The Gail model is a statistical tool, which assesses breast cancer probability, based on nonmodifiable risk factors. In contrast, the evaluation of mammographic breast density is an independent and dynamic risk factor influenced by interventions modifying breast cancer risk incidence. The aim of the present study is to compare the possibilities for risk factor integration and analysis and to search for a correlation between mammographic density and the Gail model for breast cancer risk evaluation. The subject of this prospective study is a cohort of 107 women at ages from 37 to 71 years, who have had benign breast diseases, digital mammograms, and Gail model risk evaluation. Mammographic density is evaluated in craniocaudal projection subjectively visually and objectively using the computer imaging software. (Image J software) The Gail risk evaluation is completed using the standardized NCI questionnaire (Breast Cancer Risk Assessment Tool). In concordance with the Breast Imaging Reporting and Data System (BI-RAD) by ACR, mammographic density is evaluated using a four-grade scale. Low density D1 (less than 25%) was determined in 24 cases, D2 (25-50%) in 36 cases, D3 (51-75%) in 31 cases and high density D4 (greater than 75%) in 16 cases. According to the Gail model, 80 (74,8%) of the examined patients did not have an increased risk (less than 1,67% for a five-year period), whereas the remaining 27 (25,2%) had a statistically significant increase in risk (greater than 1,67% for a term of five years). Women with increased risk more often present with denser breast (34% with D3, D4 versus 18,3% for D1, D2). The Gail model does not fully explain the correlation between breast density and statistically calculated risk. The development of more detailed tools, which take into consideration breast density, as well as other risk factors, may be helpful for a more accurate evaluation of the individual risk for breast cancer.
For decades now breast cancer tissue resection has been the primary method of choice for treating the disease, however this was not the case throughout the history of medicine. For centuries breast cancer was considered to be incurable via surgical approaches and that only early, low grade, lesions can be removed safely. Not until the 19 th century, an increase in primary surgical therapy for the disease (mainly radical mastectomies) was becoming evident due to the teachings of Morgagni, in addition to a complete re-conceivement of the etiological process of the disease by Le Dran. Currently, practitioners have achieved a very high level of proficiency in treating the disease via continuous refinement of the aforementioned facts. This resulted in tissue and organ sparing local surgical approaches, including wide local excisions through para-areolar incisions and even skin and nipple-sparing mastectomies, which have long overpassed the unnecessary and primitive high morbidity approaches performed in the earlier attempts to treat breast cancer. KEYWORDS breast surgery techniques, breast cancer treatment, breast history Early history of breast cancer Currently, breast cancer (BC) surgical excision remains the gold standard for treating the disease and due to its significant social and economic impact, researchers and clinicians have attempted to identify the pathogenic processes giving rise to the disease. However it took centuries for medical practitioners to reach these conclusions. Nonetheless, even throughout the ages breast cancer has been capturing the attention of medicine and surgery practitioners universally, with the Smith Surgical Papyrus (3000-2500 b.c.
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