The Contribution of Clinical Breast Examination to the Accuracy of Breast Screening

The Contribution of Clinical Breast Examination to the Accuracy of Breast Screening
Anna M. Chiarelli , Vicky Majpruz, Patrick Brown, MarcThériault, Rene Shumak, Verna Mai
J Natl Cancer Inst 2009;101:1236–1243

Link to Journal

Sensitivity of referrals was higher for women who were screened at regional cancer centers or affiliated centers that offered CBE in addition to mammography than for women screened at affiliated centers that did not offer CBE (initial screen: 94.9% and 94.6%, respectively, vs 88.6%; subsequent screen: 94.9% and 91.7%, respectively, vs 85.3%). Mammography sensitivity was similar between centers that offered CBE and those that did not. However, women without cancer who were screened at regional cancer centers or affiliated centers that offered CBE had a higher false-positive rate than women screened at affiliated centers that offered only mammography (initial screen: 12.5% and 12.4%, respectively, vs 7.4%; subsequent screen: 6.3% and 8.3%, respectively, vs 5.4%)

Women should be informed of the benefits and risks of having a CBE in addition to mammography for breast screening

Variability of Interpretive Accuracy Among Diagnostic Mammography Facilities

Variability of Interpretive Accuracy Among Diagnostic Mammography Facilities
Sara L. Jackson, Stephen H. Taplin, Edward A. Sickles, Linn Abraham, William E. Barlow, Patricia A. Carney, Berta Geller, Eric A. Berns, Gary R. Cutter, and Joann G. Elmore

Link to Journal

A breast cancer surveillance consortium review of interpretation accuracy of diagnostic exams between various mammography facilities at the participating breast cancer surveillance consortium sites. Much is known about interpretive accuracy in screening cohorts, but little is known about diagnostic exams where the risk of malignancy is much higher (1:12 diagnostic compared with 5:1000 screening).

Prevention of Breast Cancer in Postmenopausal Women: Approaches to Estimating and Reducing Risk

Prevention of Breast Cancer in Postmenopausal Women: Approaches to
Estimating and Reducing Risk
Steven R. Cummings, Jeffrey A. Tice, Scott Bauer, Warren S. Browner, Jack Cuzick, Elad Ziv, Victor Vogel, John Shepherd, Celine Vachon, Rebecca Smith-Bindman, and Karla Kerlikowske
J. Natl. Cancer Inst. published 10 March 2009, 10.1093/jnci/djp018

Link to journal

Another UCSF/CPMC paper reviewig breast cancer risk factors and breast density. Their conclusions are that from the evidence from these reviews supports systematic assessment of postmenopausal women for breast cancer risk with risk factors and assessment of breast density.
Chemoprevention should be considered for those at high risk; however, cost-benefit analyses are needed to provide specific recommendations about who should be offered chemoprevention. Several lifestyle changes can be recommended to postmenopausal women, regardless of their estimated risk category.

Beyond the Gail Model: Lobular Involution May Help Refine Breast Cancer Risk Assessment

Beyond the Gail Model: Lobular Involution May Help Refine Breast Cancer Risk Assessment
Karen Rowan
J. Natl. Cancer Inst. 2009 101: 134-135; doi:10.1093/jnci/djn505

Link to Journal