Cardiovascular Morbidity and Mortality After Treatment for Ductal Carcinoma In Situ of the Breast

Boekel, Naomi B.; Schaapveld, Michael; Gietema, Jourik A.; Rutgers, Emiel J. T.; Versteegh, Michel I.M.; Visser, Otto; Aleman, Berthe M.P.; Leeuwen, Flora E. van

doi:10.1093/jnci/dju156

Cited by 34 publications

(30 citation statements)

References 24 publications

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“…The critical point in survival care appears after the discharge from oncology or specialist care, when these women remain at long-term risk of complications due to treatment and the risk of relapses [13]. However, it is not clear whether women who have received cancer therapy are more likely to develop other comorbidities than those without a history of cancer [14]. Because of this, it is essential that breast cancer survivors, besides breast cancer specific prevention, receive the standardized preventive care as the women without cancer history.…”

Section: Introductionmentioning

confidence: 99%

Health care services use among long-term breast cancer survivors: a systematic review

et al. 2019

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Purpose Long-term breast cancer survivors are women surviving at least 5 years after diagnosis. This systematic review aimed to summarize the main characteristics and patterns of healthcare service use (frequency of visits, health providers visited, and preventive care performed) among long-term breast cancer survivors. Methods We used standard Cochrane Collaboration methods and searched the MEDLINE and EMBASE databases up to January 2018. We included English language observational studies reporting health service use among long-term cancer survivors. The quality of the studies was appraised through the ROBINS-I assessment tool. Two independent reviewers performed both the study quality assessment and the data extraction. Results A total of 23 observational studies were included that reported data on health services use by long-term breast cancer survivors. Despite heterogeneity among studies, about half of them reported that breast cancer survivors visited a medical provider at least once a year, as recommended by breast cancer survival guidelines. Although survivors visited medical providers with the recommended frequency, a substantial number used specialist care instead of primary care during follow-up. The results showed underuse of the recommended annual mammogram. Conclusions Long-term breast cancer survivors differ in their health services use with regard to the frequency of visits as well as the health providers seen. Our results indicate the need for active surveillance through primary care providers in coordination with specialized care. Implications for cancer survivors This review could help to standardize the management of breast cancer survivors and decisionmakers to adapt their guidelines and clinical protocols.

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Section: Introductionmentioning

confidence: 99%

Health care services use among long-term breast cancer survivors: a systematic review

et al. 2019

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“…107,114,115 The reductions in mortality risk have been attributed to modern radiotherapy techniques, leading to reduction in dose delivery to the heart and coronary arteries. The transition to megavoltage radiotherapy systems has reduced the mean dose to the heart by approximately 50% (4.7-2.3 Gy), 116 while other contributors to dose reduction include breath-hold techniques, respiratory gating and prone positioning.…”

Section: 97mentioning

confidence: 99%

Is the false-positive rate in mammography in North America too high?

Le¹,

Mothersill²,

Seymour³

et al. 2016

BJR

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The practice of investigating pathological abnormalities in the breasts of females who are asymptomatic is primarily employed using X-ray mammography. The importance of breast screening is reflected in the mortality-based benefits observed among females who are found to possess invasive breast carcinoma prior to the manifestation of clinical symptoms. It is estimated that population-based screening constitutes a 17% reduction in the breast cancer mortality rate among females affected by invasive breast carcinoma. In spite of the significant utility that screening confers in those affected by invasive cancer, limitations associated with screening manifest as potential harms affecting individuals who are free of invasive disease. Disease-free and benign tumour-bearing individuals who are subjected to diagnostic work-up following a screening examination constitute a population of cases referred to as false positives (FPs). This article discusses factors contributing to the FP rate in mammography and extends the discussion to an assessment of the consequences associated with FP reporting. We conclude that the mammography FP rate in North America is in excess based upon the observation of overtreatment of in situ lesions and the disproportionate distribution of detriment and benefit among the population of individuals recalled for diagnostic work-up subsequent to screening. To address the excessive incidence of FPs in mammography, we investigate solutions that may be employed to remediate the current status of the FP rate. Subsequently, it can be suggested that improvements in the breast-screening protocol, medical litigation risk, image interpretation software and the implementation of image acquisition modalities that overcome superimposition effects are promising solutions.

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“…This should also include the fact that the risk of severe late adverse effects due to RT is low nowadays if RT is performed according to guideline recommendations [2,21,22]. A recent population-based study from the Netherlands found no increased risk for cardiovascular morbidity or mortality in patients with DCIS treated with postoperative RT [23]. …”

Section: Results Of Rt In Low-risk Dcis: the Rtog 9804 Trialmentioning

confidence: 99%

Radiotherapy of Ductal Carcinoma In Situ

Krug

Souchon

2015

Breast Care

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Ductal carcinoma in situ (DCIS) is a heterogeneous disease in both its biology and clinical course. In the past, recurrence rates after breast-conserving surgery have been as high as 30% after 10 years. The introduction of mammography screening and advances in imaging have led to an increase in the detection of DCIS. The focus of this review is on the role of radiotherapy in the multidisciplinary treatment, including current developments in hypofractionation and boost delivery, and attempts to define low-risk subsets of DCIS for which the need for adjuvant radiation is repeatedly questioned.

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Cardiovascular Morbidity and Mortality After Treatment for Ductal Carcinoma In Situ of the Breast

Cited by 34 publications

References 24 publications

Health care services use among long-term breast cancer survivors: a systematic review

Health care services use among long-term breast cancer survivors: a systematic review

Is the false-positive rate in mammography in North America too high?

Radiotherapy of Ductal Carcinoma In Situ

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