Breast cancer screening Flashcards
What age should women get a mammography?
ACS:
- Women 40-44 should have choice to start annual mammograms
- 45-54: annual mammograms
- > 55: biennial mammograms
U.S Prev. Services:
- Biennial screening 50-74
Insufficient to assess screening mammography >75
Sensitivity vs specificity of BSE vs CBE vs Mammography?
BSE: 12-14% low
CBE:
Low sensitivity
High specificity
Mammography
High ish sensitivity
High specificity
Average time for CBE
3 min
Under the age of 30, what is the likely single breast lump?
Fibroadenoma
what is the likely single breast lump in:
Women 30s-40s
- Fibroadenoma
- Fibrocystic change
- Atypical hyperplasia
- Other benign problem
what is the likely single breast lump in:
50 and older
Cyst
Non-invasive cancer
Pt
10 year risk?
- 2,.4% (screen at 50)
1.1% (Never screen bc she never pasts 2.4% threshold)
47% (screen at 44)
clinical breast exams are best at detection what size lesions?
> 1 cm
Mammography
- 2 indications for
- how do breast cancers appear?
- Screening
- Diagnostic
BC appear white on mammograms
*but so do dense breasts in young women
Are mammograms more or less sensitive in younger patients?
Less sensitive
Sensitivity:
- negative rules out
- low false negative
- probability that a test detects disease when disease is present
Categories in BI-RADS (1-6)
Category 0 - incomplete, need more imaging
- Negative
- Benign
- Probably benign
- Suspicious
- Highly suggestive of malignancy
- Known biopsy proven malignancy
Leading and second risk factor for breast cancer
- Being female
- Older age >50
- Genetic
* prolonged E exposure
What chromosomes are BRCA1 and 2 located on?
BRCA1:
Ch 17
BRCA2:
Ch 13
- abnl genes are inherited in AD pattern
- highly penetrant manner, with various expressivity
- Basic lvl of resource
2. Limited level of resource
- Basic lvl of resource:
- applied in single clinical intxn
- Clinical hx and CBE - Limited level of resource
- intended to produce major outcome improvements
- attainable with limited financial means and modest infrastructure
- Single or multiple clinical intxns
- targeted CBE for high risk groups
- Diagnostic breast US / mammography for + CBE
- Enhanced lvl resource
4. Maximum lvl resource
- Enhanced lvl resource
- services increase the # and quality of therapeutic options and patient choice
- ie: diagnostic mammography - Maximum lvl resource
- do not adapt to resource constraints
- population based mammographic screening
- other imaging tech for high risk groups
