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Abramson Cancer CenterNCI CANCERLIT® Search: Screening and Prevention of Breast Cancer - October 2002
National Cancer Institute®
Last Modified: October 1, 2002
- Mammographic parenchymal patterns and risk of breast cancer at and after a prevalence screen in Singaporean women.
- Fat intake and breast cancer risk in an area where fat intake is low: a case-control study in Indonesia.
- Comparison of dietary assessment methods in a low-fat dietary intervention program.
- Mammographic screening: no reliable supporting evidence?
- Mammographic screening: no reliable supporting evidence?
- Mammographic screening: no reliable supporting evidence?
- Cancer screening for the primary care physician.
- [Hormonal contraception using estroprogestins]
- Long-term health risks and benefits of oral contraceptive use.
- [Can breast cancer be prevented?]
- Can we prevent breast cancer?
- Worldwide variations in the lifetime probability of reproductive cancer in women: implications of best-case, worst-case, and likely-case
- The prevention of breast cancer through reduced ovarian steroid exposure.
- Breast cancer screening for women younger than 40.
- Pilot trial of a gonadotropin hormone agonist with replacement hormones as a prototype contraceptive to prevent breast cancer.
- Breast cancer control programme in developing countries.
- Breast cancer in sub-Saharan African women.
- Hormone therapy: three perspectives. Fibrocystic breast disease: contraindication for oral contraceptive therapy.
- UICC Multidisciplinary Project on Breast Cancer: the epidemiology, aetiology and prevention of breast cancer.
- Hormonal contraception and cancer.
- Evaluating well-woman clinics.
- [Psychometry in gynecological research (author's transl)]
- Hysterectomy, tubal sterilization, and the risk of breast cancer.
- Changes in mammographic densities induced by a hormonal contraceptive designed to reduce breast cancer risk.
- Breast cancer risk: protective effect of an early first full-term pregnancy versus increased risk of induced abortion.
- A rational approach to prenatal screening and intervention.
- An effective manual on breast self-examination.
- Role of surgery in the prophylaxis of hereditary cancer syndromes.
- Women's decisions regarding management of breast cancer risk.
- Chemoprevention of breast cancer: a promising idea with an uncertain future.
- First results from the International Breast Cancer Intervention Study (IBIS-I): a randomised prevention trial.
- Receipt of clinical preventive medical services among psychiatric patients.
- Whither chemoprevention?
- A possible tumor suppressor role of the KLF5 transcription factor in human breast cancer.
- [Breast self-examination--a comparison of routine teaching and a more comprehensive patient education program]
- Breast cancer risk-factor and screening awareness among women nurses and teachers in Amman, Jordan.
- Suppression of unspecific enhancement on breast magnetic resonance imaging (MRI) by antiestrogen medication.
- [Review of risk factors for breast cancer--what's new?]
- [Specific estrogen receptor modulators (SERMs)]
- Cancer prevention: from concept to practice.
- BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and prevalence of other breast cancer susceptibility genes.
- Nutrition and survival after the diagnosis of breast cancer: a review of the evidence.
- Mammography and hereditary breast cancer.
- Twenty-year follow-up of the breast cancers diagnosed during the Breast Cancer Detection Demonstration Project.
- The meaning of "adjusted" and "observed" survival rates.
- Reducing deaths from breast cancer in Canada. The Workshop Group.
- Canadian National Breast Screening Study: public health implications.
- Breast screening.
- Recruiting women for breast screening. Family Physician Model strategy.
- Women at high risk for breast cancer: preventive strategies.
- NBSS: opportunity to compromise the process.
- Fighting the battle against breast cancer. So close and yet so far.
- Breast cancer treatment and chemoprevention.
- Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer. Seventh International Conference on Adjuvant
- [1st revision of the National Consensus on Breast Cancer Treatment]
- Race, ethnicity, and disparities in breast cancer: victories and challenges.
- Health beliefs and self breast examination in black women.
- Web site development: applying aesthetics to promote breast health education and awareness.
- Program evaluation in health care. Health Services Research Group.
- What influences family physicians' cancer screening decisions when practice guidelines are unclear or conflicting?
- The Canadian National Breast Screening Study: opportunity for a rethink.
- The Canadian National Breast Screening Study: a clinician's perspective.
- Canadian National Breast Screening Study: 1. Breast cancer detection and death rates among women aged 40 to 49 years.
- Canadian National Breast Screening Study: 2. Breast cancer detection and death rates among women aged 50 to 59 years.
- Vitamins for chronic disease prevention in adults: scientific review.
- [Economic aspects of specialized preventive screening for breast cancer]
- Women and breast cancer: is it really possible for the public to be well informed?
- Public education about breast cancer.
- Public education about breast cancer.
- Can tamoxifen prevent breast cancer?
- When considering attacks against the National Breast Screening Study, consider the sources.
- Tamoxifen and cancer of the endometrium.
- Preventive practice among primary care physicians in British Columbia: relation to recommendations of the Canadian Task Force on the Periodic
- Recruitment of women into trials.
- Recruitment of women into trials.
- Routinely teaching breast self-examination is dead. What does this mean?
- Oophorectomy for breast cancer: history revisited.
- Randomized trial of breast self-examination in Shanghai: final results.
- Re: tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study.
- Age as a factor in breast cancer knowledge, attitudes and screening behaviour.
- Public education about breast cancer.
- Effect of service screening mammography on population mortality from breast carcinoma.
- The impact of organized mammography service screening on breast carcinoma mortality in seven Swedish counties.
- Addressing the support needs of women at high risk for breast cancer: evidence-based care by advanced practice nurses.
- The effect of an educational intervention on promoting breast self-examination in older African American and Caucasian women.
- Cancer screening among community health center women: eliminating the gaps.
- The truth in reviews.
- The evidence to support mammography screening.
- The risk of breast cancer associated with dietary lignans differs by CYP17 genotype in women.
- Phytoestrogen concentrations in serum from Japanese men and women over forty years of age.
- Early detection of breast cancer by self-examination: the influence of perceived barriers and health conception.
- The determinants of breast cancer screening behavior: a focus group study of women in the United Arab Emirates.
- Emphasizing screening activities in a community health center: a case study of a breast cancer screening project.
- Behavioral Risk Factor Surveillance, 1991: monitoring progress toward the nation's year 2000 health objectives.
- Conferences point to growing concern about possible links between breast cancer, environment.
- [Screening for cancer]
- Trends in self-reported use of mammograms (1989-1997) and Papanicolaou tests (1991-1997)--Behavioral Risk Factor Surveillance System.
- Canada Health Monitor results concerning screening mammography.
- Effect of breast-feeding on risk of breast cancer.
- Randomization in the Canadian National Breast Screening Study: a review for evidence of subversion.
- The review of randomization in the Canadian National Breast Screening Study. Is the debate over?
- The review of randomization in the Canadian National Breast Screening Study. What does the verdict mean for clinicians?
- Checking random assignment with claims data.
- NBSS: changes were made, suspicious changes were not.
Table of Contents
1
UI - 10750598
AU - Jakes RW; Duffy SW; Ng FC; Gao F; Ng EH
TI -
Mammographic parenchymal patterns and risk of breast cancer at and after
a prevalence screen in Singaporean women.
SO - Int J Epidemiol 2000 Feb;29(1):11-9
AD - NMRC Clinical Trials & Epidemiology Research Unit, Singapore.
BACKGROUND: The objective of this study was to assess the effect of
mammographic parenchymal patterns on risk of breast cancer detected at
first screen or in the period following a negative screen. METHODS: The
study utilizes a nested case-control design with 132 breast cancer
patients detected at first screen (from a total of 29 193 screened) and
42 breast cancer patients detected in the period following the first
screen. These patients were matched to 348 screened-negative controls.
The mammograms were classified according to Tabar's classification for
parenchymal pattern and statistical analysis was done by conditional
logistic regression. RESULTS: The risk of breast cancer for women with
Tabar pattern IV was significantly high when compared to the remaining
patterns (odds ratio 2.59). Risk factors for Tabar pattern IV coincided
largely with established risk factors for breast cancer. CONCLUSION: The
study confirms the increased risk of breast cancer associated with Tabar
pattern IV (approximately Wolfe pattern P2), in an Asian population.
This pattern is associated with nulliparity and high educational status
and is strongly associated with grade 3 cancers.
2
UI - 10750599
AU - Wakai K; Dillon DS; Ohno Y; Prihartono J; Budiningsih S; Ramli M; Darwis
TI -
I; Tjindarbumi D; Tjahjadi G; Soetrisno E; Roostini ES; Sakamoto G;
Herman S; Cornain S
Fat intake and breast cancer risk in an area where fat intake is low: a
case-control study in Indonesia.
SO - Int J Epidemiol 2000 Feb;29(1):20-8
AD - Department of Preventive Medicine, Nagoya University School of Medicine,
Japan.
BACKGROUND: Associations of fat and other macronutrients with breast
cancer risk are not clear in areas where fat intake is low. METHODS: We
conducted a hospital-based case-control study from 1992 to 1995 in
Jakarta, Indonesia. RESULTS: The study, based on 226 cases and 452 age
and socioeconomic status matched controls, provided the following
findings. (a) In the pre-marriage period, the greater the fat or protein
consumption, the larger the risk, whereas decreasing risk with
increasing carbohydrate intake was detected. The odds ratio (OR) for the
highest quartile of intake relative to the lowest was 8.47 (95% CI:
4.03-17.8) for fat, 2.19 (95% CI: 1.30-3.69) for protein, and 0.16 (95%
CI: 0.08-0.31) for carbohydrate. A positive association with fat and a
negative one with carbohydrate were also observed for the post-marriage
period, but of weaker magnitude compared to the pre-marriage period. (b)
The effects of macronutrient intakes were stronger among premenopausal
than among postmenopausal women. (c) Most of the associations of protein
and carbohydrate were insignificant after adjustment for fat intake.
CONCLUSIONS: These findings suggest that fat intake might be an
important determinant of breast cancer among populations with a low fat
diet in Indonesia.
3
UI - 11962245
AU - Simon MS; Lababidi S; Djuric Z; Uhley V; Depper J; Kresge C; Klurfeld
TI -
DM; Heilbrun LK
Comparison of dietary assessment methods in a low-fat dietary
intervention program.
SO - Nutr Cancer 2001;40(2):108-17
AD - Division of Hematology and Oncology, Karmanos Cancer Institute, Wayne
State University School of Medicine, Detroit, MI 48201, USA.
simonm@karmanos.org
The food frequency questionnaire (FFQ) is commonly utilized for
assessment of dietary fat intake, but its validity among individuals
following a low-fat diet is unclear. We evaluated the agreement of
nutrient estimates derived from FFQ, 24-h recall, and 3-day food records
obtained from 104 participants in a randomized trial of a low-fat
dietary intervention for women at elevated breast cancer risk.
Comparisons were made for total calories, percent calories from fat, and
total fat after 1 yr. Correlation was assessed using standard methods
based on a null hypothesis of no agreement between instruments as well
as by a methodology based on a null hypothesis that the instruments
should be in agreement. With the use of standard methods, FFQ estimates
for women on the low-fat diet were significantly correlated to records
only for percent calories from fat (r = 0.39), whereas recall and record
estimates were significantly correlated for all three dietary variables.
Using the new method, we found no significant correlation between FFQ
and either recalls or records for women following a low-fat diet but
significant correlation between recall and record estimates for total
calories (r = 0.67). Traditional correlation testing may overestimate
the extent of agreement in dietary instruments among women on a low-fat
diet. We found empirical support for the nontraditional method.
4
UI - 12241901
AU - du Bois A
TI -
Mammographic screening: no reliable supporting evidence?
SO - Lancet 2002 Aug 31;360(9334):719-20; discussion 720-1
5
UI - 12241902
AU - Bonneux L
TI -
Mammographic screening: no reliable supporting evidence?
SO - Lancet 2002 Aug 31;360(9334):720; discussion 720-1
6
UI - 12241903
AU - Werth J
TI -
Mammographic screening: no reliable supporting evidence?
SO - Lancet 2002 Aug 31;360(9334):720; discussion 720-1
7
UI - 12243426
AU - Ashkar K; Bulbul M; Sharara A; Hourani M; Hamadeh GN
TI -
Cancer screening for the primary care physician.
SO - J Med Liban 2001 Sep-Oct;49(5):298-302
AD - American University of Beirut-Medical Center, Department of Family
Medicine, Lebanon. k_ashkar@yahoo.com
Cancer screening guidelines are developed by numerous agencies. These
guidelines are often conflicting leaving the primary care physician in a
difficult position. He (she) is requested to choose the best test for
his or her patients taking into consideration the principles of
screening, the test cost and most importantly the patient's emotional
and physical well-being. Screening for some cancers, like lung cancer,
has been considered of no benefit. Other cancers, like breast, colon,
cervix and prostate, have been the subject of numerous recommendations:
For breast cancer, clinical examination and mammography are recommended
every 1-2 years for women between 50 to 70 years. For cervical cancer,
PAP smear is suggested every 1-3 years and for colorectal cancer, a
yearly fecal occult blood, sigmoidoscopy or colonoscopy every 5-10
years. Annual serum prostate specific antigen (PSA) and digital rectal
examination screening for prostate cancer are still controversial.
8
UI - 2187166
AU - Grio R; Piacentino R; Cellura A; Caccuri D; Zaccheo F; Baccarini G;
TI -
Marchino GL; Borgarino S; Fuda G
[Hormonal contraception using estroprogestins]
SO - Minerva Ginecol 1990 Mar;42(3):49-53
AD - Istituto di Ginecologia e Ostetricia Cattedra A, Universita degli Studi
di Torino.
Today the estroprogestagen pill is the most valid method of
contraception given that its benefits far outweigh its risks. The paper
stresses the importance of a thorough anamnestic, clinical and
laboratory examination so as to obtain correct and safe steroid
contraception. The efficacy and excellent tolerance of the combined
method currently make it the most widespread form of oral contraception.
9
UI - 2092241
AU - Peterson HB; Lee NC
TI -
Long-term health risks and benefits of oral contraceptive use.
SO - Obstet Gynecol Clin North Am 1990 Dec;17(4):775-88
AD - Division of Reproductive Health, Center for Chronic Disease Prevention
and Health Promotion, Centers for Disease Control, Atlanta, Georgia.
The contraceptive effect of oral contraceptive use provides an important
health benefit, particularly in developing countries, where the risks of
pregnancy and childbearing are increased. Several important
noncontraceptive health benefits of oral contraceptive use include the
prevention of endometrial and ovarian cancers. Data are generally
reassuring concerning the risks of oral contraceptive use, which include
cardiovascular disease and breast and cervical cancer.
10
UI - 2063386
AU - Vatten LJ
TI -
[Can breast cancer be prevented?]
SO - Tidsskr Nor Laegeforen 1991 May 30;111(14):1745-8
AD - Kreftavdelingen Regionsykehuset i Trondheim.
More than six-fold variation in incidence between countries, an
increasing incidence among immigrants to high incidence areas, and a
general increase in the incidence of breast cancer within countries, are
factors which suggest a potential for prevention. Reproductive factors
such as early menarche, late age at first full term birth, nulliparity,
and late age at menopause increase risk of breast cancer, but
manipulation of any one of these factors does not seem to be a realistic
preventive tool. Nevertheless, the future possibility of using tamoxifen
as a chemopreventive agent against breast cancer is discussed,
particularly in relation to women at increased risk due to familial
clustering. Alcohol consumption by young women, and overweight among
postmenopausal women may also increase the incidence of breast cancer.
Consequently, reduced alcohol intake by young women, and weight
reduction among overweight women after menopause may reduce the risk of
breast cancer.
11
UI - 1892745
AU - Baum M; Ziv Y; Colletta AA
TI -
Can we prevent breast cancer?
SO - Br J Cancer 1991 Aug;64(2):205-7
12
UI - 1559340
AU - Petitti DB; Porterfield D
TI -
Worldwide variations in the lifetime probability of reproductive cancer
in women: implications of best-case, worst-case, and likely-case
assumptions about the effect of oral contraceptive use.
SO - Contraception 1992 Feb;45(2):93-104
AD - Department of Family and Community Medicine, University of California,
San Francisco School of Medicine 94143.
Cancer incidence in countries representative of three patterns of
reproductive cancer and age-specific mortality was used to estimate the
effect of oral contraceptive use on the lifetime probability of
reproductive cancer under three sets of assumptions about the effects of
oral contraceptives. Under the set of assumptions considered likely,
oral contraceptives were estimated to reduce or increase only slightly
the lifetime probability of any reproductive cancer in each setting.
Under worst-case assumptions, oral contraceptives were estimated to
increase the lifetime probability of reproductive cancer only modestly
in settings with low cancer rates and in settings with high rates of
breast, ovarian, and endometrial cancer, but it might have a large
impact on lifetime probability of reproductive cancer in settings with
high cervical cancer rates. Under best-case assumptions, oral
contraceptives were estimated to decrease the lifetime probability of
reproductive cancer in each setting; this reduction was estimated to be
greatest in settings where endometrial and ovarian cancer incidence are
high.
13
UI - 1622631
AU - Spicer DV; Pike MC
TI -
The prevention of breast cancer through reduced ovarian steroid
exposure.
SO - Acta Oncol 1992;31(2):167-74
AD - University of Southern California School of Medicine, Department of
Preventive Medicine, Los Angeles 90033-9987.
Analysis of epidemiologic data on cancers of the breast, ovary and
endometrium; the effects of endogenous hormones on cell proliferation;
and current carcinogenesis concepts, suggest that hormonal
contraceptives can be developed that will reduce lifetime risk of all 3
cancers. The 'unopposed-estrogen hypothesis' accounts for endometrial
cancer risk factors. Ovarian cancer risk is closely related to the total
frequency of ovulation. The risk of breast cancer can be explained by an
'estrogen-plus-progestogen hypothesis'. On the basis of this analysis an
hormonal contraceptive regimen has been developed consisting of a
gonadotropin-releasing hormone agonist (GnRHA) plus continuous low-dose
add-back estrogen and a short course of progestogen every fourth month.
The total dose of add-back estrogen is estimated to be approximately 38%
that in present-day low-dose combination-type oral contraceptives
(COCs). The total dose of progestogen is approximately 15% that in COCs.
This regimen prevents ovulation and should thus reduce ovarian cancer
risk. It also reduces the exposure of the endometrium to unopposed
estrogen, and the exposure of the breast to estrogen-plus-progestogen.
It is estimated that use of such a regimen for 10 years will only reduce
lifetime risk of endometrial cancer by one-sixth, but lifetime risk of
ovarian cancer is estimated to be reduced by two-thirds, and lifetime
risk of breast cancer is estimated to be reduced by one-half.
14
UI - 8435564
AU - Gili AF; Poonja Z; Kalra BB
TI -
Breast cancer screening for women younger than 40.
SO - Can Fam Physician 1993 Jan;39():65-72
AD - University of Alberta Hospital.
The charts of 661 women aged 15 to 39 revealed that almost 50% of
teenage patients had had breast screening examinations. Most of the
physicians and residents involved began performing and teaching breast
examination to patients in their teens. Concerned that it might do more
harm than good, the Canadian guidelines do not advocate early screening.
15
UI - 8390340
AU - Spicer DV; Pike MC; Pike A; Rude R; Shoupe D; Richardson J
TI -
Pilot trial of a gonadotropin hormone agonist with replacement hormones
as a prototype contraceptive to prevent breast cancer.
SO - Contraception 1993 May;47(5):427-44
AD - Department of Medicine, University of Southern California School of
Medicine, Los Angeles.
Combination oral contraceptive (COC) users have reduced risks of ovarian
and endometrial cancer, but COCs have not reduced breast cancer risk. We
have previously argued that a hormonal contraceptive with substantially
lower doses of sex-steroids should reduce breast cancer risk by
decreasing the breast epithelial cell proliferation below usual
premenopausal levels. We report here the preliminary results of a pilot
trial with such a prototype contraceptive consisting of an agonist of
gonadotropin releasing hormone (GnRHA) administered with low doses of an
oral estrogen (0.625 mg of conjugated estrogen, CE, for 6 days every
week) and intermittent oral progestogen (10 mg of medroxyprogesterone
acetate, MPA, for 13 days every 4 months). Eighteen subjects at
five-fold or greater increased breast cancer risk were entered and
randomized -12 to the contraceptive arm and 6 to a control arm. The
principal endpoints included tolerance of the regimen, vaginal bleeding
patterns, and the regimen's effect on the endometrium, bone metabolism,
and lipids. A symptom questionnaire was used to assess tolerance; the
contraceptive subjects had fewer symptoms following initiation of the
regimen. This results from the elimination of symptoms associated with
the luteal phase of the menstrual cycle, commonly referred to
collectively as premenstrual syndrome, PMS. The few occurrences of hot
flushes or vaginal dryness that did occur were eliminated by small
increases in estrogen dose (0.9 mg CE). Scheduled vaginal bleeding
occurred associated with most periods of progestogen administration.
Unscheduled bleeding or spotting was infrequent and decreased with time
on the regimen. A beneficial rise in high-density lipoprotein
cholesterol was evident in the contraceptive subjects. Despite the use
of an estrogen dose which is known to prevent loss of bone mineral
density in normal postmenopausal women, an annualized loss of 1.9% was
seen in contraceptive subjects. It is hypothesized that this is
secondary to inhibition of ovarian androgen production by the GnRHA,
which may additionally account for changes in libido occasionally
reported with GnRHA. The study continues with the addition of a small
dose of androgen to replace that lost by the action of the GnRHA.
16
UI - 8253093
AU - Pinotti JA; Barros AC; Hegg R; Zeferino LC
TI -
Breast cancer control programme in developing countries.
SO - Eur J Gynaecol Oncol 1993;14(5):355-62
AD - Gynecologic Clinic, Hospital das Clinicas, Medical School, Sao Paulo
University.
Breast cancer is a very important health problem in developing
countries, where its incidence has increased in the last decades.
Mortality rates due to breast cancer have also increased, and the main
reason for this is late diagnosis. The authors demonstrate that
organizing programmes for early breast cancer detection is possible by
making use of simple resources. A set of tiered interventions is
proposed, stratified in levels of complexity: Level 1--Identification of
abnormal breast by health professionals; Level 2--Medical assistance to
women whose breast is considered abnormal, in order to diagnose and
treat benign diseases and recognize suspect cases of cancer; Level
3--Management of the women with suspected or diagnosed breast cancer by
a multidisciplinary team. Therefore, a proposal for wide action for
breast cancer control in developing countries is presented.
17
UI - 7839882
AU - Anim JT
TI -
Breast cancer in sub-Saharan African women.
SO - Afr J Med Med Sci 1993 Mar;22(1):5-10
AD - College of Medicine, King Faisal University, Dammam, Saudi Arabia.
The literature on breast cancer in sub-Saharan women is reviewed. In
general, breast cancer is the second most common malignancy of women in
the region, after cancer of the uterine cervix. Available reports
indicate that data on the disease are incomplete and mostly, of
epidemiological or clinical nature. Breast cancer is less common in
sub-Saharan Africa compared to the Western countries (USA or Europe),
occurs in younger individuals with peak incidences about a decade
younger and the majority present late, with advanced, sometimes terminal
disease. Absence of health educational programmes on cancer as well as
lack of screening facilities in nearly all countries in the region are
contributory factors to the late presentation of the cases. The need for
more in-depth studies of the disease in the black African population has
been highlighted.
18
UI - 6898646
AU - Cook D
TI -
Hormone therapy: three perspectives. Fibrocystic breast disease:
contraindication for oral contraceptive therapy.
SO - J Nurse Midwifery 1980 Mar-Apr;25(2):15-6
19
UI - 3455923
AU - Miller AB; Bulbrook RD
TI -
UICC Multidisciplinary Project on Breast Cancer: the epidemiology,
aetiology and prevention of breast cancer.
SO - Int J Cancer 1986 Feb 15;37(2):173-7
20
UI - 3955285
AU - Drife J; Guillebaud J
TI -
Hormonal contraception and cancer.
SO - Br J Hosp Med 1986 Jan;35(1):25-9
The natural menstrual cycle can influence the development of some
cancers. Combined oral contraceptives, which replace normal hormonal
fluctuations with steadier levels of artificial sex hormones, appear to
protect against cancers of the endometrium and ovary, but their effect
on carcinomas of the breast and cervix remains uncertain.
21
UI - 6889241
AU - Lloyd G
TI -
Evaluating well-woman clinics.
SO - Practitioner 1983 May;227(1379):735-43
22
UI - 7232306
AU - Wenderlein JM
TI -
[Psychometry in gynecological research (author's transl)]
SO - Schweiz Rundsch Med Prax 1981 Mar 24;70(13):554-60
23
UI - 3369418
AU - Irwin KL; Lee NC; Peterson HB; Rubin GL; Wingo PA; Mandel MG
TI -
Hysterectomy, tubal sterilization, and the risk of breast cancer.
SO - Am J Epidemiol 1988 Jun;127(6):1192-201
AD - Division of Reproductive Health, Center for Health Promotion and
Education, Centers for Disease Control, Atlanta, GA 30333.
Studies suggest that hysterectomy and tubal sterilization may alter the
function of the remaining ovaries. Conceivably, this effect could alter
breast cancer risk. To investigate whether these surgeries affect breast
cancer risk, the authors analyzed data collected between December 1,
1980, and April 30, 1983, in a population-based, case-control study of
women aged 20-54 years, the Cancer and Steroid Hormone Study. Compared
with never-sterilized women, women with hysterectomy and no remaining
ovaries had a decreased risk of breast cancer (relative risk (RR) = 0.7,
95% confidence interval (CI) = 0.6-0.8). Risk was lowest in women who
had their surgery before age 40 years or 15 or more years in the past;
surgery at an early age provided greater protection than surgery in the
distant past. Hysterectomy with one or two remaining ovaries was also
inversely associated with breast cancer risk (RR = 0.8, 95% CI =
0.7-0.9), but no relation was found with age at surgery or time since
surgery. Women with tubal sterilization had a slightly increased risk of
breast cancer, which was of borderline statistical significance (RR =
1.2, 95% CI = 1.0-1.3). However, no relation was found with age at
surgery or time since surgery. The data suggest that hysterectomy with
bilateral oophorectomy decreases the breast cancer risk in women aged
less than 55 years, possibly by curtailing ovarian function at a
critical period. However, neither hysterectomy without bilateral
oophorectomy nor tubal sterilization appears to substantially alter
breast cancer risk in women of this age.
24
UI - 8120917
AU - Spicer DV; Ursin G; Parisky YR; Pearce JG; Shoupe D; Pike A; Pike MC
TI -
Changes in mammographic densities induced by a hormonal contraceptive
designed to reduce breast cancer risk.
SO - J Natl Cancer Inst 1994 Mar 16;86(6):431-6
AD - University of Southern California School of Medicine, Los Angeles
90033-9987.
BACKGROUND: It has been known for some time that oral contraceptives
substantially reduce the risk of endometrial and ovarian cancer, but
they do not reduce the risk of breast cancer. A hormonal contraceptive
regimen has been developed which uses a gonadotropin-releasing hormone
against (GnRHA) to suppress ovarian function, and this regimen includes
the administration of very low doses of both estrogen and progestogen.
This hormonal contraceptive regimen attempts to minimize exposure of the
breast epithelium to these steroids and to preserve the maximum
beneficial effects of estrogen, while still preventing endometrial
hyperplasia. PURPOSE: Our purpose was to determine whether changes
occurred in mammographic densities between baseline and 1 year for women
on this hormonal contraceptive regimen with reduced estrogen and
progestogen levels compared with women in a control group. METHODS:
Twenty-one women were randomly assigned in a 2:1 ratio to the
GnRHA-based contraceptive group (14 women) or to a control group (seven
women). The contraceptive group received the following: 7.5 mg
leuprolide acetate depot by intramuscular injection every 28 days; 0.625
mg conjugated estrogen by mouth for 6 days out of 7 every week; and 10
mg medroxyprogesterone acetate orally for 13 days every fourth 28-day
cycle. The control group received no medication. Baseline and 1-year
follow-up mammograms of contraceptive and control subjects were reviewed
in a blinded fashion by two radiologists. RESULTS: Comparison of the
changes between the baseline and 1-year mammograms in the two groups of
women showed significant (P = .039) reduction in mammographic densities
at 1 year for women on the contraceptive regimen. Assessing the
reduction in mammographic densities by noting the fineness of fibrous
septae showed a highly significant (P = .0048) difference in the
contraceptive regimen group. One of the women on the contraceptive
regimen was withdrawn from the study because of poor compliance.
CONCLUSION: The reduced estrogen and progestogen exposures to the breast
that were achieved by the hormonal contraceptive regimen resulted in
substantial reductions in follow-up mammographic densities at 1 year
compared with baseline. Although there is no direct evidence that such a
reduction in densities will lead to a reduced risk of breast cancer,
indirect evidence for a protective effect of this regimen is that early
menopause reduces breast cancer risk, and that menopause is associated
with a reduction in mammographic densities.
25
UI - 9243587
AU - Canty L
TI -
Breast cancer risk: protective effect of an early first full-term
pregnancy versus increased risk of induced abortion.
SO - Oncol Nurs Forum 1997 Jul;24(6):1025-31
AD - University of Incarnate Word, San Antonio, TX, USA.
PURPOSE/OBJECTIVES: To examine the question of whether an early first
full-term pregnancy (FFTP) protects against breast cancer and whether
interruption of the pregnancy with an induced abortion increases breast
cancer risk. DATA SOURCES: Published medical and epidemiology journal
articles, books, scientific reports, news interviews of researchers,
scientific journals. DATA SYNTHESIS: Continually increasing breast
cancer rates cannot be explained by the American Cancer Society risk
factors, which account for only 25% of cases. Induced abortion is a
newly recognized risk factor and has been prevalent in our society since
it was legalized in 1973. CONCLUSIONS: Early FFTP confers protection,
while induced abortion confers risk. Most specific and controlled
variables studies indicate 150% risk for abortions performed on women
younger than 18 years of age. Studies have yet to discover the full
impact of induced abortion because women who underwent legalized
abortion in 1973 are just reaching ages of highest breast cancer
incidence. IMPLICATIONS FOR NURSES: Awareness of a controversial risk
factor and its relevance to women allows nurses to include this
information when educating and supporting patients. Specifically, nurses
need to include questions on this reproductive risk when eliciting a
patient's reproductive history. Nurses should further be aware of the
emotional impact disclosure may have.
26
UI - 9647530
AU - Yagel S; Anteby E
TI -
A rational approach to prenatal screening and intervention.
SO - Hum Reprod 1998 May;13(5):1126-8
AD - Department of Obstetrics and Gynecology, Hadssah Mt Scopus, Jerusalem,
Israel.
27
UI - 10050165
AU - Devi R; Singh MM; Kumar R; Walia I
TI -
An effective manual on breast self-examination.
SO - World Health Forum 1998;19(4):388-9
AD - Nehru Hospital, Chandigarh, India.
28
UI - 12167572
AU - Roukos DH; Kappas AM; Tsianos E
TI -
Role of surgery in the prophylaxis of hereditary cancer syndromes.
SO - Ann Surg Oncol 2002 Aug;9(7):607-9
29
UI - 12219430
AU - MacDonald DJ
TI -
Women's decisions regarding management of breast cancer risk.
SO - Medsurg Nurs 2002 Aug;11(4):183-6
AD - City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
Twenty-three unaffected women with a family history of breast or ovarian
cancer participated in a study to ascertain their cancer-related
concerns, beliefs, and preferences for risk management. Their
perceptions related to breast cancer risk management options have
implications for practicing nurses.
30
UI - 12243912
AU - Kinsinger LS; Harris R
TI -
Chemoprevention of breast cancer: a promising idea with an uncertain
future.
SO - Lancet 2002 Sep 14;360(9336):813-4
AD - Cecil G Sheps Center for Health Services Research, University of North
Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. lkins@med.unc.edu
31
UI - 12243915
AU - IBIS investigators
TI -
First results from the International Breast Cancer Intervention Study
(IBIS-I): a randomised prevention trial.
SO - Lancet 2002 Sep 14;360(9336):817-24
BACKGROUND: Three clinical trials on the use of tamoxifen to prevent
breast cancer have reported mixed results. The overall evidence supports
a reduction in the risk of breast cancer, but whether this benefit
outweighs the risks and side-effects associated with tamoxifen is
unclear. METHODS: We undertook a double-blind placebo-controlled
randomised trial of tamoxifen, 20 mg/day for 5 years, in 7152 women aged
35-70 years, who were at increased risk of breast cancer. The primary
outcome measure was the frequency of breast cancer (including ductal
carcinoma in situ). Analyses were by intention to treat after exclusion
of 13 women found to have breast cancer at baseline mammography.
FINDINGS: After median follow-up of 50 months (IQR 32-67), 69 breast
cancers had been diagnosed in 3578 women in the tamoxifen group and 101
in 3566 in the placebo group (risk reduction 32% [95% CI 8-50];
p=0.013). Age, degree of risk, and use of hormone-replacement therapy
did not affect the reduction. Endometrial cancer was non-significantly
increased (11 vs 5; p=0.2) and thromboembolic events were significantly
increased with tamoxifen (43 vs 17; odds ratio 2.5 [1.5-4.4], p=0.001),
particularly after surgery. There was a significant excess of deaths
from all causes in the tamoxifen group (25 vs 11, p=0.028).
INTERPRETATION: Prophylactic tamoxifen reduces the risk of breast cancer
by about a third. Temporary cessation of tamoxifen should be considered
and the use of appropriate antithrombotic measures is recommended during
and after major surgery or periods of immobilisation. Prophylactic use
of tamoxifen is contraindicated in women at high risk of thromboembolic
disease. The combined evidence indicates that mortality from
non-breast-cancer causes is not increased by tamoxifen. The overall risk
to benefit ratio for the use of tamoxifen in prevention is still
unclear, and continued follow-up of the current trials is essential.
32
UI - 12161681
AU - Carney CP; Allen J; Doebbeling BN
TI -
Receipt of clinical preventive medical services among psychiatric
patients.
SO - Psychiatr Serv 2002 Aug;53(8):1028-30
AD - Department of Psychiatry, University of Iowa College of Medicine, Iowa
City, 52242, USA. caroline-carney@uiowa.edu
A total of 267 patients who were receiving care for psychiatric and
substance use disorders at a university medical center completed a
self-report instrument assessing their previous receipt of clinical
preventive services. High rates of mammography and Pap tests within the
past year were observed (76 and 77 percent). Rates of immunization
(hepatitis B and tetanus vaccines) varied from 11 percent to 78 percent.
Rates of preventive counseling for sexual practices, diet, and avoidance
of alcohol were lower than 25 percent in all groups. Only 6 percent of
all patients reported having been screened for gun ownership, despite
the high risk of suicide among gun owners.
33
UI - 12196271
AU - Sledge GW Jr
TI -
Whither chemoprevention?
SO - Clin Breast Cancer 2002 Aug;3(3):173
34
UI - 12242654
AU - Chen C; Bhalala HV; Qiao H; Dong JT
TI -
A possible tumor suppressor role of the KLF5 transcription factor in
human breast cancer.
SO - Oncogene 2002 Sep 26;21(43):6567-72
AD - Department of Pathology, University of Virginia Health System,
Charlottesville, Virginia, VA 22908, USA.
The 13q21 tumor suppressor locus, as defined by chromosomal deletion,
harbors the KLF5 transcription factor which may have tumor suppressor
function. To investigate whether KLF5 plays a role in breast cancer, we
evaluated all genes and/or expressed sequence tags (ESTs) within a 3.3
Mb common region of deletion at 13q21. Of these, only KLF5 mRNA was
expressed at high levels in non-neoplastic breast epithelial cells and
in normal human mammary tissue, but at lower levels in various breast
cancer cell lines. Using the real time TaqMan PCR assay, hemizygous
deletion at KLF5 was detected in 13 out of 30, or 43% of breast cancer
cell lines tested, and various degrees of loss of expression were
detected in 21 out of 30, or 70% of these cell lines. Each of the cases
with hemizygous deletion also exhibited loss of KLF5 expression,
suggesting that loss of expression can result from chromosomal deletion,
and that KLF5 may undergo haploinsufficiency during carcinogenesis. Only
one of the 30 breast cancer cell lines tested exhibited a mutation in
KLF5, and neither promoter methylation nor homozygous deletion was
detected in any of the cell lines. In contrast, loss of heterozygosity
(LOH) was frequently detected at KLF5. Re-expression of wild-type KLF5
in T-47D breast cancer cells significantly inhibited colony formation in
these cells. Of the KLF5-transfected clones that did form colonies, none
were found to express KLF5 mRNA. These findings suggest that loss of
function by deletion and/or loss of expression frequently occurs at
KLF5, and KLF5 suppresses tumor cell growth in breast cancer.
35
UI - 12229117
AU - Gastrin G
TI -
[Breast self-examination--a comparison of routine teaching and a more
comprehensive patient education program]
SO - Duodecim 2002;118(2):209
36
UI - 12181496
AU - Madanat H; Merrill RM
TI -
Breast cancer risk-factor and screening awareness among women nurses and
teachers in Amman, Jordan.
SO - Cancer Nurs 2002 Aug;25(4):276-82
AD - Department of Health Science, College of Health and Human Performance,
Brigham Young University, Provo, Utah 84602, USA.
Breast cancer awareness studies of women in Jordan do not exist. This
study used data from 163 nurses and 178 teachers surveyed in Amman to
determine 2 dimensions of breast cancer awareness: general breast cancer
awareness, defined as knowledge of risk factors associated with the
disease and breast cancer screening awareness, defined as knowledge of
breast self-examination and mammography. The survey instrument was based
on 2 previously validated knowledge-based questionnaires in the
literature (Breast Cancer Knowledge Test and the Comprehensive Breast
Cancer Questionnaire). Analysis of covariance indicated that family
history was associated with general breast cancer awareness. Profession,
age, and family history significantly influenced breast cancer screening
awareness. The average percentage of correct responses to general breast
cancer awareness was adjusted for select covariates (adjusted means).
The adjusted mean general awareness score for nurses was not
significantly different from that of teachers (P =.8470). Nurses were
more aware than teachers of the importance of breast cancer screening
and its techniques. The adjusted mean screening awareness score for
nurses was 88.3%, compared with 73.1% for teachers (P <.0001). These
results provide important information about the level of breast cancer
awareness among women nurses and teachers in Jordan and may be useful
for developing future prevention and screening education programs.
37
UI - 12195760
AU - Heinig A; Lampe D; Kolbl H; Beck R; Heywang-Kobrunner SH
TI -
Suppression of unspecific enhancement on breast magnetic resonance
imaging (MRI) by antiestrogen medication.
SO - Tumori 2002 May-Jun;88(3):215-23
AD - Department of Diagnostic Radiology, Martin-Luther-Universitat
Halle-Wittenberg, Halle, Germany.
AIMS AND BACKGROUND: The value of breast MRI may be impaired by
unspecific enhancement. This may leave patients with difficult-to-assess
breast tissue with an uncertain diagnosis. We examined whether this
unspecific enhancement (which is mostly due to proliferative or
hyperplastic changes of benign breast tissue) may be suppressed by
antiestrogen medication. METHODS: In a trial of treatment, 10 peri- or
postmenopausal patients who exhibited diffuse and/or focal enhancement
on breast MRI before tamoxifen medication agreed to undergo a short-term
tamoxifen treatment. MRI monitoring was performed 2, 4 and 8 weeks after
onset of antiestrogen therapy (tamoxifen, 30 mg per day). RESULTS: Six
patients showed a significant decrease of enhancement. Unchanged (n = 3)
or increased (n = 1) enhancement was seen in 4 patients. One of the
three patients with unchanged enhancement proved to have diffuse lobular
carcinoma in situ. CONCLUSIONS: Part of the unspecific enhancement seen
on breast MRI can probably be suppressed by short-term antiestrogen
medication.
38
UI - 12222134
AU - Haimov-Kochman R; Lavy Y; Hochner-Celinkier D
TI -
[Review of risk factors for breast cancer--what's new?]
SO - Harefuah 2002 Aug;141(8):702-8, 761
AD - Center for Education and Advancement of Women's Health in Menopause,
Hadassah University Hospital, Mt. Scopus, Hebrew University, Jerusalem.
Breast cancer is the most common malignancy in women and constitutes 18%
of all cancers in women. Female gender, age and country of birth are the
strongest determinants of disease risk. Family history and mutations in
tumor suppressor genes BRCA1 and BRCA2 are important correlates of
lifetime risk. Genetic polymorphisms associated with estrogen synthesis
and metabolism are viewed as major factors in breast cancer prevalence
in specific populations. Atypical hyperplasia and ductal/lobular
carcinoma in situ although uncommon, are considered as pre-malignant
conditions as well as markers for invasive breast cancer. Lately,
increased bone density and high breast tissue density on mammogram in
postmenopausal women have been reported in association with increased
risk of breast carcinoma, probably attributable to increased levels of
endogenous estrogen. Serum estrogen levels are higher in breast cancer
cases as compared with controls. Current use of oral contraceptives and
prolonged, current or recent use of postmenopausal hormonal replacement
therapy are also considered as risk factors for breast cancer. Tamoxifen
and raloxifene, selective estrogen receptor modulators, were shown to
reduce breast cancer risk among high-risk women. Various nutrients were
evaluated for their possible effect on breast cancer risk but further
studies are needed. High socioeconomic status is found to be associated
with increased risk of breast malignancy for as yet unestablished
reasons. Studying breast cancer risk factors and further research into
the molecular etiology of the disease will enable early diagnosis and
detection of high-risk women and ultimately improve prognosis.
39
UI - 12355995
AU - Tremollieres F; Lopes P
TI -
[Specific estrogen receptor modulators (SERMs)]
SO - Presse Med 2002 Sep 7;31(28):1323-8
AD - Unite de menopause et maladies osseuses metaboliques, service
d'endocrinologie, CHU Rangueil, Toulouse (31).
PRINCIPLE CHARACTERISTICS: Specific estrogen receptor modulators (SERMs)
are non-steroid molecules that maintain some of the agonist properties
of estrogens on bone tissue and cardiovascular system, but not their
stimulating effects on the gynecological sphere. OLD AND NEW MOLECULES:
SERMs were formerly known as "antiestrogens" in reference to their
primary inhibition of breast tumor growth. Hence, tamoxifen has been
used for many years as adjuvant treatment of breast cancer. However, its
long-term use is limited by the risk of endometrial hyperplasia, which
has led to the development of new molecules devoid of this side effect.
Among these molecules, raloxifen, more specifically reserved for the
prevention of osteoporosis in menopausal women, has been the subject of
major pre-clinical and clinical developments. THE EFFECTS OF RALOXIFEN:
In the prevention of postmenopausal bone loss and vertebral fractures,
the effects of raloxifen have been established in several randomized,
double-blind studies against placebo, which were the basis of its
current marketing authorization. Moreover, raloxifen has a favorable
effect on lipid profile and, contrary to oral estrogens, does not
increase the C-Reactive protein. Endometrial tolerance is good and it is
associated with a significant reduction in the incidence of breast
cancer in elderly osteoporotic women. ITS PLACE IN THERAPY: Raloxifen's
properties raise the question of its place, together with hormone
replacement therapy (HRT), in the management of menopausal women. Its
absence of efficacy in the control of the climacteric syndrome does not
a priori make it a treatment of choice at the beginning of
postmenopausal phase. How
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