Breast cancer is the leading site of new cancer cases in women. Breast cancer detection is currently primarily based on physical examination by health care professionals, chance findings by women, breast self-examination and mammography used for diagnosis or for routine screening. Early enough detection through mass screening with mammography has been introduced in many countries in the hope that early intervention would lead to reduced mortality and less aggressive treatment. The aim of this publication is to provide an independent, authoritative review of the evidence of the efficacy and effectiveness of breast cancer screening. This will be of value to governments, public health officials and others concerned with policy recommendations for cancer control.

The enormous expansion seen over the last decade in the mammo graphic detection of breast cancer lesions, especially the use of screen ing procedures for the early detection of clinically unsuspected tumors, has made it necessary to summarize the experience made by various centers in the world. The 2nd International Copenhagen Symposium on Detection of Breast Cancer afforded an opportunity of gathering scientists from all over the world to discuss the various problems of early breast cancer detection with special reference to screening procedures. This book forms a synthesis of the information presented by leading scientists from many of the world's mammo graphic centers, particularly those in Sweden and the USA. Hence, the reader will have the opportunity to study the outstanding work carried out by various institutes and centers of breast cancer screening. It is our sincere hope that a study of this volume will encourage other scientists to join in the work on screening procedures. S. Brunner B. Langfeldt P. E. Andersen Contents S. A. Feig: 1 Hypothetical Breast Cancer Risk from Mammography S. A. Feig: Benefits and Risks of Mammography 11 R. L. Egan and M. B. McSweeney: Multicentric Breast Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . 28 M. B. McSweeney and R. L. Egan: Breast Cancer in the Younger Patient: A Preliminary Report 36 M. B. McSweeney and R. L. Egan: Bilateral Breast Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . ' 41 N. Bjurstam: The Radiographic Appearance of Normal and Metastatic Axillary Lymph Nodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 M. Moskowitz, S. A. Feig, C. Cole-Beuglet, S. H.

Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.

Winner of the Council Chair's Choice Award at the 2019 British Medical Association Awards. Cancer Prevention and Screening offers physicians and all clinical healthcare professionals a comprehensive, useful source of the latest information on cancer screening and prevention with both a global and a multidisciplinary perspective. Includes background information on epidemiology, cancer prevention, and cancer screening, for quick reference Offers the latest information for clinical application of the most recent techniques in prevention and screening of all major and many lesser cancer types Emphasises the importance of multidisciplinary teamwork in cancer screening Highlights frequent dilemmas and difficulties encountered during cancer screening Provides clear-cut clinical strategies for optimal patient education, communication, and compliance with cancer prevention techniques

This book presents and discusses research in the study of breast cancer diagnosis and prevention. Topics discussed include strategies for the prevention of breast cancer; health benefits and breast cancer screenings; access to mammography facilities; the reduction in the risk of human breast cancer by selective cyclooxygenase-2 (COX-2) inhibitors and breast cancer perceptions and knowledge among women living in a rural community.

The outlook for women with breast cancer has improved in recent years. Due to the combination of improved treatments and the benefits of mammography screening, breast cancer mortality has decreased steadily since 1989. Yet breast cancer remains a major problem, second only to lung cancer as a leading cause of death from cancer for women. To date, no means to prevent breast cancer has been discovered and experience has shown that treatments are most effective when a cancer is detected early, before it has spread to other tissues. These two facts suggest that the most effective way to continue reducing the death toll from breast cancer is improved early detection and diagnosis. Building on the 2001 report Mammography and Beyond, this new book not only examines ways to improve implementation and use of new and current breast cancer detection technologies but also evaluates the need to develop tools that identify women who would benefit most from early detection screening. Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis encourages more research that integrates the development, validation, and analysis of the types of technologies in clinical practice that promote improved risk identification techniques. In this way, methods and technologies that improve detection and diagnosis can be more effectively developed and implemented.

Uniquely designed for oncologists and general practitioners, this book offers clinicians comprehensive guidelines when dealing with women at high risk for breast cancer. Written by experts in the field on the cutting edge of this research, the following questions will be answered for the reader by the end of the book: · Who is at elevated risk for breast cancer? · Who should be genetically screened? · When and how often should we obtain imaging? · What type of imaging is adequate? · What medications are available for prevention? · When is surgical intervention appropriate? · What lifestyle changes should be implemented to prevent this disaster? With one in eight women likely to contract breast cancer in her lifetime, the significance of identifying and managing the high-risk patient is evident. Breakthroughs in the identification of genes associated with breast carcinoma, particularly BRCA1 and 2, as well as other risk factors, influence not only how patients are screened, but also how they are treated. Breast Cancer Prevention and Treatment provides a guided approach to prevention of breast cancer in women at elevated risk for this malignancy.

Each year more than 180,000 new cases of breast cancer are diagnosed in women in the U.S. If cancer is detected when small and local, treatment options are less dangerous, intrusive, and costly-and more likely to lead to a cure. Yet those simple facts belie the complexity of developing and disseminating acceptable techniques for breast cancer diagnosis. Even the most exciting new technologies remain clouded with uncertainty. Mammography and Beyond provides a comprehensive and up-to-date perspective on the state of breast cancer screening and diagnosis and recommends steps for developing the most reliable breast cancer detection methods possible. This book reviews the dramatic expansion of breast cancer awareness and screening, examining the capabilities and limitations of current and emerging technologies for breast cancer detection and their effectiveness at actually reducing deaths. The committee discusses issues including national policy toward breast cancer detection, roles of public and private agencies, problems in determining the success of a technique, availability of detection methods to specific populations of women, women's experience during the detection process, cost-benefit analyses, and more. Examining current practices and specifying research and other needs, Mammography and Beyond will be an indispensable resource to policy makers, public health officials, medical practitioners, researchers, women's health advocates, and concerned women and their families.

'This book gives plenty of examples of ad hominem attacks, intimidation, slander, threats of litigation, deception, dishonesty, lies and other violations of good scientific practice. For some years I kept a folder labeled Dishonesty in breast cancer screening on top of my filing cabinet, storing articles and letters to the editor that contained statements I knew were dishonest. Eventually I gave up on the idea of writing a paper about this collection, as the number of examples quickly exceeded what could be contained in a single article.' From the Introduction The most effective way to decrease women's risk of becoming a breast cancer patient is to avoid attending screening. Mammography screening is one of the greatest controversies in healthcare, and the extent to which some scientists have sacrificed sound scientific principles in order to arrive at politically acceptable results in their research is extraordinary. In contrast, neutral observers increasingly find that the benefit has been much oversold and that the harms are much greater than previously believed. This groundbreaking book takes an evidence-based, critical look at the scientific disputes and the information provided to women by governments and cancer charities. It also explains why mammography screening is unlikely to be effective today. All health professionals and members of the public will find these revelations disturbingly illuminating. It will radically transform the way healthcare policy makers view mammography screening in the future. 'If Peter Gotzsche did not exist, there would be a need to invent him ...It may still take time for the limitations and harms of screening to be properly acknowledged and for women to be enabled to make adequately informed decisions. When this happens, it will be almost entirely due to the intellectual rigour and determination of Peter Gotzsche.' From the Foreword by Iona Heath, President, RCGP 'If you care about breast cancer, and we all should, you must read this book. Breast cancer is complex and we cannot afford to rely on the popular media, or on information from marketing campaigns from those who are invested in screening. We need to question and to understand. The story that Peter tells matters very much.' From the Foreword by Fran Visco, President, National Breast Cancer Coalition.

The optimal management of breast cancer patients relies on the expertise of a team of medical specialists including radiologists, surgeons, radiation therapists and medical oncologists. Much of the progress in breast cancer management made over the last several years reflects the translation of observations made in the laboratory to the clinic. Critically evaluating the impact of new treatment approaches relies on a commitment to well-designed clinical trials. In this volume, Advances in Breast Cancer Management, a renowned group of breast cancer experts have been asked to provide their perspective on management issues that directly effect patients on a day-to-day basis. Dr. Melody Cobleigh discusses the consequences of estrogen deprivation and the ways of ameliorating secondary symptoms and the potential long-term morbidity. Drs. Haigh and Guiliano review the sentinel lymph node biopsy technique including results from their extensive experience. Dr. Abram Recht places into perspective the potential benefit of post-mastectomy radiotherapy and reviews recent trials that address this issue. Dr. Dennis Slamon takes from us from the laboratory to the clinic in explaining the development of Herceptin as a paradigm for therapy targeted to specific molecular characteristics of breast cancer tumor cells. Drs. Nieto, Shpall, Crump and Pritchard offer different perspectives on the future of high-dose chemotherapy with stem cell transplantation as a treatment for breast cancer patients. Drs.