate, raloxifene, and tibolone when used for primary prevention of breast cancer vary by heterogeneity in subpopulations? Key Question 4. What is the evidence that harms or secondary potential benefits listed above affect treatment choice, concordance, adherence, and persistence to treatment with tamoxifen citrate, raloxifene, and tibolone when used for primary prevention of breast cancer? Key Question 5. What methods, such as clinical risk-assessment models, have been used to identify women who could benefit from medications to reduce risk of breast cancer?

Download or read book Future Research Needs to Reduce the Risk of Primary Breast Cancer in Women written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-05-17 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast cancer is the second most commonly diagnosed cancer in women in the United States, with over 200,000 new cases of invasive breast cancer expected in women in 2010. It is the second most common cause of cancer-related death in women, killing over 40,000 women each year. Tamoxifen was approved by the U.S. Food and Drug Administration (FDA) in 1999 as a preventive strategy for women at high risk of developing breast cancer. Data from the 2000 National Health Interview Survey estimated that 10 million U.S. women ages 35 to 79 years of age were candidates for tamoxifen preventive therapy and for 2.4 million of these women, the benefits would outweigh the harms. However, despite its approval for more than a decade, less than one percent of women use tamoxifen as a preventive therapy. In 2007, the FDA approved the use of raloxifene hydrochloride for reduction in the risk of invasive breast cancer in postmenopausal women with osteoporosis and/or at high risk for invasive breast cancer. In 2008, the Agency for Healthcare Research and Quality (AHRQ) commissioned the Oregon Evidence-based Practice Center (Oregon EPC) to conduct a comparative effectiveness review (CER) on the effectiveness of medications to reduce the risk of primary breast cancer in women. Briefly, the five key questions addressed by the review were: (1) In adult women without preexisting breast cancer, what is the comparative effectiveness of selective estrogen receptor modulators (SERMs) tamoxifen and raloxifene, and the selective tissue estrogenic activity regulator (STEAR) tibolone, when used to reduce risk for primary breast cancer on improving short-term and long-term outcomes? (2) What is the evidence for harms? (3) How do outcomes vary by heterogeneity in subpopulations? (4) What is the evidence that harms or secondary potential benefits affect treatment choice, concordance, adherence, and persistence to treatment? (5) What methods, such as clinical risk-assessment models, have been used to identify women who could benefit from medications to reduce risk of breast cancer?

Download or read book Systematic Reviews to Answer Health Care Questions written by Heidi D. Nelson and published by Lippincott Williams & Wilkins. This book was released on 2024-02-21 with total page 313 pages. Available in PDF, EPUB and Kindle. Book excerpt: Accessible, practical, and student-friendly, Systematic Reviews to Answer Health Care Questions, Second Edition, by Dr. Heidi D. Nelson, uses easy-to-understand, step-by-step instruction and real-world examples to illustrate important concepts and principles of today’s systematic reviews. You’ll learn how to form key questions, select evidence, and perform comprehensive reviews not just in predictable circumstances, but when basic rules don’t apply—honing your ability to think critically and solve problems. Perfect for investigators, medical students and faculty, practitioners, policymakers, and others who need to refine their understanding of or approach to systematic reviews, this powerful text goes beyond merely teaching how to catalog and collect, helping readers learn to evaluate, synthesize, and deliver results that will help shape the practice of health care.

Download or read book The Breast written by K. I. Bland and published by Saunders. This book was released on 2009 with total page 822 pages. Available in PDF, EPUB and Kindle. Book excerpt: Offering the most comprehensive, up-to-date information on the diagnosis and management of, and rehabilitation following, surgery for benign and malignant diseases of the breast, this surgical reference is now in a new edition available in both print and online for easy, convenient access to the absolute latest advances.

Download or read book Primary Care Medicine written by Allan Goroll and published by Lippincott Williams & Wilkins. This book was released on 2020-09-02 with total page 7089 pages. Available in PDF, EPUB and Kindle. Book excerpt: Long regarded as “the book” in the field for in-depth learning as well as decision support at the point of care, Primary Care Medicine, 8th Edition, continues its tradition as a comprehensive, evidence-based, action-oriented information resource. Presented in companion electronic format updated quarterly, its problem-based orientation spans the full spectrum of problems encountered in adult primary care practice. Chapters address screening, diagnosis, prevention and management, including indications for referral and approaches to patient education and shared decision making. Clear, practical, bulleted recommendations and an extensive annotated bibliography of best references follow detailed discussions of pathophysiology, clinical presentation, differential diagnosis, and strategies for workup and treatment. Now with its 40th-anniversary edition, this exceptional text is a must-have resource for physicians, nurse practitioners, physician assistants, students, and residents- offering the most complete and up-to-date resource available for primary care education and practice.

Download or read book Cancer and Aging Handbook written by Keith M. Bellizzi and published by John Wiley & Sons. This book was released on 2012-07-20 with total page 499 pages. Available in PDF, EPUB and Kindle. Book excerpt: A state-of-the-art, multidisciplinary approach to cancer and aging With the majority of cancers occurring in individuals over the age of 65 against a backdrop of an expanding aging population, there is an urgent need to integrate the areas of clinical oncology and geriatric care. This timely work tackles these issues head-on, presenting a truly multidisciplinary and international perspective on cancer and aging from world-renowned experts in geriatrics, oncology, behavioral science, psychology, gerontology, and public health. Unlike other books on geriatric oncology that focus mainly on treatment, Cancer and Aging Handbook: Research and Practice examines all phases of the cancer care continuum, from prevention through evidence-based diagnosis and treatment to end-of-life care. Detailed clinical and research information helps guide readers on effective patient care as well as caregiver training, research, and intervention. Coverage includes: Epidemiology of cancer in older adults, plus the unique physical, mental, and social issues involved Strategies and guidelines for prevention, screening, and treatment of older individuals with cancer The most common cancers in the elderly, including breast, colorectal, lung, prostate, and ovarian cancer Cancer survivorship in older adults as well as the all-critical issues of palliative care and pain management Emerging topics such as caregiver and family issues, different models of care, and cost considerations An essential resource for clinicians and caregivers as well as researchers interested in this evolving field, Cancer and Aging Handbook is also useful for public health professionals and policymakers who need to formulate services and allocate resources for the growing population of older cancer patients.

Download or read book Primary Care Medicine written by Allan H. Goroll and published by Lippincott Williams & Wilkins. This book was released on 2014-05-29 with total page 5495 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinicians and students at all levels and in all primary care disciplines will benefit from the clear, practical, evidence-based writing and recommendations that address the full spectrum of clinical problems encountered in the adult primary care practice. Whether it’s the answer to a screening, prevention, evaluation, or management question or a comprehensive approach to a complex condition, the reader will find a review of best evidence integrated with considerations of affordability, cost-effectiveness, convenience and patient preference. Chapters present actionable, scientifically validated guidance that allows physicians to go beyond standard consensus guidelines and provide highly personalized care. Special consideration is given to team-based approaches of primary care delivery, recognizing its increasing importance to achieving high levels of practice performance. Primary Care Medicine’s digital format and quarterly updates ensure current, point-of-care decision support. New, online resources include a recommended curriculum for trainees and faculty, emphasizing a core knowledge base needed for all members of the primary care team, and access to state-of-the-art, condition-specific decision grids to facilitate patient participation in shared decision-making.

Download or read book Oncology in Primary Care written by Michal Rose and published by Lippincott Williams & Wilkins. This book was released on 2013-04-01 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: Oncology in Primary Care is for primary care clinicians who need practical and concise information on caring for their patients with cancer. Written in an easy-to-browse format, chapters cover risk factors, prevention, screening, prognosis, and surveillance strategies—valuable information that helps primary care clinicians advise their patients regarding therapeutic and end-of-life decisions and become true partners in the care of their patients with cancer. Each chapter also includes an abundance of figures and tables to help clinicians find quick answers to questions commonly encountered in the primary care setting. Plus, a companion website is available allowing easy accessibility to the content.

Download or read book The Menopause Maze written by Dr Megan A. Arroll and published by Singing Dragon. This book was released on 2016-05-19 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Hot flushes, night sweats, insomnia... How on earth do I cope with symptoms of the menopause?" There is no single answer to this question. Based on up-to-date research, this book provides an honest account of the pros and cons of the different options for managing the menopause so that you can make an informed decision about the best approach for your particular situation. It covers hormone replacement therapy (HRT), bioidentical HRT, medication, lifestyle, nutrition, and complementary therapies, from acupuncture and reflexology to tai chi and yoga. This is everything you need to know about the issues you may face during the perimenopause and menopause, how to support your body as the changes start, and the conventional, alternative and self-help therapies that can ease your symptoms.

Download or read book Targeted Therapies in Breast Cancer written by Gw Sledge and published by Clinical Pub. This book was released on 2012-06 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This new volume updates the reader on selected areas of targeted therapy in breast cancer, with special emphasis on chemoprevention strategies, drug resistance, biomarkers, combination chemotherapy, angiogenesis inhibition and pharmacogenomics in the context of clinical efficacy. This selected review of targeted therapies will guide the reader on effective treatment as part of an integrated programme of patient management.

Download or read book Developing a Protocol for Observational Comparative Effectiveness Research A User s Guide written by Agency for Health Care Research and Quality (U.S.) and published by Government Printing Office. This book was released on 2013-02-21 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)

Download or read book Clinical Preventive Services for Women written by Institute of Medicine and published by National Academies Press. This book was released on 2011-10-27 with total page 249 pages. Available in PDF, EPUB and Kindle. Book excerpt: Women suffer disproportionate rates of chronic disease and disability from some conditions, and often have high out-of-pocket health care costs. The passage of the Patient Protection and Affordable Care Act of 2010 (ACA) provides the United States with an opportunity to reduce existing health disparities by providing an unprecedented level of population health care coverage. The expansion of coverage to millions of uninsured Americans and the new standards for coverage of preventive services that are included in the ACA can potentially improve the health and well-being of individuals across the United States. Women in particular stand to benefit from these additional preventive health services. Clinical Preventive Services for Women reviews the preventive services that are important to women's health and well-being. It recommends that eight preventive health services for women be added to the services that health plans will cover at no cost. The recommendations are based on a review of existing guidelines and an assessment of the evidence on the effectiveness of different preventive services. The services include improved screening for cervical cancer, sexually transmitted infections, and gestational diabetes; a fuller range of contraceptive education, counseling, methods, and services; services for pregnant women; at least one well-woman preventive care visit annually; and screening and counseling for interpersonal and domestic violence, among others. Clinical Preventive Services for Women identifies critical gaps in preventive services for women as well as measures that will further ensure optimal health and well-being. It can serve as a comprehensive guide for federal government agencies, including the Department of Health and Human Services and the Center for Disease Control and Prevention; state and local government agencies; policy makers; health care professionals; caregivers, and researchers.

Download or read book Breast Diseases written by Guilherme Novita and published by Springer Nature. This book was released on 2019-10-08 with total page 604 pages. Available in PDF, EPUB and Kindle. Book excerpt: Designed in a small-format for practical reading and point-of-care setting use, this work presents the most up-to-date concepts on breast diseases. The main objective of this book is to propagate current knowledge of the most frequent breast diseases, being a quick reference, evidence-based manual covering the major clinical scenarios in mastology. The essence of the work can be summarized in the following sentence: "access to maximum content in the least amount of time.” The book contains data that will allow readers to understand and treat patients with different complaints and diseases. Each chapter presents a flow chart and a summary of the five major publications on the subject. This is unique in comparison with other books in this medical specialty. Developed by a team of international expert specialists who deal with breast pathologies on a daily basis, the book also includes additional contributions from experienced, renowned professionals in interdisciplinary specialties related to the main area. This book will be of interest to physicians who deal with breast diseases and wish to improve their knowledge through exposure to state-of-the-art data and best practices advice. It is also directed to medical students and residents in training within mastology. (This title was originally published in Portuguese by the Brazilian publisher Atheneu in 2011 and has sold very well and gone into a third edition, published in 2017. The Editors have all English language rights, detailed in the attached contract, although it is in Portuguese).

Download or read book Diseases of the Breast written by Jay R. Harris and published by Lippincott Williams & Wilkins. This book was released on 2014-05-14 with total page 3116 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stay on top of the latest knowledge in the field with this must-have resource for all clinicians who treat breast diseases. Expand your knowledge of every aspect of breast diseases as a diverse and distinguished group of internationally-recognized experts summarize the current knowledge, including biology and epidemiology, clinical features, and management. Ideal for any clinician seeing patients with breast disease, especially carcinoma of the breast, This full color 5th Edition of the authoritative text in the field is designed to foster the understanding necessary to provide optimal patient care.. Features Covering the latest major clinical trials, along with concise management summaries for each clinical chapter. Illustrations and tables that emphasize breast imaging, microscopic and gross histology, anatomy, and procedural technique enhance visual understanding. Algorithms on problem management in all aspects of breast disease from benign processes to breast carcinoma inform clinical practice. eBook with content updates is included with purchase New chapters have been added on pathology of in situ carcinomas, prophylactic contralateral mastectomy, implications of obesity in breast cancer, and an overview of survivorship issues To keep perspectives fresh and updated, over one third of the authors are new to this edition

Download or read book Williams Textbook of Endocrinology E Book written by Shlomo Melmed and published by Elsevier Health Sciences. This book was released on 2011-05-12 with total page 1920 pages. Available in PDF, EPUB and Kindle. Book excerpt: The latest edition of Williams Textbook of Endocrinology edited by Drs. Shlomo Melmed, Kenneth S. Polonsky, P. Reed Larsen, and Henry M. Kronenberg, helps you diagnose and treat your patients effectively with up-to-the minute, practical know-how on all endocrine system disorders. Comprehensive yet accessible, this extensively revised 12th Edition updates you on diabetes, metabolic syndrome, obesity, thyroid disease, testicular disorders, and much more so you can provide your patients with the most successful treatments. Find scientific insight and clinical data interwoven in every chapter, reflecting advances in both areas of this constantly changing discipline, and presented in a truly accessible format. You’ll also access valuable contributions from a dynamic list of expert authors and nearly 2.000 full-color images to help you with every diagnosis. This title has everything you need to manage any and all the clinical endocrinopathies you may encounter. Rely on the one reference that integrates rapidly evolving basic and clinical science in a cohesive, user-friendly format, definitively addresses every topic in the field, and has remained a standard for more than half a century. Update your know-how and skills to diagnose and treat your patients most effectively with exhaustively revised content on diabetes, metabolic disease, thyroid cancer, fertility problems, testicular problems, weight issues, and much more. Apply reliable guidance on endocrine conditions of growing interest like hypothyroidism and testicular disorders, with dedicated new chapters that expound on the latest research findings. Overcome any clinical challenge with comprehensive and easy-to-use coverage of everything from hormone activity, diagnostic techniques, imaging modalities, and molecular genetics, to total care of the patient. Apply the latest practices with guidance from expert authors who contribute fresh perspectives on every topic.

Download or read book Breast Cancer and the Environment written by Institute of Medicine and published by National Academies Press. This book was released on 2012-04-20 with total page 468 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast cancer remains the most common invasive cancer among women. The primary patients of breast cancer are adult women who are approaching or have reached menopause; 90 percent of new cases in U.S. women in 2009 were diagnosed at age 45 or older. Growing knowledge of the complexity of breast cancer stimulated a transition in breast cancer research toward elucidating how external factors may influence the etiology of breast cancer. Breast Cancer and the Environment reviews the current evidence on a selection of environmental risk factors for breast cancer, considers gene-environment interactions in breast cancer, and explores evidence-based actions that might reduce the risk of breast cancer. The book also recommends further integrative research into the elements of the biology of breast development and carcinogenesis, including the influence of exposure to a variety of environmental factors during potential windows of susceptibility during the full life course, potential interventions to reduce risk, and better tools for assessing the carcinogenicity of environmental factors. For a limited set of risk factors, evidence suggests that action can be taken in ways that may reduce risk for breast cancer for many women: avoiding unnecessary medical radiation throughout life, avoiding the use of some forms of postmenopausal hormone therapy, avoiding smoking, limiting alcohol consumption, increasing physical activity, and minimizing weight gain. Breast Cancer and the Environment sets a direction and a focus for future research efforts. The book will be of special interest to medical researchers, patient advocacy groups, and public health professionals.