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Flashcards in Breast cancer screening Deck (17)
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1

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

2

Sensitivity vs specificity of BSE vs CBE vs Mammography?

BSE: 12-14% low

CBE:
Low sensitivity
High specificity

Mammography
High ish sensitivity
High specificity

3

Average time for CBE

3 min

4

Under the age of 30, what is the likely single breast lump?

Fibroadenoma

5

what is the likely single breast lump in:
Women 30s-40s

1. Fibroadenoma
2. Fibrocystic change
3. Atypical hyperplasia
4. Other benign problem

6

what is the likely single breast lump in:
50 and older

Cyst
Non-invasive cancer

7

Pt

10 year risk?
- 2,.4% (screen at 50)

1.1% (Never screen bc she never pasts 2.4% threshold)

47% (screen at 44)

8

clinical breast exams are best at detection what size lesions?

>1 cm

9

Mammography
- 2 indications for
- how do breast cancers appear?

1. Screening
2. Diagnostic

BC appear white on mammograms
*but so do dense breasts in young women

10

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

11

Categories in BI-RADS (1-6)

Category 0 - incomplete, need more imaging
1. Negative
2. Benign
3. Probably benign
4. Suspicious
5. Highly suggestive of malignancy
6. Known biopsy proven malignancy

12

Leading and second risk factor for breast cancer

1. Being female
2. Older age >50
3. Genetic
*prolonged E exposure

13

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

14

1. Basic lvl of resource
2. Limited level of resource

1. Basic lvl of resource:
- applied in single clinical intxn
- Clinical hx and CBE
2. 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

15

3. Enhanced lvl resource
4. Maximum lvl resource

3. Enhanced lvl resource
- services increase the # and quality of therapeutic options and patient choice
- ie: diagnostic mammography

4. Maximum lvl resource
- do not adapt to resource constraints
- population based mammographic screening
- other imaging tech for high risk groups

16

ACS:
- when should women have choice to start annual mammograms?
- When should women start getting mammograms every year?
- BSE?

Choice - 40

Should - 45 every year
(if >55 then every 2 years)

*US prevent. task force:
- biennial mammography at 50

17

Deliberative model
- doctor should do what?
- Pt autonomy

Engage pt in dialog on what patient SHOULD do
- doctor is teacher/friend

autonomy: moral self development and look at alternatives