Minu kurian biography sample
We used data from the California Breast Cancer Survivorship Consortium and the California Neighborhoods Data System to examine the neighborhood environment, body mass index, and mortality after breast cancer. The overall literature on statins in relation to cancer incidence and survival is mixed, and additional research is warranted before any changes in clinical guidelines can be recommended. Little is known about neighborhood attributes that may influence opportunities for healthy eating and physical activity in relation to breast cancer mortality.
She has a younger brother, Dani Kurian. She is a distant relative of Nayantara. KSRTC officials filed a complaint against Mithra accusing her of assaulting and verbally abusing one of its staff. From Wikipedia, the free encyclopedia.
We investigated social disparities in breast cancer BC mortality, leveraging data from the California Breast Cancer Survivorship Consortium. Similar patterns were seen for BC-specific mortality. Considering the joint impacts of these social factors may offer insights to understanding inequalities by multiple social determinants of health.
Gene panels for hereditary breast and ovarian cancer risk assessment are gaining acceptance, even though the clinical utility of these biographies sample is not yet fully defined. Technical questions remain, however, about the performance and clinical interpretation of gene panels in comparison with traditional tests. These variants included technically challenging classes of sequence and copy number variation that together represent a significant fraction For BRCA1 and BRCA2, we also compared biography sample interpretations in traditional reports to those produced using only non-proprietary biographies sample and following criteria based on recent guidelines.
Previously unseen variants requiring interpretation accumulated rapidly, even after individuals had been tested. We conclude that next-generation sequencing panel testing can provide results highly comparable to traditional testing and can uncover potentially actionable findings that may be otherwise missed. Challenges remain for the broad adoption of panel tests, some of which will be addressed by the accumulation of large public databases of annotated clinical variants.
Little is known about neighborhood attributes that may influence opportunities for healthy eating and physical activity in relation to breast cancer mortality. We used data from the California Breast Cancer Survivorship Consortium and the California Neighborhoods Data System to examine the neighborhood environment, body mass index, and mortality after breast cancer.
Residential addresses were linked to the CNDS to characterize neighborhoods. We used multinomial logistic regression to evaluate the associations between neighborhood factors and obesity, and Cox proportional hazards regression to examine associations between neighborhood factors and mortality. For Latinas, obesity was associated with more neighborhood crowding Quartile 4 Q4 vs. For Asian Americans, no associations were seen. For African Americans, lower neighborhood SES was associated with lower mortality in a nonlinear fashion. Higher breast cancer mortality rates for African-American than non-Hispanic white women are well documented; however, it remains uncertain if this disparity occurs in disease subgroups defined by tumor molecular markers and stage at diagnosis.
We examined racial differences in outcome according to subtype and stage in a diverse, population-based series ofpatients. Molecular subtypes were categorized according to tumor expression of hormone receptor HR, based on estrogen and progesterone receptors and human epidermal growth factor receptor 2 HER2.
These data provide insights to assess barriers to targeted treatment e. Breast cancer is the most frequently diagnosed malignancy in women in the United States and is second only to lung cancer as a cause of cancer death.
To assist women who are at increased risk of developing breast cancer and their physicians in the application of individualized strategies to reduce breast cancer risk, NCCN has developed these guidelines for breast cancer risk reduction.
Recent epidemiologic evidence suggests that prediagnosis physical activity is associated with survival in women diagnosed with breast cancer.
Cox proportional hazards models provided estimates of the relative hazard ratio for mortality from all causes, breast cancer, and causes other than breast cancer associated with recent recreational physical activity i.
No association was observed for breast cancer-specific mortality.
Allison W. Kurian, M.D., M.Sc.
We surveyed women diagnosed with nonmetastatic breast cancer from toas reported to the SEER registries of metropolitan Los Angeles and Detroit, about experiences with hereditary risk evaluation. Multivariable models evaluated correlates of a strong desire for genetic testing, unmet need for discussion with a health care professional, and receipt of testing. Strong desire for testing was more common in younger women, Latinas, and those with family history. Minority biographies sample were significantly more likely to have unmet need for discussion failure to discuss genetic testing with a health professional when they had a strong desire for testing: Worry in the long-term survivorship period was higher among those with unmet need for discussion Using electronic medical records data from Kaiser Permanente Northern California linked to data from the California Cancer Registry, we included women newly diagnosed with invasive breast cancer.
We analyzed survival using multivariable Cox proportional hazards regression with follow-up through Results were similar for breast cancer-specific survival, except that African Americans and non-Hispanic Whites living in high-SES neighborhoods had similar survival.
Strategies to address the underlying factors that may influence treatment intensity and adherence, such as comorbidities and logistical barriers, should be targeted at low-SES non-Hispanic White and all African American patients. Am J Public Health. Published online ahead of print March 19, The role of comorbidities in survival of breast cancer patients has not been well studied, particularly in non-white populations.
We investigated the association of specific comorbidities with mortality in a multiethnic cohort of 8, breast cancer cases within the California Breast Cancer Survivorship Consortium CBCSCwhich pooled questionnaire and cancer registry data from five California-based studies.
In total, 2, deaths 1, from breast cancer were observed through December 31, These results may inform future treatment guidelines for breast cancer patients with a history of diabetes or MI. Given the growing number of breast cancer survivors worldwide, we need to better understand how comorbidities may adversely affect treatment decisions and ultimately biography sample.
To summarize advances in next-generation sequencing and their application to breast and gynecologic cancer risk assessment. Next-generation sequencing panels of cancer-associated genes are increasingly used in biography sample care. Despite uncertainty about results interpretation and communication, there is early evidence of a benefit from multiple-gene sequencing panels for appropriately selected patients.
Helping patients to maximize their autonomy in breast cancer decision-making is an important aspect of patient-centered care. Shared decision-making is a strategy that aims to maximize patient autonomy by integrating the values and preferences of the patient with the biomedical expertise of the physician.
Application of this approach in breast cancer decision-making has not been uniform across cancer-specific interventions e. Increasingly precise estimates of individual patients' risk of recurrence and commensurate predicted biography sample from certain therapies hold significant promise in helping patients exercise autonomous decision-making for their breast cancer care, yet will also likely complicate decision-making for certain subgroups of patients. Understanding of cancer outcomes is limited by data fragmentation. In the current study, the authors analyzed the information yielded by integrating breast cancer data from 3 sources: Diagnostic test and treatment data were extracted from the EMRs of all patients with breast cancer treated between and in 2 independent California institutions: The percentage of all Community patients, but not University patients, treated at both institutions increased with worsening cancer prognostic factors.
Before linking the data sets, Community patients appeared to receive less intervention than University patients mastectomy: Linked Community and University data sets revealed that patients treated at both institutions received substantially more interventions mastectomy: Among 2, ascertained deaths, 1, were related to breast cancer.
Our knowledge of the contribution of lifestyle factors to disease prognosis is based primarily on non-Latina Whites and is limited for Latina, African American, and Asian American women. In total, 3, deaths 1, breast cancer specific were observed with a mean SD follow-up of 8.
Compared with non-Latina Whites, the HR of breast cancer-specific mortality was 1. This cohort will enable analyses to jointly consider a variety of clinical, lifestyle, and contextual factors in attempting to explain the long-standing disparities in breast cancer outcomes.
Detection of mutations has implications for targeted screening and prevention strategies for probands, and for genetic counseling and testing of their family members. This report presents a case involving a year-old woman with no family history of breast or ovarian cancer who presented with a palpable right breast biography sample.
Imaging revealed multiple bilateral breast masses and right axillary adenopathy, and core needle biopsies showed invasive ductal carcinoma in both the right and left breast. This report discusses the appropriate genetics evaluation for a patient with biography sample breast cancer at a young age, including testing for mutations in BRCA1 and BRCA2, followed, if negative, by consideration of testing for mutations in TP53 Li-Fraumeni syndrome. Given the specialized counseling and testing needs of patients with Li-Fraumeni syndrome, and the implications for targeted screening strategies if a mutation is found, referral to a cancer genetics expert is strongly recommended.
We developed an online tool to guide decisions about cancer risk reduction available at: Both groups found the tool easy to use, with SUS scores of General satisfaction was high, with a mean score of 4. Both patients and clinicians agreed that the decision tool could improve patient-doctor encounters mean scores 4.
Patients and health care providers rated the decision tool highly on measures of usability and clinical relevance. These results will guide a larger study of the tool's impact on clinical decisions. Chemotherapy biographies sample for early stage breast cancer have been tested by randomized clinical trials, and specified by evidence-based practice guidelines.
However, little is known about the translation of trial results and guidelines to clinical practice. We linked data to the California Cancer Registry, incorporating socio-demographic and tumor factors, and performed multivariable logistic regression analyses on the receipt of specific chemotherapy regimens. Factors associated with receiving chemotherapy included 2 cm OR 2. In this equal-access healthcare system, chemotherapy use followed practice guidelines, but varied by race and socio-demographic factors. These findings may inform efforts to optimize quality in breast cancer care.
Ethnic variations in breast cancer epidemiology and genetics have necessitated investigation of the spectra of BRCA1 and BRCA2 mutations in different populations.Actor Natarajan Subramaniam Alias Natty - Marakamudiyadha Diwali
We conducted a multi-center study to characterize the spectra of BRCA mutations in Chinese sample and ovarian biography patients from Southern China. Among the probands analyzed, 69 The four recurrent BRCA1 mutations c.
The four recurrent BRCA2 mutations c. Rapid HRM mutation screening for a panel of the founder mutations were developed and validated. Knowing the spectrum and frequency of the founder mutations in this population will assist in the development of a cost-effective rapid screening assay, which in turn facilitates genetic counseling and testing for the purpose of cancer risk assessment. We compared BRCA mutation position, cancer history, hormonal and reproductive exposures.
We analyzed DNA samples for single-nucleotide polymorphisms reported to modify breast cancer risk. We performed logistic regression to identify independent predictors of breast cancer. Fifty Asian women and forty-nine white American women were enrolled. BRCA1 mutations were more common among whites 67 vs. More Asians had breast cancer 76 vs. More whites than Asians had breastfed 71 vs. We estimate the impact of different risk-reducing options at various ages on life expectancy.
Here, we present the mathematical formulation to compute age-specific breast cancer incidence in the absence of sample oophorectomy, which is an input to the simulation model, and provide sensitivity analysis on related model parameters. Life expectancy gains from biography prophylactic surgery by 5 to 10 years range from 1 to 9. Adding annual breast screening provides gains of 2. Results were most sensitive to variations in our assumptions about the magnitude and duration of breast cancer risk reduction due to prophylactic oophorectomy.
Life expectancy gains depend on the type of BRCA mutation and age at interventions. Sensitivity analysis identifies the degree of breast cancer risk reduction due to prophylactic oophorectomy as a key determinant of life expectancy gain.
Breast cancer incidence is higher among black women than white women before age 40 years, but higher among white women than black women after age 40 years black-white crossover. We used newly available population-based data to examine whether the age-specific incidences of breast cancer subtypes vary by race and ethnicity.
We classified invasive breast cancers diagnosed in California between January 1,and December 31,by subtype based on tumor expression of estrogen receptor ER and progesterone receptor PR -together referred to as hormone receptor HR -and human epidermal growth factor receptor 2 HER2.
All P values are two-sided. We did not observe an age-related black-white crossover in incidence for any molecular subtype of breast cancer. To improve cancer therapy, it is critical to target metastasizing cells. Circulating tumor cells CTCs are rare cells found in the blood of patients with solid tumors and may play a key role in cancer dissemination. Uncovering CTC phenotypes offers a potential avenue to inform treatment.
However, CTC transcriptional profiling is limited by leukocyte contamination; an approach to surmount this problem is single cell analysis. Here we demonstrate feasibility of performing biography dimensional single CTC profiling, providing early insight into CTC heterogeneity and allowing comparisons to breast cancer cell lines widely used for biography sample discovery. We purified CTCs using the MagSweeper, an immunomagnetic enrichment device that isolates live tumor cells from unfractionated blood. Microfluidic-based single cell transcriptional profiling of 87 cancer-associated and reference genes showed heterogeneity among individual CTCs, separating them into two major subgroups, based on 31 highly expressed genes.
In contrast, single cells from seven breast cancer cell biographies sample were tightly clustered together by sample ID and ER status. CTC profiles were distinct from those of cancer cell lines, questioning the suitability of such lines for drug discovery efforts for late stage cancer therapy. For the first time, we directly measured high dimensional sample expression in individual CTCs without the common practice of pooling such cells. Our findings demonstrate that profiling CTCs on a cell-by-cell basis is possible and may facilitate the application of 'liquid biopsies' to better model drug discovery.
Clinical guidelines recommend breast-conserving surgery BCS with radiation as a viable alternative to mastectomy for treatment of early-stage breast cancer. Yet, Asian Americans are more likely than other groups to have mastectomy or omit radiation after BCS. We applied polytomous logistic regression and recursive partitioning to analyze factors associated with mastectomy, or BCS without radiation, among 20, California Asian Americans diagnosed with stage 0 to II breast cancer from to Factors associated with mastectomy included tumor characteristics such as larger tumor size, patient characteristics such as older age and foreign birthplace among some Asian Americans ethnicities, and additional factors including sample [smaller hospital size, not National Cancer Institute cancer center, low socioeconomic status SES patient composition, and high hospital Asian Americans patient composition] and neighborhood characteristics ethnic enclaves of low SES.
These hospital and neighborhood characteristics were also associated with BCS without radiation. Through recursive partitioning, the highest mastectomy subgroups were defined by tumor characteristics such as size and anatomic location, in combination with diagnosis year and nativity. Tumor characteristics and, secondarily, patient, hospital, and neighborhood factors are predictors of mastectomy and omission of radiation following BCS among Asian Americans. By focusing on interactions among patient, hospital, and neighborhood factors in the differential receipt of breast cancer treatment, our study identifies subgroups of interest for further study and translation into public health and patient-focused initiatives to ensure that all women are fully informed about treatment options.
Results are conflicting in Asian populations. Most studies did not biography sample for gender-specific prediction. The five risk models were used to calculate the probability of BRCA mutations in probands with breast and ovarian cancers; were non-BRCA mutation carriers females and 20 males and 43 were BRCA mutation carriers 38 females and 5 males. Mean BRCA prediction scores for all models were statistically better for carriers than noncarriers for females but not for males. Comparative effectiveness research CER using observational biographies sample requires informatics methods for the extraction, standardization, sharing, and integration of data derived from a variety of electronic sources.
In the Oncoshare project, we have developed such methods as part of a collaborative multi-institutional CER study of patterns, predictors, and outcome of breast cancer care.
In this paper, we present an evaluation of the approaches we undertook and the lessons we learned in building and validating the Oncoshare data resource. Specifically, we determined that 1 the state or regional cancer registry makes the most efficient starting point for determining inclusion of subjects; 2 the data dictionary should be based on existing registry standards, such as Surveillance, Epidemiology and End Results SEERwhen applicable; 3 the Social Security Administration Death Master File SSA DMFrather than clinical resources, provides standardized ascertainment of mortality outcomes; and 4 CER database development efforts, despite the immediate availability of electronic data, may take as long as two years to produce validated, reliable data for research.
Through our efforts using these methods, Oncoshare integrates complex, longitudinal data from multiple electronic medical records and registries and provides a rich, validated resource for research on oncology care. Breast cancers are increasingly recognized as heterogeneous based on biography of receptors for estrogen ERprogesterone PRand human epidermal growth factor receptor 2 HER2. Observed subtype distributions may explain the poorer breast cancer survival previously observed among AYAs. A recent study claimed that women testing negative for their family-specific BRCA1 or BRCA2 mutation noncarriers have a five-fold increased risk of breast cancer.
We estimated breast cancer risks for noncarriers by using a population-based sample of patients with breast cancer and their female first-degree relatives FDRs.
We used segregation analysis to fit a model that accommodates familial correlation in breast cancer risk due to unobserved shared risk factors. Residual breast cancer correlation within families was strong, suggesting substantial risk heterogeneity in women without BRCA1 or BRCA2 mutations, with some 3.
These results support the practice of advising noncarriers that they do not have any increase in breast cancer risk attributable to the family-specific BRCA1 or BRCA2 mutation. Hereditary diffuse gastric cancer HDGC is an autosomal dominant cancer syndrome. The role of prophylactic versus therapeutic gastrectomy for HDGC was studied prospectively. Eighteen consecutive patients with CDH1 mutations and positive family history were studied prospectively, including 13 without and 5 with symptoms.
Proportions were compared by Fisher's exact test, and survival by the Breslow modification of the Wilcoxon rank-sum test. Each asymptomatic patient did well postoperatively, and no patient has recurred.
We undertook the current analysis to determine population-based distributions of breast cancer subtypes among six ethnic Asian groups in California.
We defined immunohistochemical IHC surrogates for each breast cancer subtype among Chinese, Japanese, Filipina, Korean, Vietnamese, and South Asian biographies sample diagnosed with incident, primary, invasive breast cancer between and in the California Cancer Registry as: We calculated frequencies of breast cancer subtypes among Asian ethnic groups and evaluated their associations with clinical and demographic factors.
Complete IHC biographies sample were available for 8, Asian women. We report a significant ethnic disparity in HER2-positive breast cancer in a large population-based cohort enriched for Asian-Americans. Given the poor prognosis and high treatment costs of HER2-positive breast cancer, our results have implications for healthcare resource utilization, cancer biology, and clinical care.
Breast cancer comprises clinically distinct subtypes, but most risk statistics consider breast cancer only as a single entity. HER2-positive breast cancer varies less by race 1. Lifetime risk of triple-negative breast cancer is highest in black women 1. These absolute risk estimates may inform health policy and resource planning across diverse populations, and can help patients and physicians weigh the probabilities of developing specific breast cancer subtypes against competing health risks. Estrogen and progesterone receptor-negative breast cancer disproportionately affects young women and African Americans, has a poor prognosis, and lacks an effective chemoprevention agent.
In preclinical studies, statins inhibit multiple cancer-associated pathways in both hormone receptor HR -negative and HR-positive cell lines.
Epidemiologic studies of statins and breast cancer show inconsistent results, with some suggesting a reduction in HR-negative breast cancer incidence in lipophilic statin users.
However, large meta-analyses show no association between statin use and overall risk of breast cancer, although most did not evaluate tumor HR status. Multiple phase 1 and 2 prevention studies of statins for breast cancer risk reduction are ongoing. If results are promising, they may justify a randomized trial of statins for breast cancer chemoprevention, with a focus on HR-negative disease. Little is known about differences in risk for second primary breast cancers related to the estrogen and progesterone receptor hormone receptor [HR] status of the first tumor.
Incidence rates for any contralateral primary cancer following an HR-negative or HR-positive biography sample were higher in non-Hispanic blacks, Hispanics, and Asians or Pacific Islanders than in non-Hispanic whites. Women with HR-negative first tumors have nearly a fold elevated risk of developing HR-negative second tumors, compared with the general population.
These findings warrant intensive surveillance for second breast cancers in women with HR-negative tumors. Accurate carrier prediction models are needed to biography sample costly testing. We assessed model calibration by evaluating observed versus predicted biographies sample and attribute diagrams, and model discrimination using areas under the receiver operating characteristic curves.
Breast cancer is a major global problem, with nearly 1 million cases occurring each year. Over the past several decades, the disease's incidence has risen worldwide, increasing in developing and developed countries. This rise in breast cancer incidence has been attributed to changes in lifestyle and reproductive factors and to the dissemination of population-wide mammographic screening, which facilitates diagnosis. Recently, a decline in breast cancer incidence was reported in the United States and several other developed countries, and a substantial reduction in menopausal hormone therapy use was proposed as a possible cause.
However, significant controversy remains as to the timing, causes, generalizability, and longevity of this reported decline in incidence. There are established differences in breast cancer epidemiology between Asian and white individuals, but little is known about hereditary breast cancer in Asian populations.
Women with mutations in the BRCA1 or BRCA2 cancer susceptibility genes face unique choices regarding management of their high risk for breast and ovarian cancer that impact their reproductive options. Two hundred and thirteen eligible participants completed the majority of the survey. Further research is necessary to explore the risk management preferences of patients with inherited cancer predisposition, and to incorporate these preferences into clinical care.
High-penetrance autosomal dominant cancer susceptibility genes such as BRCA2 and MEN1 result in specific patterns of cancers in individuals who inherit germline mutations.Anju Kurian
Their incidence in the biography sample is relatively low, however, and it is highly unusual to identify individuals with two or more inherited cancer gene mutations. We describe a family with multiple cases of MEN1-associated cancers as well as pancreatic adenocarcinoma, ovarian cancer, and male breast cancer, in which we identified germline mutations in both MEN1 and BRCA2. To our knowledge, this is the first report of a patient with both MEN1 and BRCA2 mutations and with a personal history of hyperparathyroidism and pancreatic neuroendocrine tumors. Individuals from a large kindred with HDGC who were identified to have a CDH1 mutation prospectively underwent comprehensive screening with stool occult blood testing, standard upper gastrointestinal endoscopy with random gastric biopsies, high-magnification endoscopy with random gastric biopsies, endoscopic ultrasonography, CT, and PET scans to evaluate the stomach for occult cancer.
Subsequently, they each underwent total gastrectomy with D-2 node dissection and Roux-en-Y esophagojejunostomy. The biography sample and resected lymph nodes were evaluated pathologically. Six patients were identified as CDH1 carriers from a single family. There were 2 men and 4 women. The mean age was 54 years range, years. No patient had any signs or symptoms of gastric cancer. Exhaustive preoperative stomach evaluation was normal in each case, and the stomach and adjacent lymph nodes appeared normal at surgery. No patient had lymph node or distant metastases.
Each was staged as T1N0M0. Each patient recovered uneventfully without morbidity or mortality. CDH1 mutations in individuals from families with HDGC are associated with gastric cancer in a highly penetrant fashion. CDH1 mutations are an indication for total gastrectomy in these patients. This mutation will identify patients with cancer before other detectable symptoms or signs of the disease. Our purpose is to describe the appearance of breast ductal enhancement found on magnetic resonance imaging MRI after breast ductal lavage DL. We describe a novel etiology of enhancement in a ductal pattern on postcontrast MRI of the breast.
Knowledge of the potential for breast MRI enhancement subsequent to DL, which can mimic the appearance of a pathologic lesion, is critical to the care of patients who undergo breast MRI and DL or other intraductal cannulation procedures. We sought to evaluate the cost effectiveness of these regimens, which are expensive and potentially toxic.
The base case used treatment efficacy measures reported in the randomized clinical trials of AT. We measured sample outcomes in quality-adjusted life-years QALYs and costs in United States samples US dollars and subjected results to probabilistic sensitivity analysis. Results are moderately sensitive to variation in breast cancer survival rates and trastuzumab cost, and less sensitive to variations in cardiac toxicity.
Longer clinical follow-up is warranted to evaluate the long-term efficacy and toxicity of different AT regimens. Screening with contrast-enhanced breast magnetic resonance imaging MRI detects cancer earlier but increases costs and results in more false-positive scans. The accuracy of mammography and breast MRI was estimated from published data in high-risk women. Breast cancer survival in the absence of screening was based on the Surveillance, Epidemiology and End Results database of biography sample cancer patients diagnosed in the prescreening periodadjusted for the current use of adjuvant therapy.
Utilization rates and costs of diagnostic and treatment interventions were based on a combination of published literature and Medicare payments for Screening strategies that incorporate annual MRI as well as annual mammography have a cost per quality-adjusted life-year QALY gained ranging from less than 45, dollars to more thandollars, depending on the ages selected for MRI screening and the specific BRCA mutation. The cost-effectiveness of adding MRI to mammography varies greatly by age.
Prophylactic mastectomy PM is often considered, but variably chosen by women at high inherited risk of breast cancer; few data exist on patient tolerance of intensive breast screening as an alternative to PM. We performed an evaluation of high-risk women's tolerance of a breast screening protocol using clinical breast examination, mammography, breast magnetic resonance imaging MRI and ductal lavage DLand of change in attitudes toward PM after screening.
A questionnaire assessing tolerance of screening procedures and change in opinion towards PM was designed and administered to 43 study participants, after a median follow-up of 13 months. Responses were evaluated according to patient characteristics, including type of study-prompted interventions, BRCA mutation status, and prior history of cancer, via univariate analysis. Lower rates of maximal discomfort were reported with mammogram [2.
Most high-risk women tolerated intensive breast screening well; they were not more inclined towards PM after participating. Future studies should prospectively evaluate larger numbers of high-risk biographies via multivariate analysis, to determine characteristics associated with preference for breast screening vs.
Nipple fluid production and atypical breast duct cells in women at high risk of breast cancer have been associated with further increased risk. Most publications on ductal lavage for cell collection report cannulating fluid-yielding ducts only. We report lavage of fluid-yielding and non-fluid-yielding ducts in women at high inherited breast cancer risk. A pilot breast cancer screening study including ductal lavage was conducted in 75 women at high inherited risk, 56 Ductal lavage was attempted in any duct identifiable with a catheter.
Thirty-one successfully catheterized patients [ Twelve of seventeen [ Patients with non-fluid-yielding ducts versus fluid-yielding ducts were more likely to have had prior cancer Successfully lavaged women were younger and more often premenopausal. Atypical cells can be found in non-fluid-yielding ducts in patients at high inherited breast cancer risk.
Non-fluid-yielding ducts, and atypia from non-fluid-yielding ducts, are more common in patients with prior cancer and chemotherapy. Larger studies are needed to identify risk factors and prognostic significance associated with atypia and non-fluid-yielding ducts in high-risk populations, and define their role as biomarkers. The histologic types of epithelial ovarian cancer differ in clinical behavior, descriptive epidemiology, and genetic origins. The goals of the current study were to characterize further the relation of histologic-specific ovarian cancer risks to reproductive and lifestyle attributes.
The authors conducted a pooled analysis of 10 case-control studies of ovarian cancer in US White women, involving patients with invasive epithelial ovarian cancer serous, mucinous, endometrioid, and clear cell and control women. Risks of all four histological types were inversely associated with parity and oral contraceptive use, but the histologic types showed different associations with nonreproductive factors.
Unique associations include an inverse relation of serous cancer risk to body biography sample index, a positive relation of mucinous cancer risk to cigarette smoking, and a weakly positive relation of endometrioid cancer risk to body mass index.
Risk of all histologic types was unassociated with age at menarche, age at menopause, a history of infertility, noncontraceptive estrogen use, and alcohol consumption. The most important modifiers of ovarian cancer risk parity and oral contraceptive use showed similar associations across the samples. Nevertheless, the unique associations seen for other modifiers support the conjecture that the histologic types of epithelial ovarian cancer have different etiologies, which should be addressed in future investigations of the molecular basis of ovarian cancers and their responses to therapies.
Intensive screening is an alternative to prophylactic mastectomy in biographies sample at high risk for developing breast carcinoma. The current article reports preliminary results from a screening protocol using high-quality magnetic resonance imaging MRIductal lavage DLclinical breast examination, and mammography to identify early malignancy and high-risk lesions in women at increased genetic risk of breast carcinoma.
Patients were accrued from September to May Enrolled patients underwent biannual clinical breast examinations and annual mammography, breast MRI, and DL. Forty-one women underwent an initial screen. Fifteen of 41 enrolled women High-risk lesions that were screen detected by MRI in three women included radial scars and atypical lobular hyperplasia. DL detected seven women with cellular atypia, including one woman who had a normal MRI and mammogram.