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Evidence-Based Breast Cancer Prevention: The Importance of Individual Risk

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Breast cancer generally originates in the tissues of the ducts and lobules of the breast. From past 25 years, screening mammography is the mainstay for the prevention of breast cancer. From past 2 years, 64% of women aged 40 to 49 years and 72% of women aged 50 to 65 years have undergone screening mammography. 63% of women in U.S are routinely screen mammography every 9 to 20 months.

U.S. Preventive Services Task Force (USPSTF) recommends universal screening mammography for women aged 40 to 49 years based on specific benefits and harms considered in women. 60% of false-positive results appeared in age group of 40 years. Biopsy rates were slightly lower in women age group of 40 to 49 when compared to women aged 50 to 69 years.

Improvement in primary and secondary breast cancer prevention is effective by implementing the risk assessment in primary care, mammography facilities and should provide tailored recommendations for prevention based on individual risk. The age to initiate screening and continue screening is above 70 years and should be dependent on the pretest risk for disease. Strategies should be considered to minimize harm and maximize prevention of the disease. Routine assessment of risk factors, calculating the breast cancer risk, and reporting risk in women and care providers in an easily understandable format should be implemented.

Screening mammography in women aged 70 to 74 years should be considered in general health, presence of comorbidies, and willingness to have additional tests and treatment of clinically insignificant breast lesion.

Prescribing tamoxifen and raloxifene have been shown to reduce the risk for invasive breast cancer, as reported in recent systematic reviews. Benefits of chemoprevention outweigh the harms for women aged 35 to 60 years.

Health professionals need to educate about communication skill regarding the risks of breast cancer in women. Potential benefits and harms of preventing interventions and understanding the factors to assist women and influence the choice of intervention.

Source: http://www.annals.org/content/151/10/750.full.

Written by: healthplus24.com team

Date last updated: December 09, 2014

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