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NCCN Clinical Practice Guidelines in Oncology. Breast Cancer, Version 3

Journal of the National Comprehensive Cancer Network: JNCCN (Impact Factor: 4.24). 11/2009; 7(10):1060-96.
Source: PubMed

ABSTRACT The goal of these guidelines is to give health care providers a practical and consistent framework for screening and evaluating a spectrum of breast lesions. Clinical judgment should always be an important component of optimal patient management. If the physical breast examination, radiologic imaging, and pathologic findings are not concordant, the clinician should carefully reconsider the assessment of the patient's problem. Involving patients in treatment decisions empowers them to determine an acceptable level of breast cancer risk in the screening and/or follow-up procedures.

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Available from: Benjamin Olney Anderson, May 05, 2014
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    • "For example, women in the current sample are relatively young compared to current recommended guidelines by the U.S. Preventive Services Task Force (2009). However , the women were within the range of guidelines per the American Cancer Society (2014b) and the National Comprehensive Cancer Network (Bevers et al., 2009). Although the current sample included women living in rural and urban areas, the sample was underpowered to test differences in rural and urban women's experiences. "
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    ABSTRACT: Purpose/Objectives: To explore ethnic differences in psychological distress and social withdrawal after receiving an abnormal mammogram result and to assess if coping strategies mediate ethnic differences. Design: Descriptive correlational. Setting: Two urban mobile mammography units and a rural community hospital in the state of Washington. Sample: 41 Latina and 41 non-Latina Caucasian (NLC) women who had received an abnormal mammogram result. Methods: Women completed standard sociodemographic questions, Impact of Event Scale-Revised, the social dimension of the Psychological Consequences Questionnaire, and the Brief COPE. Main Research Variables: Ethnicity, psychological distress, social withdrawal, and coping. Findings: Latinas experienced greater psychological distress and social withdrawal compared to NLC counterparts. Denial as a coping strategy mediated ethnic differences in psychological distress. Religious coping mediated ethnic differences in social withdrawal. Conclusions: Larger population-based studies are necessary to understand how ethnic differences in coping strategies can influence psychological outcomes. This is an important finding that warrants additional study among women who are and are not diagnosed with breast cancer following an abnormal mammogram. Implications for Nursing: Nurses may be able to work with Latina patients to diminish denial coping and consequent distress. Nurses may be particularly effective, given cultural values concerning strong interpersonal relationships and respect for authority figures.
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    • "For example, small breast cancers in BRCA1 carriers are more aggressive than average cancers [7] and over-diagnosis is less of a problem [8], but there is also a high mortality associated with small node-negative hereditary cancers [7] and there is little correlation between tumor size and survival for small BRCA1-positive cancers [7] [9]. MRI has now been adopted widely for screening of mutation carriers [10] [11]. Studies to date that support the use of MRI in BRCA1 carriers are based on sensitivity [12] [13] [14] and not on mortality and we should not take a mortality benefit for granted. "
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    ABSTRACT: •Personalized medicine is a response to emerging technologies and commercialization•Testing for high risk genes will not impact on global cancer rates.•Testing for low risk genes has little promise for preventing cancer.•The impact of new technologies should be evaluated from a population perspective•We must consider alternate ways to deliver information in the clinic.•Genetic tests will have most potential for impact if made available to all.
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    • "In this respect, clinical early-staging programmes in LMCs such as clinical breast examination and breast selfexamination screening could be an appealing alternative and thus the National Comprehensive Cancer Network (NCCN) recommended clinical breast examination and breast self-awareness as appropriate steps for screening and diagnosis of breast cancer (Bevers et al., 2009). Moreover, breast self-examination may be an effective primary tool to promote in breast health education and this contributes towards increased general awareness when initiating new programmes for early breast cancer detection. "
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    ABSTRACT: Low-income and middle-income countries (LMCs), beset with challenges like socio-economical, infrastructural and massive epidemics of infectious diseases; are also currently being heavily burden with chronic diseases which will further affect not only the individual but also threaten the economic development of the communities and countries. Cancers are among the major causes and in 2008, an estimated 56% of the 12.7 million new cancer cases and 63% of the 7.6 million cancer deaths in the world were in developing countries [1]. World-wide breast cancer is the most frequent cause of cancer death in women and the second leading oncological causes of death in women in Africa [1,2]. The incidence of breast cancer in Asia peaks among women in their forties, whereas in high-income countries it peaks among women in their sixties [3]. LMCs already accounted for the 45% of the breast cancer incidence and 54% of the annual breast cancer deaths around the globe [4]. Moreover, the projected global breast cancer cases will grow from 1.4 million in 2008 to over 2.1 million cases in 2030 [5]. The mortality rates in LMCs are disproportionately higher due to late-stage presentation and due to limited diagnostic and treatment facilities. Notably, successful implementation of early detection programmes in the general population is more challenging in these settings due to barriers like lack of education, misconceptions, sociocultural, economic, health systems issues, fatalism, low compliance towards screening and poor governance [4-6]. In this respect, clinical early-staging programmes in LMCs such as clinical breast examination (CBE) and breast self examination (BSE) screening could be an appealing alternative and thus the National Comprehensive Cancer Network (NCCN) recommended CBE and breast self-awareness as appropriate steps for breast cancer screening and diagnosis [7]. Moreover, BSE may be an effective primary tool to promote through in breast health education and this contributes to increased general awareness when initiating new programmes for early breast-cancer detection. In Malaysia, a programme with skilled health staff and raising public awareness resulted in a decrease in stage III–IV tumours from 60% to 35% in 4 years [6]. Abuidris and colleagues showed that the implementation of a breast-cancer screening programme using local non-medical volunteers is feasible in rural Sudanese communities and this could be a global generic approach of importance to researcher and policy makers to further develop to promote changing the attitudes of populations and government towards cancer awareness and interventions [2]. Farhat Yaqub reported the Punjab’s cancer awareness campaign programme launched by the Government of Punjab, India early this year by the voluntary involvement of the trained community outreach workers. This is an excellent example of a population-based approach to raising awareness programme worthy of being followed by other LMCs [8]. Lastly, another important example of interventions to increase breast cancer awareness is the impact of the annual breast cancer awareness month (BCAM) campaign, reported by the Glynn and colleagues. This was highly successful in motivating online activity on breast cancer early detection and control, which holds useful lessons for other cancer awareness initiatives [9]. In addition to focusing on education at all levels, mass communication devices like electronic media (e.g. national televisions, radios, internet) and printed media (national news papers) is to be utilized. Also, breast cancer survivors can help bolster the importance of early diagnosis and treatment. In many settings, involvement of religious and other community leaders in promoting screening and self-awareness programmes might also help to improve participation and outcomes [2,4,6]. In general, in addition to the search for appropriate and feasible screening approaches, raising public awareness and access programmes should be a priority. It will enhance up-coming innovative approaches to control breast cancer to be more effective within the diversity that exists in low resource settings [10]. 1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 12:2893-917. 2. Abuidris DO, Elsheikh A, Ali M, Musa H, Elgaili E, Ahmed AO, Sulieman I, Mohammed SI. Breast-cancer screening with trained volunteers in a rural area of Sudan: a pilot study. Lancet Oncol. 2013; 4:363-70. 3. Leong SP, Shen ZZ, Liu TJ, Agarwal G, Tajima T, Paik NS, Sandelin K, Derossis A, Cody H, Foulkes WD. Is breast cancer the same disease in Asian and Western countries? World J Surg. 2010; 10:2308-24. 4. Anderson BO. Understanding social obstacles to early breast cancer detection is critical to improving breast cancer outcome in low- and middle-resource countries. Cancer 2010; 19:4436- 9. 5. Story HL, Love RR, Salim R, Roberto AJ, Krieger JL, Ginsburg OM. Improving outcomes from breast cancer in a low-income country: lessons from Bangladesh. Int J Breast Cancer 2012; 2012:423562. 6. Harford JB. Breast-cancer early detection in low-income and middle- income countries: do what you can versus one size fits all. Lancet Oncol 2011; 3:306-12. 7. Bevers TB, Anderson BO, Bonaccio E, Buys S, Daly MB, Dempsey PJ, Farrar WB, Fleming I, Garber JE, Harris RE, Heerdt AS, Helvie M, Huff JG, Khakpour N, Khan SA, Krontiras H, Lyman G, Rafferty E, Shaw S, Smith ML, Tsangaris TN, Williams C, Yankeelov T. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis. J Natl Compr Canc Netw 2009; 7:1060-96. 8. Farhat Yaqub. Punjab’s cancer awareness campaign. Lancet Oncol, News. 2013; 14 9. Glynn RW, Kelly JC, Coffey N, Sweeney KJ, Kerin MJ. The effect of breast cancer awareness month on internet search activity--a comparison with awareness campaigns for lung and prostate cancer. BMC Cancer 2011; 11:442. 10. Bridges JFP, Anderson BO, Buzaid AC, Jazieh AR, Niessen LW, Blauvelt BM, Buchanan D: Identifying important breast cancer control strategies in Asia, Latin America and the Middle East/North Africa. BMC Health Serv Res 2011; 11:227
    European Journal of Cancer Prevention 10/2013; 23(4). DOI:10.1097/CEJ.0000000000000043 · 2.76 Impact Factor
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