Download or read book Future Research Needs to Reduce the Risk of Primary Breast Cancer in Women written by and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The 2009 comparative effectiveness review (CER) on the effectiveness of medications to reduce the risk of primary breast cancer in women without preexisting cancer demonstrated the efficacy of two SERMs, tamoxifen citrate (RR, 0.70; 95% CI, 0.59 to 0.82; 4 trials) and raloxifene (RR, 0.44; CI, 0.27 to 0.71; 2 trials). However, the CER also outlined many adverse effects and unknowns about the medications. The objective of this pilot project was to engage stakeholders to develop and prioritize a list of research questions to address the research gaps related to the CER. First, the goal was to provide sufficient detail--including population, intervention, comparator, and outcome (PICO)--for researchers and funders to use in the development of research proposals and solicitations, respectively. Second, this project was intended to identify a feasible and effective approach to identify and prioritize future research from systematic reviews in general.

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 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.

Download or read book Diseases of the Breast written by Jay R. Harris and published by Lippincott Williams & Wilkins. This book was released on 2012-03-28 with total page 3432 pages. Available in PDF, EPUB and Kindle. Book excerpt: Completely revised and updated, and now in full color throughout, the Fourth Edition of this definitive reference is a must for all clinicians who treat breast diseases. Leading experts summarize the current knowledge of breast diseases, including their clinical features, management, underlying biologies, and epidemiologies. In addition to complete coverage of malignant breast diseases, benign diseases are discussed in relation to subsequent breast cancer development. The book reviews all major clinical trials and summarizes the information they provide on early detection and management of breast cancer. Close attention is also given to the increasing importance of molecular biology and genetics in this field. This edition features more than thirty new contributors, fourteen new or completely rewritten chapters, and more clinically oriented chapters. A companion Website will offer the fully searchable text and an image bank. Also included with this edition is the Anatomical Chart Company's Breast Anatomy and Disorders Pocket Guide. This durable, portable folding pocket guide provides a visual and textual overview of breast anatomy, disorders, and breast self-examination. With a write-on, wipe-off laminated surface, this guide is perfect for the on-the-go practitioner to show patients, caregivers, and families.

Download or read book Meeting Psychosocial Needs of Women with Breast Cancer written by National Research Council and published by National Academies Press. This book was released on 2004-04-12 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: In Meeting Psychosocial Needs of Women with Breast Cancer, the National Cancer Policy Board of the Institute of Medicine examines the psychosocial consequences of the cancer experience. The book focuses specifically on breast cancer in women because this group has the largest survivor population (over 2 million) and this disease is the most extensively studied cancer from the standpoint of psychosocial effects. The book characterizes the psychosocial consequences of a diagnosis of breast cancer, describes psychosocial services and how they are delivered, and evaluates their effectiveness. It assesses the status of professional education and training and applied clinical and health services research and proposes policies to improve the quality of care and quality of life for women with breast cancer and their families. Because cancer of the breast is likely a good model for cancer at other sites, recommendations for this cancer should be applicable to the psychosocial care provided generally to individuals with cancer. For breast cancer, and indeed probably for any cancer, the report finds that psychosocial services can provide significant benefits in quality of life and success in coping with serious and life-threatening disease for patients and their families.

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 A Review of the Department of Defense s Program for Breast Cancer Research written by Institute of Medicine and published by National Academies Press. This book was released on 1997-08-31 with total page 151 pages. Available in PDF, EPUB and Kindle. Book excerpt: According to current statistical data, one in eight women will be diagnosed with breast cancer. The five-year survival rate for breast cancer patients has improved in recent years, but the overall mortality rates have changed little. In 1993 Congress allocated $210 million for breast cancer research as part of the Department of Defense budget. An Institute of Medicine (IOM) committee was convened at that time to advise the U.S. Army Medical Research and Development Command on strategies for managing a breast cancer research program. This book evaluates the program's management and achievements to date. Although it is too early to evaluate the program in terms of breakthrough results and new insights produced by the funded projects or investigators, this book documents the process used to select research proposals for funding and analyzes the portfolio of funded projects in terms of their responsiveness to the recommendations and fundamental questions articulated in the 1993 IOM report.

Download or read book Reducing Environmental Cancer Risk written by Suzanne H. Reuben and published by DIANE Publishing. This book was released on 2010-10 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Though overall cancer incidence and mortality have continued to decline in recent years, cancer continues to devastate the lives of far too many Americans. In 2009 alone, 1.5 million American men, women, and children were diagnosed with cancer, and 562,000 died from the disease. There is a growing body of evidence linking environmental exposures to cancer. The Pres. Cancer Panel dedicated its 2008¿2009 activities to examining the impact of environmental factors on cancer risk. The Panel considered industrial, occupational, and agricultural exposures as well as exposures related to medical practice, military activities, modern lifestyles, and natural sources. This report presents the Panel¿s recommend. to mitigate or eliminate these barriers. Illus.

Download or read book Advances in Breast Cancer Management 2nd edition written by William J. Gradishar and published by Springer Science & Business Media. This book was released on 2000-08-31 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt: The optimal management of breast cancer patients relies on the expertise of a team of medical specialists including radiologists, surgeons, radiation therapists and medical oncologists. Much of the progress in breast cancer management made over the last several years reflects the translation of observations made in the laboratory to the clinic. Critically evaluating the impact of new treatment approaches relies on a commitment to well-designed clinical trials. In this volume, Advances in Breast Cancer Management, a renowned group of breast cancer experts have been asked to provide their perspective on management issues that directly effect patients on a day-to-day basis. Dr. Melody Cobleigh discusses the consequences of estrogen deprivation and the ways of ameliorating secondary symptoms and the potential long-term morbidity. Drs. Haigh and Guiliano review the sentinel lymph node biopsy technique including results from their extensive experience. Dr. Abram Recht places into perspective the potential benefit of post-mastectomy radiotherapy and reviews recent trials that address this issue. Dr. Dennis Slamon takes from us from the laboratory to the clinic in explaining the development of Herceptin as a paradigm for therapy targeted to specific molecular characteristics of breast cancer tumor cells. Drs. Nieto, Shpall, Crump and Pritchard offer different perspectives on the future of high-dose chemotherapy with stem cell transplantation as a treatment for breast cancer patients. Drs.

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 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book HER2 Positive Breast Cancer written by Sara Hurvitz and published by Elsevier Health Sciences. This book was released on 2018-07-26 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: Get a quick, expert overview of clinically-focused topics and guidelines that are relevant to testing for HER2, which contributes to approximately 25% of breast cancers today. This concise resource by Drs. Sara Hurvitz, and Kelly McCann consolidates today’s available information on this growing topic into one convenient resource, making it an ideal, easy-to-digest reference for practicing and trainee oncologists.

Download or read book Medication Use for the Risk Reduction of Primary Breast Cancer in Women written by Heidi D. Nelson and published by . This book was released on 2019 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Medications to reduce breast cancer risk are an effective prevention intervention for women at increased risk, although medications also cause adverse effects. PURPOSE: To update the 2013 U.S. Preventive Services Task Force (USPSTF) systematic review on the use of medications to reduce the risk of primary breast cancer. DATA SOURCES: Searches included the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, EMBASE, and MEDLINE (January 1, 2013 to February 1, 2019); and manual review of reference lists. Studies published before 2013 were identified from prior systematic reviews for the USPSTF. STUDY SELECTION: Discriminatory accuracy studies of breast cancer risk assessment methods; double-blind, placebo-controlled or head-to-head randomized controlled trials (RCT) of tamoxifen, raloxifene, and aromatase inhibitors for primary prevention of breast cancer that enrolled women without preexisting breast cancer; and RCTs and observational studies of harms of medications. DATA EXTRACTION: One investigator abstracted data on study methods; setting; population characteristics; eligibility criteria; interventions; numbers enrolled and lost to followup; method of outcome ascertainment; and results for each outcome and a second investigator checked abstractions for accuracy. Two investigators independently assessed study quality using methods developed by the USPSTF. DATA SYNTHESIS (RESULTS): Eighteen risk models evaluated in 25 studies had generally low discriminatory accuracy in predicting the probability of breast cancer in an individual (c-statistics 0.55 to 0.65). Most models performed only slightly better than age alone as a risk predictor. No studies evaluated optimal ages or frequencies of risk assessment. In placebo-controlled trials, tamoxifen (risk ratio [RR] 0.69; 95% confidence interval [CI], 0.59 to 0.84; 7 fewer cases per 1000 women over 5 years of use [95% CI, 4 to 12]; 4 trials), raloxifene (RR 0.44; 95% CI, 0.24 to 0.80; 9 fewer cases [95% CI, 3 to 15]; 2 trials), and the aromatase inhibitors exemestane and anastrozole (RR 0.45; 95% CI, 0.26 to 0.70; 16 fewer cases [95% CI, 8 to 24]; 2 trials) reduced invasive breast cancer. Risk for invasive breast cancer was higher for raloxifene than tamoxifen in the Study of Tamoxifen And Raloxifene (STAR) head-to-head trial (RR, 1.24; 95% CI, 1.05 to 1.47) after long-term followup. Effects did not differ by age of initiation or duration of use (3 to 5 years), although these effects were not directly compared. Risk reduction persisted at least 8 years after discontinuation in tamoxifen trials with long-term followup. All medications reduced estrogen receptor positive, but not estrogen receptor negative invasive breast cancer; tamoxifen reduced noninvasive cancer in two trials; and breast-cancer specific and all-cause mortality were not reduced. In placebo-controlled trials, raloxifene (RR 0.61; 95% CI, 0.53 to 0.73; 2 trials) reduced vertebral fractures; tamoxifen reduced nonvertebral fractures in the National Surgical Adjuvant Breast and Bowel Project (NSABP P-1) trial (RR 0.66; 95% CI, 0.45 to 0.98); while the aromatase inhibitors had no effect on fractures. Tamoxifen and raloxifene had similar effects on reducing fractures at multiple vertebral and nonvertebral sites in the STAR head-to-head trial. In placebo-controlled trials, tamoxifen (RR 1.93; 95% CI, 1.33 to 2.68; 4 trials) and raloxifene (RR 1.56; 95% CI, 1.11 to 2.60; 2 trials) increased thromboembolic events, while aromatase inhibitors did not. Raloxifene caused fewer thromboembolic events (RR 0.75; 95% CI, 0.60 to 0.93) than tamoxifen in the STAR head-to-head trial. Tamoxifen, raloxifene, and aromatase inhibitors did not increase coronary heart disease events or strokes. In placebo-controlled trials, tamoxifen increased endometrial cancer (RR 2.25; 95% CI, 1.17 to 4.41; 3 trials), while raloxifene and aromatase inhibitors did not. In the STAR head-to-head trial, raloxifene caused fewer cases of endometrial cancer (RR 0.55; 95% CI, 0.36 to 0.83) and endometrial hyperplasia (RR 0.19; 95% CI, 0.12 to 0.29), and fewer hysterectomies (RR 0.45; 95% CI, 0.37 to 0.54) than tamoxifen. Tamoxifen increased cataracts (RR 1.22; 95% CI, 1.08 to 1.48; 3 trials) and cataract surgery compared with placebo, while raloxifene and aromatase inhibitors did not. Risks for thromboembolic events and endometrial cancer with tamoxifen were higher for older compared with younger women and returned to normal after discontinuation. All medications caused adverse effects, such as vasomotor or musculoskeletal symptoms, that varied by medication. Risks for invasive cancer were generally reduced in all population subgroups evaluated based on menopausal status (pre and postmenopausal); family history of breast cancer; body mass index categories; modified Gail model risk categories; and age at menarche, parity, or age at first live birth, although results varied. Tamoxifen and anastrozole had larger effects in reducing invasive breast cancer in women with previous breast lesions (lobular carcinoma in situ, atypical ductal hyperplasia, or atypical lobular hyperplasia). LIMITATIONS: Trials were limited by clinical heterogeneity related to different medications, exposure durations, eligibility criteria, adherence, and ascertainment of outcomes. No trials compared timing and duration directly. Long-term followup data were lacking from most trials, and followup was particularly short for the aromatase inhibitors. Trials were not designed for subgroup comparisons and analysis of differences may be underpowered. CONCLUSIONS: Tamoxifen, raloxifene, and the aromatase inhibitors exemestane and anastrozole reduce invasive breast cancer in women without preexisting breast cancer, but also cause adverse effects that vary by medication. Tamoxifen and raloxifene increase thromboembolic events and tamoxifen increases endometrial cancer and cataracts. Identifying candidates for therapy is complicated by risk stratification methods that demonstrate low accuracy.

Download or read book Women s Health Research written by Institute of Medicine and published by National Academies Press. This book was released on 2010-10-27 with total page 439 pages. Available in PDF, EPUB and Kindle. Book excerpt: Even though slightly over half of the U.S. population is female, medical research historically has neglected the health needs of women. However, over the past two decades, there have been major changes in government support of women's health research-in policies, regulations, and the organization of research efforts. To assess the impact of these changes, Congress directed the Department of Health and Human Services (HHS) to ask the IOM to examine what has been learned from that research and how well it has been put into practice as well as communicated to both providers and women. Women's Health Research finds that women's health research has contributed to significant progress over the past 20 years in lessening the burden of disease and reducing deaths from some conditions, while other conditions have seen only moderate change or even little or no change. Gaps remain, both in research areas and in the application of results to benefit women in general and across multiple population groups. Given the many and significant roles women play in our society, maintaining support for women's health research and enhancing its impact are not only in the interest of women, they are in the interest of us all.

Download or read book Comparative Effectiveness of Medications to Reduce Risk of Primary Breast Cancer in Women written by H. D. Nelson and published by . This book was released on 2009 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Adjuvant Therapy for Breast Cancer written by Monica Castiglione and published by Springer Science & Business Media. This book was released on 2009-07-11 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Adjuvant treatment is administered prior to or as follow up to surgical procedures for breast cancer. Proven success in using medical therapies allowing for breast conserving procedures or reducing risk of occurrence. Although there has been much progress towards a cure, including the introduction of new targeted therapies, metastasizing cancer remains highly incurable.

Download or read book Breast Cancer in Young Women written by Oreste Gentilini and published by Springer Nature. This book was released on 2020-02-07 with total page 218 pages. Available in PDF, EPUB and Kindle. Book excerpt: This contributed book covers all aspects concerning the clinical scenario of breast cancer in young women, providing physicians with the latest information on the topic. Young women are a special subset of patients whose care requires dedicated expertise. The book, written and edited by internationally recognized experts who have been directly involved in the international consensus guidelines for breast cancer in young women, pays particular attention to how the disease and its planned treatment can be effectively communicated to young patients. Highly informative and carefully structured, it provides both theoretical and practice-oriented insight for practitioners and professionals involved in the different phases of treatment, from diagnosis to intervention, to follow-up – without neglecting the important role played by prevention.

Download or read book Breast Cancer written by Umberto Veronesi and published by Springer. This book was released on 2017-11-03 with total page 928 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides the reader with up-to-date information on important advances in the understanding of breast cancer and innovative approaches to its management. Current and emerging perspectives on genetics, biology, and prevention are first discussed in depth, and individual sections are then devoted to pathology, imaging, oncological surgery, plastic and reconstructive surgery, medical oncology, and radiotherapy. In each case the focus is on the most recent progress and/or state of the art therapies and techniques. Further topics to receive detailed consideration include particular conditions requiring multidisciplinary approaches, the investigation of new drugs and immunological agents, lifestyle and psychological aspects, and biostatistics and informatics. The book will be an excellent reference for practitioners, interns and residents in medical oncology, oncologic surgery, radiotherapy, pathology, and human genetics, researchers, and advanced medical students.