Is Clinical Breast Examination Important for Breast Cancer Detection?

Provencher, Louise; Hogue, Jean-Charles; Desbiens, Christine; Poirier, Brigitte; Poirier, Éric; Boudreau, Dominique K.; Joyal, Marilyne; Diorio, Caroline; Duchesne, Nathalie; Chiquette, Jocelyne

doi:10.3747/co.23.2881

Cited by 69 publications

(60 citation statements)

References 42 publications

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“…In contrast with cancers detected by mammography alone, those detected by clinical breast examination had more aggressive features. Clinical breast examination (CBE) is a low-cost assessment that could improve the detection of breast cancer and could prompt breast ultrasonography in the case of a negative mammogram (11).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Treatment Failure for Early Breast Cancer after Breast Conserving Surgery

Aldaqaf¹,

Brătucu²

2018

chr

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RezumatIntroducere: Cancerul de sân este cel mai frecvent tip de cancer la femeile din ţările occidentale dezvoltate şi devine şi mai semnificativ în multe ţări în curs de dezvoltare. Chirurgia de conservare a sânilor a devenit standardul de aur pentru pacienţii cu cancer de sân (stadiul I, II) cu cancer de sân timpuriu, cu o selecţie adecvată a pacienţilor. Factori de risc importanţi pentru eşecul tratamentului, includ starea marginilor de rezecţie, vârsta, multicentricitatea tumorii şi utilizarea radioterapiei şi a terapiei hormonale adjuvante. Scopul: Stabilirea variabilelor de prognostic pentru recidiva tumorilor mamare ipsilaterale în cancer de sân incipient după chirurgia conservatoare de sân şi rata de supravieţuire. Materiale şi metodă: Am analizat 100 de paciente cu cancer de sân incipient care au suferit chirurgie de conservare a sânilor. Datele au fost analizate pentru eşecul tratamentului; analiza a fost efectuată prin test Chi-pătrat (χ 2 ), regresie multivariată Cox şi Kaplan Maier pentru analiza supravieţuirii. Rezultate: 100 de pacienţi au suferit chirurgie de conservare a sânilor pentru cancer de sân incipient. Au fost 75% dintre pacienţii cu vârsta peste 40 de ani. Tumorile T2 au fost observate la 87% dintre pacienţi şi la 53% dintre pacienţi au fost implicaţi noduli. Modelul de recurenţă a fost de 14%; Pe analiza multivariată, gradul şi marja tumorilor au fost corelate cu supravieţuirea locală fără boală. Supravieţuirea fără boală locală la 3 ani şi supravieţuirea globală a fost de 86% şi, respectiv, 97%. Results: 100 female patients underwent BCS for EBC. There were 75% of patients above 40 years old. T2 tumours were observed in 87% of patients and 53% patients had nodal involvement. There was a pattern of recurrence of 14%; Using the multivariate analysis tumour grade and margin were correlated to local disease free survival. The 3 years local disease free survival and overall survival was of 86 % and 97% respectively. Conclusion: Breast conservative surgery is a highly accepted surgery for early breast cancer with good result. Tumour grade and margin were correlated to local disease free survival.

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Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Treatment Failure for Early Breast Cancer after Breast Conserving Surgery

Aldaqaf¹,

Brătucu²

2018

chr

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“…Particularly for women less than 50 and more than 69 years of age, in the moderate‐ and high‐risk groups, it is recommended that CBE should be a part of routine periodic examinations by trained healthcare professionals (Provencher et al. ) and in older women (Jatoi ; Schwab et al. ).…”

Section: Discussionmentioning

confidence: 99%

“…CBE is a low cost tool advocated widely in low-resource and middle-resource countries (Anderson et al 2011;Gelband et al 2016). Particularly for women less than 50 and more than 69 years of age, in the moderate-and high-risk groups, it is recommended that CBE should be a part of routine periodic examinations by trained healthcare professionals (Provencher et al 2016) and in older women (Jatoi 2015;Schwab et al 2015).…”

Section: Discussionmentioning

confidence: 99%

Targeting breast cancer outcomes‐what about the primary relatives?

Johnston

Sugrue

2017

Molec Gen & Gen Med

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BackgroundUp to 65% of newly diagnosed breast cancer patients had not been screened correctly before diagnosis resulting in increased stage of cancer at presentation. This study assessed whether their primary relatives are, in turn, assessed appropriately.MethodsAn ethically approved prospective study involving 274 primary relatives of women diagnosed with breast cancer, between 2009–2012, at a symptomatic breast unit in Ireland. Telephone interview established: demographics, menstrual history, family history verification, breast screening history. Personal risk level was calculated and whether current screening met screening guidelines. Participants were enrolled into appropriate screening programs if currently not in one and results analyzed.ResultsTwo hundred and fifteen of the 280 (76.8%) newly diagnosed patients responded giving details of their 274 primary relatives; this made up the study cohort. Mean age 50 ± 10 (35–75). Thirty two percent were low risk, 64% moderate and 4% high. 190/274 (69%) were being screened appropriately. Seventy five relatives were then assessed with: mammography in 55, Mg and US in 16. Four underwent a biopsy and to date none had cancer. Surveillance was: annual screening in 48%; national screening program and General Practitioner (GP) in 33%; GP only in over 65s in 13%; 6% await further assessment at specialist genetics clinics where their surveillance will be decided.ConclusionsThis study has identified an opportunity to improve the delivery of appropriate screening to higher risk primary relatives of patients with breast cancer. This necessitates an integrated national approach involving providers of primary care, patients and screening breast programs.

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“…The decision was based on clinical experience, expected risks and benefits 9 , and current opposing guidelines. Recently, a retrospective study concluded that a significant number of cancers would have been missed if clinical breast exams had not been performed 61 .…”

Section: Discussionmentioning

confidence: 99%

Recommendations on Breast Cancer Screening and Prevention in the Context of Implementing Risk Stratification: Impending Changes to Current Policies

Gagnon

Lévesque

Borduas³

et al. 2016

Current Oncology

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In recent years, risk stratification has sparked interest as an innovative approach to disease screening and prevention. The approach effectively personalizes individual risk, opening the way to screening and prevention interventions that are adapted to subpopulations. The international perspective project, which is developing risk stratification for breast cancer, aims to support the integration of its screening approach into clinical practice through comprehensive tool-building. Policies and guidelines for risk stratification-unlike those for population screening programs, which are currently well regulated-are still under development. Indeed, the development of guidelines for risk stratification reflects the translational aspects of perspective.Here, we describe the risk stratification process that was devised in the context of perspective, and we then explain the consensus-based method used to develop recommendations for breast cancer screening and prevention in a risk-stratification approach. Lastly, we discuss how the recommendations might affect current screening policies.

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Is Clinical Breast Examination Important for Breast Cancer Detection?

Abstract: Background Screening clinical breast examination (cbe) is controversial; the use of cbe is declining not only as a

Cited by 69 publications

References 42 publications

Prognostic Factors of Treatment Failure for Early Breast Cancer after Breast Conserving Surgery

Prognostic Factors of Treatment Failure for Early Breast Cancer after Breast Conserving Surgery

Targeting breast cancer outcomes‐what about the primary relatives?

Recommendations on Breast Cancer Screening and Prevention in the Context of Implementing Risk Stratification: Impending Changes to Current Policies

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