The Breast : official journal of the European Society of Mastology
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The aim of this study was to describe breast ductal carcinoma in situ (DCIS) incidence trends in women in the Girona province during a period of 25 years. The influence of age, use of mammography and implementation of the breast cancer screening programs was explored. Incidence of subsequent invasive breast cancers (IBC) and DCIS treatment was also considered. ⋯ The upward trend of DCIS was mainly related to an increase in mammography use either opportunistic or as a result of screening implementation.
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Review
Breast cancer early detection methods for low and middle income countries, a review of the evidence.
Organized national mammographic screening has been adopted as the gold standard for breast cancer early detection in western countries; however it may not be the most cost-effective approach to early detection in low and middle income countries (LMC) as it is very demanding in terms of human and financial resources. Moreover, its benefit to harm ratio has been questioned lately, particularly in women <50 years, the age group which produces the majority of breast cancer cases in LMC. ⋯ They are reviewed and discussed in the present paper, together with evidence about mammographic screening relevant to LMC. Alternative screening tests (clinical breast-exam and self breast-exam) are examined, then the pro- and cons- for various strategies (opportunistic screening, population based screening and clinical downstaging) are discussed.
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To assess the feasibility of lymphatic mapping and determine the lymphatic drainage pathways in patients previously treated with breast conserving therapy (BCT). ⋯ Lymphatic mapping seems feasible after previous BCT with axillary treatment, in spite of a relatively low identification rate. Aberrant drainage tends to be more frequent after previous treatment with ALND.
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The purpose of our study was to evaluate the accuracy of axillary ultrasound and ultrasound-guided fine needle aspiration cytology (FNAC) in the preoperative diagnosis of axillary metastases. ⋯ 106/429 (24.7%) Node-positive axillae were identified by ultrasound-guided FNAC and spared unnecessary sentinel node biopsy. Unfortunately, the percentage of false negative results of ultrasound-guided FNAC (28.1%, 323/1150) was very high.
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After introduction of sentinel node biopsy (SNB) in patients with breast cancer a higher proportion of micrometastases and isolated tumor cells are being detected. Prognostic impact and clinical relevance of this minimal nodal involvement is under debate and substantial variation in the use of axillary surgery and/or systemic adjuvant treatment could be expected. ⋯ Describing time-trends and predictors of axillary and systemic treatment of patients with breast cancer and micrometastases or isolated tumor cells in their sentinel lymph node(s).