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Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors 风险调整的癌症筛查和预防(RiskAP):基于风险因素的学习筛查对早期疾病检测的补充筛查
IF 2.1 4区 医学
Breast Care Pub Date : 2021-08-12 DOI: 10.1159/000517182
R. Schmutzler, Björn Schmitz-Luhn, B. Borisch, P. Devilee, D. Eccles, P. Hall, J. Balmaña, S. Boccia, P. Dabrock, G. Emons, W. Gaissmaier, J. Gronwald, S. Houwaart, S. Huster, K. Kast, A. Katalinic, S. Linn, S. Moorthie, P. Pharoah, K. Rhiem, T. Spranger, D. Stoppa-Lyonnet, J. V. van Delden, M. Van den Bulcke, C. Woopen
{"title":"Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors","authors":"R. Schmutzler, Björn Schmitz-Luhn, B. Borisch, P. Devilee, D. Eccles, P. Hall, J. Balmaña, S. Boccia, P. Dabrock, G. Emons, W. Gaissmaier, J. Gronwald, S. Houwaart, S. Huster, K. Kast, A. Katalinic, S. Linn, S. Moorthie, P. Pharoah, K. Rhiem, T. Spranger, D. Stoppa-Lyonnet, J. V. van Delden, M. Van den Bulcke, C. Woopen","doi":"10.1159/000517182","DOIUrl":"https://doi.org/10.1159/000517182","url":null,"abstract":"Background: Risk-adjusted cancer screening and prevention is a promising and continuously emerging option for improving cancer prevention. It is driven by increasing knowledge of risk factors and the ability to determine them for individual risk prediction. However, there is a knowledge gap between evidence of increased risk and evidence of the effectiveness and efficiency of clinical preventive interventions based on increased risk. This gap is, in particular, aggravated by the extensive availability of genetic risk factor diagnostics, since the question of appropriate preventive measures immediately arises when an increased risk is identified. However, collecting proof of effective preventive measures, ideally by prospective randomized preventive studies, typically requires very long periods of time, while the knowledge about an increased risk immediately creates a high demand for action. Summary: Therefore, we propose a risk-adjusted prevention concept that is based on the best current evidence making needed and appropriate preventive measures available, and which is constantly evaluated through outcome evaluation, and continuously improved based on these results. We further discuss the structural and procedural requirements as well as legal and socioeconomical aspects relevant for the implementation of this concept.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"17 1","pages":"208 - 223"},"PeriodicalIF":2.1,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46321367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
PharmaNews PharmaNews
IF 2.1 4区 医学
Breast Care Pub Date : 2021-08-01 DOI: 10.1159/000518907
{"title":"PharmaNews","authors":"","doi":"10.1159/000518907","DOIUrl":"https://doi.org/10.1159/000518907","url":null,"abstract":"Das biologische Tumorprofil nimmt in der Behandlung des Mammakarzinoms eine entscheidende Rolle ein: Es ist ein zentraler Faktor bei der Therapiewahl – und beeinflusst maßgeblich die Prognose der Patientinnen. Während beispielsweise beim HER2-positiven Mammakarzinom die Prognose durch die Entwicklung perso-nalisierter Behandlungsstrategien wie Perjeta® (Pertuzumab), Kadcyla® (Trastuzumab-Emtansin) oder das jüngst zugelassene Kombinationspräparat Phesgo® enorm verbessert wurde, gilt das TNBC nach wie vor als ein schwer zu behandelnder Subtyp mit äußerst ungünstiger Prognose [1]. Einen bedeutsamen Fortschritt in der Behandlung des TNBC bietet die Krebsimmuntherapie mit Tecentriq (Atezolizumab) – bislang ist der PD-L1-Inhibitor in Kombination mit nab-Paclitaxel aber nur im fortgeschrittenen Krankheitsstadium zugelassen [2]. * pCR = pathologische Komplettremission.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"16 1","pages":"433 - 434"},"PeriodicalIF":2.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47698107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Front & Back Matter 正面和背面
IF 2.1 4区 医学
Breast Care Pub Date : 2021-08-01 DOI: 10.1159/000519184
B. Gulluoglu, V. Hanf
{"title":"Front & Back Matter","authors":"B. Gulluoglu, V. Hanf","doi":"10.1159/000519184","DOIUrl":"https://doi.org/10.1159/000519184","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46336477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Consensus Recommendations of the German Consortium for Hereditary Breast and Ovarian Cancer 德国遗传性乳腺癌和卵巢癌协会的共识建议
IF 2.1 4区 医学
Breast Care Pub Date : 2021-07-19 DOI: 10.1159/000516376
K. Rhiem, B. Auber, S. Briest, N. Dikow, N. Ditsch, Neda Dragicevic, S. Grill, E. Hahnen, J. Horváth, B. Jaeger, K. Kast, M. Kiechle, E. Leinert, S. Morlot, M. Püsken, Dieter Schäfer, S. Schott, C. Schroeder, U. Siebers-Renelt, C. Solbach, N. Weber-Lassalle, I. Witzel, C. Zeder-Göss, R. Schmutzler
{"title":"Consensus Recommendations of the German Consortium for Hereditary Breast and Ovarian Cancer","authors":"K. Rhiem, B. Auber, S. Briest, N. Dikow, N. Ditsch, Neda Dragicevic, S. Grill, E. Hahnen, J. Horváth, B. Jaeger, K. Kast, M. Kiechle, E. Leinert, S. Morlot, M. Püsken, Dieter Schäfer, S. Schott, C. Schroeder, U. Siebers-Renelt, C. Solbach, N. Weber-Lassalle, I. Witzel, C. Zeder-Göss, R. Schmutzler","doi":"10.1159/000516376","DOIUrl":"https://doi.org/10.1159/000516376","url":null,"abstract":"Background: The German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) has established a multigene panel (TruRisk®) for the analysis of risk genes for familial breast and ovarian cancer. Summary: An interdisciplinary team of experts from the GC-HBOC has evaluated the available data on risk modification in the presence of pathogenic mutations in these genes based on a structured literature search and through a formal consensus process. Key Messages: The goal of this work is to better assess individual disease risk and, on this basis, to derive clinical recommendations for patient counseling and care at the centers of the GC-HBOC from the initial consultation prior to genetic testing to the use of individual risk-adapted preventive/therapeutic measures.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"17 1","pages":"199 - 207"},"PeriodicalIF":2.1,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000516376","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41391862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Factors Indicating Surgical Excision in Classical Type of Lobular Neoplasia of the Breast 典型乳腺小叶性肿瘤手术切除的因素分析
IF 2.1 4区 医学
Breast Care Pub Date : 2021-07-07 DOI: 10.1159/000516609
C. Elfgen, C. Tausch, A. Rodewald, U. Güth, C. Rageth, V. Bjelic-Radisic, M. Fleisch, C. Kurtz, J. Gonzalez Diaz, Z. Varga
{"title":"Factors Indicating Surgical Excision in Classical Type of Lobular Neoplasia of the Breast","authors":"C. Elfgen, C. Tausch, A. Rodewald, U. Güth, C. Rageth, V. Bjelic-Radisic, M. Fleisch, C. Kurtz, J. Gonzalez Diaz, Z. Varga","doi":"10.1159/000516609","DOIUrl":"https://doi.org/10.1159/000516609","url":null,"abstract":"Purpose: Classical type of lobular neoplasia (LN) encompassing both atypical lobular hyperplasia and classical lobular carcinoma in situ of the breast is a lesion with uncertain malignant potential and has been the topic of several studies with conflicting outcome results. The aim of our study was to clarify outcome-relevant factors and treatment options of classical LN. Methods: We performed a pathological re-evaluation of the preoperative biopsy specimens and a retrospective clinical and radiological data analysis of 160 patients with LN from the Breast Center Zurich. Open surgery was performed in 65 patients, vacuum-assisted biopsy (VAB) in 79 patients, and surveillance after breast core needle biopsy (CNB) in 16 patients. Results: The upgrade rate into ductal carcinoma in situ/invasive cancer was the highest in case of imaging/histology discordance (40%). If the number of foci in the biopsy specimen was ≥3, the upgrade rate in the consecutive surgical specimens was increased (p = 0.01). The association of classical LN with histological microcalcification correlated with shortened disease-free survival (p < 0.01), whereas other factors showed no impact on follow-up. Conclusions: Surveillance or subsequent VAB after CNB of LN is sufficient in most cases. Careful consideration of individual radiological and histological factors is required to identify patients with a high risk of upgrade into malignancy. In those cases, surgical excision is indicated.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"17 1","pages":"121 - 129"},"PeriodicalIF":2.1,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000516609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48977029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Malignancy Rate and Malignancy Risk Assessment in Different Lesions of Uncertain Malignant Potential in the Breast (B3 Lesions): An Analysis of 192 Cases from a Single Institution 乳腺不同恶性潜能不确定病变(B3型病变)的恶性发生率及恶性风险评估:来自某机构192例病例分析
IF 2.1 4区 医学
Breast Care Pub Date : 2021-07-01 DOI: 10.1159/000517109
S. Mohrmann, Anna Maier-Bode, F. Dietzel, P. Reinecke, N. Krawczyk, T. Kaleta, U. Kreimer, G. Antoch, T. Fehm, Katrin Roth
{"title":"Malignancy Rate and Malignancy Risk Assessment in Different Lesions of Uncertain Malignant Potential in the Breast (B3 Lesions): An Analysis of 192 Cases from a Single Institution","authors":"S. Mohrmann, Anna Maier-Bode, F. Dietzel, P. Reinecke, N. Krawczyk, T. Kaleta, U. Kreimer, G. Antoch, T. Fehm, Katrin Roth","doi":"10.1159/000517109","DOIUrl":"https://doi.org/10.1159/000517109","url":null,"abstract":"Background: The question of how to deal with B3 lesions is of emerging interest. Methods: In the breast diagnostics of 192 patients between 2009 and 2016, a minimally invasive biopsy revealed a B3 lesion with subsequent resection. This study investigates the malignancy rate of different B3 subgroups and the risk factors that play a role in obtaining a malignant finding. Results: The distribution of B3 lesions after minimally invasive biopsy was as follows: atypical ductal hyperplasia (ADH), 7.3%; flat epithelial atypia (FEA), 7.8%; lobular neoplasia (LN), 7.8%; papilloma (Pa), 49.5%; phylloidal tumour (PT), 8.9%; radial sclerosing scar (RS), 3.1%; mixed findings, 10.4%; and other B3 lesions, 5.2%. Most B3 lesions were detected by stereotactic vacuum-assisted biopsy (44.3%), 36.5% by ultrasound-assisted biopsy, and 19.3% by magnetic resonance imaging-assisted biopsy. Most B3 lesions (55.2%) were verified by surgical resection, whereas 30.7% were downgraded to a benign lesion. About 14.1% of the cases were upgraded to malignant lesions, 9.4% to ductal carcinoma in situ and 4.7% to invasive carcinoma. In relation to individual B3 lesions, the following malignancy rates were found: 28.6% (ADH), 13.3% (FEA), 33.3% (LN), 12.6% (Pa), 5.9% (PT), and 0% (RS). The most important risk factor was increasing age. Postmenopausal status was considered an increased risk for an upgrade (p = 0.015). A known malignancy in the ipsilateral breast was a significant risk factor for a malignant upgrade (p = 0.003). Conclusion: Increasing knowledge about B3 lesions allows us to develop a “lesion-specific” therapy approach in the heterogeneous group of B3 lesions, with follow-up imaging for some lesions with less malignant potential and concordance with imaging or further surgical resection in cases of disconcordance with imaging or higher malignant potential.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"17 1","pages":"159 - 165"},"PeriodicalIF":2.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000517109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44651365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Recommendation and Acceptance of Counselling for Familial Cancer Risk in Newly Diagnosed Breast Cancer Cases 新诊断癌症患者家族性癌症风险咨询的推荐与接受
IF 2.1 4区 医学
Breast Care Pub Date : 2021-06-17 DOI: 10.1159/000517021
K. Kast, Julia Häfner, E. Schröck, A. Jahn, C. Werner, C. Meisel, P. Wimberger
{"title":"Recommendation and Acceptance of Counselling for Familial Cancer Risk in Newly Diagnosed Breast Cancer Cases","authors":"K. Kast, Julia Häfner, E. Schröck, A. Jahn, C. Werner, C. Meisel, P. Wimberger","doi":"10.1159/000517021","DOIUrl":"https://doi.org/10.1159/000517021","url":null,"abstract":"Background: In clinical routine, not every patient who is offered genetic counselling and diagnostics in order to investigate a familial cancer risk predisposition opts for it. Little is known about acceptance of counselling and testing in newly diagnosed breast cancer cases in Germany. Methods: All primary breast cancer cases and patients with DCIS (ductal carcinoma in situ) treated at the University Hospital of Dresden between 2016 and 2019 were included. The number of tumor board recommendations for genetic counselling on the basis of the GC-HBOC risk criteria was recorded. Acceptance was analyzed by number of cases with counselling in the GC-HBOC-Center Dresden. Results: Of 996 primary breast cancer and DCIS cases, 262 (26.3%) were eligible for genetic counselling. Recommendation for genetic counselling was accepted by 64.1% (168/262). Of these 90.5% (152/168) opted for molecular genetic analysis. The acceptance rate for counselling increased between 2016 and 2019 from 58.3 to 72.6%. Altogether, 20.4% (31/152) patients were found to carry a pathogenic variant in the breast cancer genes BRCA1 or BRCA2. Conclusion: Acceptance of recommendation is increasing as clinical consequences augment. Optimization in providing information about hereditary cancer risk and in accessibility of counselling and testing is required to further improve acceptance of recommendation.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"17 1","pages":"153 - 158"},"PeriodicalIF":2.1,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000517021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48914701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
PharmaNews PharmaNews
IF 2.1 4区 医学
Breast Care Pub Date : 2021-06-01 DOI: 10.1159/000517550
Sabine M. Rüdesheim, Frechen, Quelle
{"title":"PharmaNews","authors":"Sabine M. Rüdesheim, Frechen, Quelle","doi":"10.1159/000517550","DOIUrl":"https://doi.org/10.1159/000517550","url":null,"abstract":"In der endokrinen Therapie prämenopausaler Frauen mit HR+/HER2−, metastasiertem Mammakarzinom wird von der AGO Mamma in Kombination mit GnRH-Agonisten und Aromataseinhibitoren als einziger CDK4/6-Inhibitor mit Doppelplus (1b B ++) Ribociclib (Kisqali®)a empfohlen [1]. Basis dieser Bewertung sind die aktuellen Ergebnisse der Studie MONALEESA-7. Diese zeigen fast 5 Jahre Gesamtüberleben bei präund perimenopausalen Patientinnen mit HR+/HER2− metastasiertem Mammakarzinom [2]. Im Rahmen der Phase-III-Studie MONALEESA-7 wurde die Kombinationstherapie mit Ribociclib und endokriner Therapie aus Goserelin sowie entweder einem Aromatasehemmer oder Tamoxifenb als initiale Therapiec mit einer alleinigen endokrinen Therapie bei präund perimenopausalen Frauen mit HR+/HER2– metastasiertem Mammakarzinom verglichen [2]. a Ribociclib ist zugelassen zur Behandlung von Frauen mit einem Hormonrezeptor (HR)-positiven, humanen epidermalen Wachstumsfaktor-Rezeptor-2 (HER2) negativen, lokal fortgeschrittenen oder metastasierten Mammakarzinom in Kombination mit einem Aromatasehemmer oder Fulvestrant als initiale endokrin-basierte Therapie oder bei Frauen mit vorangegangener endokriner Therapie. Bei präoder perimenopausalen Frauen sollte die endokrine Therapie mit einem LHRH (Luteinising Hormone-Releasing Hormone)-Agonisten kombiniert werden. b Ribociclib ist gemäß Fachinformation nicht für die Kombination mit Tamoxifen zugelassen. c Chemotherapie war im Vorfeld erlaubt, 14% der Studienteilnehmerinnen hatten diese bereits erhalten.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"16 1","pages":"315 - 318"},"PeriodicalIF":2.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000517550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48842091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Junge Patientinnen mit frühem HER2-positivem Brustkrebs 早期HER2-阳性乳腺癌症的年轻患者
IF 2.1 4区 医学
Breast Care Pub Date : 2021-06-01 DOI: 10.1159/000517549
{"title":"Junge Patientinnen mit frühem HER2-positivem Brustkrebs","authors":"","doi":"10.1159/000517549","DOIUrl":"https://doi.org/10.1159/000517549","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"16 1","pages":"312 - 314"},"PeriodicalIF":2.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000517549","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43685198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Front & Back Matter 正面和背面
IF 2.1 4区 医学
Breast Care Pub Date : 2021-06-01 DOI: 10.1159/000517784
B. Gulluoglu, V. Hanf
{"title":"Front & Back Matter","authors":"B. Gulluoglu, V. Hanf","doi":"10.1159/000517784","DOIUrl":"https://doi.org/10.1159/000517784","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45956778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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