Current Oncology

Editorial

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5 pages, 199 KiB

Open AccessEditorial

Progress and Remaining Gaps in the Early Detection and Treatment of Breast Cancer

by Jean M. Seely

Curr. Oncol. 2023, 30(3), 3201-3205; https://doi.org/10.3390/curroncol30030242 - 8 Mar 2023

Cited by 1 | Viewed by 2285

Abstract

Breast cancer affects too many of us [...] Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

Research

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12 pages, 1803 KiB

Open AccessArticle

Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients

by Roberta Rosso, Marta D’Alonzo, Valentina Elisabetta Bounous, Silvia Actis, Isabella Cipullo, Elena Salerno and Nicoletta Biglia

Curr. Oncol. 2023, 30(2), 1461-1472; https://doi.org/10.3390/curroncol30020112 - 21 Jan 2023

Cited by 18 | Viewed by 3984

Abstract

Background: Adjuvant endocrine therapy (AET) reduces breast cancer recurrence and mortality of women with hormone-receptor-positive tumors, but poor adherence remains a significant problem. The aim of this study was to analyze AET side effects and their impact on adherence to treatment. Methods: A [...] Read more.

Background: Adjuvant endocrine therapy (AET) reduces breast cancer recurrence and mortality of women with hormone-receptor-positive tumors, but poor adherence remains a significant problem. The aim of this study was to analyze AET side effects and their impact on adherence to treatment. Methods: A total of 373 breast cancer patients treated with AET filled out a specific questionnaire during their follow up visits at the Breast Unit of our Centre. Results: Side effects were reported by 81% of patients, 84% of those taking tamoxifen and 80% of those taking aromatase inhibitors (AIs). The most common side effect in the tamoxifen group was hot flashes (55.6%), while in the AI group it was arthralgia (60.6%). The addition of GnRH agonists to both tamoxifen and AI significantly worsened all menopausal symptoms. Overall, 12% of patients definitively discontinued AET due to side effects, 6.4% during the first 5 years and 24% during extended therapy. Patients who had previously received chemotherapy or radiotherapy reported a significantly lower discontinuation rate. Conclusions: AET side effects represent a significant problem in breast cancer survivors leading to irregular assumption and discontinuation of therapy. Adherence to AET may be improved by trustful patient–physician communication and a good-quality care network. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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14 pages, 454 KiB

Open AccessArticle

A Prospective Population-Based Study of Cardiovascular Disease Mortality following Treatment for Breast Cancer among Men in the United States, 2000–2019

by Duke Appiah, Megan Mai and Kanak Parmar

Curr. Oncol. 2023, 30(1), 284-297; https://doi.org/10.3390/curroncol30010023 - 25 Dec 2022

Cited by 4 | Viewed by 2314

Abstract

Male breast cancer is rare but its incidence and mortality are increasing in the United States, with racial/ethnic disparities in survival reported. There is limited evidence for cardiotoxicity of cancer treatment among men with breast cancer. We evaluated the relation between breast cancer [...] Read more.

Male breast cancer is rare but its incidence and mortality are increasing in the United States, with racial/ethnic disparities in survival reported. There is limited evidence for cardiotoxicity of cancer treatment among men with breast cancer. We evaluated the relation between breast cancer treatment and cardiovascular disease (CVD) mortality among men and investigated the salient roles that race/ethnicity play on this relation. Data were from 5216 men with breast cancer aged ≥ 40 years from the Surveillance, Epidemiology, and End Results program who were diagnosed from 2000 to 2019 and underwent surgery. Competing risk models were used to estimate hazards ratios (HR) and 95% confidence intervals (CI). During a median follow-up of 5.6 years, 1914 deaths occurred with 25% attributable to CVD. In multivariable-adjusted models, men who received chemotherapy had elevated risk for CVD (HR: 1.55, 95%CI: 1.18–2.04). This risk was higher among Hispanic men (HR: 3.96, 95%CI: 1.31–12.02) than non-Hispanic Black and non-Hispanic White men. There was no significant association between radiotherapy and CVD deaths. In this population-based study, treatment with chemotherapy was associated with elevated risk of CVD mortality in men with breast cancer. Racial/ethnic disparities in the association of chemotherapy and CVD mortality were observed. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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9 pages, 1230 KiB

Open AccessArticle

Feasibility Study and Clinical Impact of Incorporating Breast Tissue Density in High-Risk Breast Cancer Screening Assessment

by Alison Rusnak, Shawna Morrison, Erika Smith, Valerie Hastings, Kelly Anderson, Caitlin Aldridge, Sari Zelenietz, Karen Reddick, Sonia Regnier, Ellen Alie, Nayaar Islam, Rutaaba Fasih, Susan Peddle, Erin Cordeiro, Eva Tomiak and Jean M. Seely

Curr. Oncol. 2022, 29(11), 8742-8750; https://doi.org/10.3390/curroncol29110688 - 15 Nov 2022

Cited by 3 | Viewed by 2477

Abstract

Breast tissue density (BTD) is known to increase the risk of breast cancer but is not routinely used in the risk assessment of the population-based High-Risk Ontario Breast Screening Program (HROBSP). This prospective, IRB-approved study assessed the feasibility and impact of incorporating breast [...] Read more.

Breast tissue density (BTD) is known to increase the risk of breast cancer but is not routinely used in the risk assessment of the population-based High-Risk Ontario Breast Screening Program (HROBSP). This prospective, IRB-approved study assessed the feasibility and impact of incorporating breast tissue density (BTD) into the risk assessment of women referred to HROBSP who were not genetic mutation carriers. All consecutive women aged 40–69 years who met criteria for HROBSP assessment and referred to Genetics from 1 December 2020 to 31 July 2021 had their lifetime risk calculated with and without BTD using Tyrer-Cuzick model version 8 (IBISv8) to gauge overall impact. McNemar’s test was performed to compare eligibility with and without density. 140 women were referred, and 1 was excluded (BRCA gene mutation carrier and automatically eligible). Eight of 139 (5.8%) never had a mammogram, while 17/131 (13%) did not have BTD reported on their mammogram and required radiologist review. Of 131 patients, 22 (16.8%) were clinically impacted by incorporation of BTD: 9/131 (6.9%) became eligible for HROBSP, while 13/131 (9.9%) became ineligible (p = 0.394). It was feasible for the Genetics clinic to incorporate BTD for better risk stratification of eligible women. This did not significantly impact the number of eligible women while optimizing the use of high-risk supplemental MRI screening. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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17 pages, 3268 KiB

Open AccessArticle

The Impact of Organised Screening Programs on Breast Cancer Stage at Diagnosis for Canadian Women Aged 40–49 and 50–59

by Anna N. Wilkinson, Jean-Michel Billette, Larry F. Ellison, Michael A. Killip, Nayaar Islam and Jean M. Seely

Curr. Oncol. 2022, 29(8), 5627-5643; https://doi.org/10.3390/curroncol29080444 - 9 Aug 2022

Cited by 9 | Viewed by 11626

Abstract

The relationship between Canadian mammography screening practices for women 40–49 and breast cancer (BC) stage at diagnosis in women 40–49 and 50–59 years was assessed using data from the Canadian Cancer Registry, provincial/territorial screening practices, and screening information from the Canadian Community Health [...] Read more.

The relationship between Canadian mammography screening practices for women 40–49 and breast cancer (BC) stage at diagnosis in women 40–49 and 50–59 years was assessed using data from the Canadian Cancer Registry, provincial/territorial screening practices, and screening information from the Canadian Community Health Survey. For the 2010 to 2017 period, women aged 40–49 were diagnosed with lesser relative proportions of stage I BC (35.7 vs. 45.3%; p < 0.001), but greater proportions of stage II (42.6 vs. 36.7%, p < 0.001) and III (17.3 vs. 13.1%, p < 0.001) compared to women 50–59. Stage IV was lower among women 40–49 than 50–59 (4.4% vs. 4.8%, p = 0.005). Jurisdictions with organised screening programs for women 40–49 with annual recall (screeners) were compared with those without (comparators). Women aged 40–49 in comparator jurisdictions had higher proportions of stages II (43.7% vs. 40.7%, p < 0.001), III (18.3% vs. 15.6%, p < 0.001) and IV (4.6% vs. 3.9%, p = 0.001) compared to their peers in screener jurisdictions. Based on screening practices for women aged 40–49, women aged 50–59 had higher proportions of stages II (37.2% vs. 36.0%, p = 0.003) and III (13.6% vs. 12.3%, p < 0.001) in the comparator versus screener groups. The results of this study can be used to reassess the optimum lower age for BC screening in Canada. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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9 pages, 254 KiB

Open AccessArticle

Reducing Unnecessary Biopsies Using Digital Breast Tomosynthesis and Ultrasound in Dense and Nondense Breasts

by Ibrahim Hadadi, Jillian Clarke, William Rae, Mark McEntee, Wendy Vincent and Ernest Ekpo

Curr. Oncol. 2022, 29(8), 5508-5516; https://doi.org/10.3390/curroncol29080435 - 4 Aug 2022

Cited by 3 | Viewed by 2417

Abstract

Aim: To compare digital breast tomosynthesis (DBT) and ultrasound in women recalled for assessment after a positive screening mammogram and assess the potential for each of these tools to reduce unnecessary biopsies. Methods: This data linkage study included 538 women recalled for assessment [...] Read more.

Aim: To compare digital breast tomosynthesis (DBT) and ultrasound in women recalled for assessment after a positive screening mammogram and assess the potential for each of these tools to reduce unnecessary biopsies. Methods: This data linkage study included 538 women recalled for assessment from January 2017 to December 2019. The association between the recalled mammographic abnormalities and breast density was analysed using the chi-square independence test. Relative risks and the number of recalled cases requiring DBT and ultrasound assessment to prevent one unnecessary biopsy were compared using the McNemar test. Results: Breast density significantly influenced recall decisions (p < 0.001). Ultrasound showed greater potential to decrease unnecessary biopsies than DBT: in entirely fatty (21% vs. 5%; p = 0.04); scattered fibroglandular (23% vs. 10%; p = 0.003); heterogeneously dense (34% vs. 7%; p < 0.001) and extremely dense (39% vs. 9%; p < 0.001) breasts. The number of benign cases needing assessment to prevent one unnecessary biopsy was significantly lower with ultrasound than DBT in heterogeneously dense (1.8 vs. 7; p < 0.001) and extremely dense (1.9 vs. 5.1; p = 0.03) breasts. Conclusion: Women with dense breasts are more likely to be recalled for assessment and have a false-positive biopsy. Women with dense breasts benefit more from ultrasound assessment than from DBT. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

15 pages, 435 KiB

Open AccessArticle

Female Healthcare Workers’ Knowledge, Attitude towards Breast Cancer, and Perceived Barriers towards Mammogram Screening: A Multicenter Study in North Saudi Arabia

by Anfal Mohammed Alenezi, Ashokkumar Thirunavukkarasu, Farooq Ahmed Wani, Hadil Alenezi, Muhannad Faleh Alanazi, Abdulaziz Saud Alruwaili, Rasha Harbi Alashjaee, Faisal Harbi Alashjaee, Abdulaziz Khalid Alrasheed and Bandar Dhaher Alshrari

Curr. Oncol. 2022, 29(6), 4300-4314; https://doi.org/10.3390/curroncol29060344 - 15 Jun 2022

Cited by 13 | Viewed by 3835

Abstract

Breast cancer is the most commonly diagnosed cancer among women in the Kingdom of Saudi Arabia and other Middle East countries. This analytical cross-sectional study assessed knowledge, attitude towards breast cancer, and barriers to mammogram screening among 414 randomly selected female healthcare workers [...] Read more.

Breast cancer is the most commonly diagnosed cancer among women in the Kingdom of Saudi Arabia and other Middle East countries. This analytical cross-sectional study assessed knowledge, attitude towards breast cancer, and barriers to mammogram screening among 414 randomly selected female healthcare workers from multiple healthcare facilities in northern Saudi Arabia. Of the studied population, 48.6% had low knowledge, and 16.1% had a low attitude towards breast cancer risk factors and symptoms. The common barriers to mammogram screening were fear to discover cancer (57.2%) and apprehension regarding radiation exposure (57%). Logistic regression analysis found that lack of awareness regarding mammogram was significantly associated with age (p = 0.030) and healthcare workers category (ref: physicians: p = 0.016). In addition, we found a significant negative correlation between knowledge and barrier scores (Spearman’s rho: −0.315, p < 0.001). It is recommended to develop target-oriented educational programs for the healthcare workers, which would empower them to educate the community regarding the risk factors and the importance of mammogram screening. Furthermore, a prospective study is warranted in other regions of the Kingdom of Saudi Arabia to understand the region-specific training needs for the healthcare workers. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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17 pages, 1676 KiB

Open AccessArticle

Overdetection of Breast Cancer

by Martin J. Yaffe and James G. Mainprize

Curr. Oncol. 2022, 29(6), 3894-3910; https://doi.org/10.3390/curroncol29060311 - 30 May 2022

Cited by 7 | Viewed by 3432

Abstract

Overdetection (often referred to as overdiagnosis) of cancer is the detection of disease, such as through a screening program, that would otherwise remain occult through an individual’s life. In the context of screening, this could occur for cancers that were slow growing or [...] Read more.

Overdetection (often referred to as overdiagnosis) of cancer is the detection of disease, such as through a screening program, that would otherwise remain occult through an individual’s life. In the context of screening, this could occur for cancers that were slow growing or indolent, or simply because an unscreened individual would have died from some other cause before the cancer had surfaced clinically. The main harm associated with overdetection is the subsequent overdiagnosis and overtreatment of disease. In this article, the phenomenon is reviewed, the methods of estimation of overdetection are discussed and reasons for variability in such estimates are given, with emphasis on an analysis using Canadian data. Microsimulation modeling is used to illustrate the expected time course of cancer detection that gives rise to overdetection. While overdetection exists, the actual amount is likely to be much lower than the estimate used by the Canadian Task Force on Preventive Health Care. Furthermore, the issue is of greater significance in older rather than younger women due to competing causes of death. The particular challenge associated with in situ breast cancer is considered and possible approaches to avoiding overtreatment are suggested. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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20 pages, 1598 KiB

Open AccessArticle

Radiomic and Artificial Intelligence Analysis with Textural Metrics Extracted by Contrast-Enhanced Mammography and Dynamic Contrast Magnetic Resonance Imaging to Detect Breast Malignant Lesions

by Roberta Fusco, Elio Di Bernardo, Adele Piccirillo, Maria Rosaria Rubulotta, Teresa Petrosino, Maria Luisa Barretta, Mauro Mattace Raso, Paolo Vallone, Concetta Raiano, Raimondo Di Giacomo, Claudio Siani, Franca Avino, Giosuè Scognamiglio, Maurizio Di Bonito, Vincenza Granata and Antonella Petrillo

Curr. Oncol. 2022, 29(3), 1947-1966; https://doi.org/10.3390/curroncol29030159 - 13 Mar 2022

Cited by 17 | Viewed by 2718

Abstract

Purpose:The purpose of this study was to discriminate between benign and malignant breast lesions through several classifiers using, as predictors, radiomic metrics extracted from CEM and DCE-MRI images. In order to optimize the analysis, balancing and feature selection procedures were performed. Methods [...] Read more.

Purpose:The purpose of this study was to discriminate between benign and malignant breast lesions through several classifiers using, as predictors, radiomic metrics extracted from CEM and DCE-MRI images. In order to optimize the analysis, balancing and feature selection procedures were performed. Methods: Fifty-four patients with 79 histo-pathologically proven breast lesions (48 malignant lesions and 31 benign lesions) underwent both CEM and DCE-MRI. The lesions were retrospectively analyzed with radiomic and artificial intelligence approaches. Forty-eight textural metrics were extracted, and univariate and multivariate analyses were performed: non-parametric statistical test, receiver operating characteristic (ROC) and machine learning classifiers. Results: Considering the single metrics extracted from CEM, the best predictors were KURTOSIS (area under ROC curve (AUC) = 0.71) and SKEWNESS (AUC = 0.71) calculated on late MLO view. Considering the features calculated from DCE-MRI, the best predictors were RANGE (AUC = 0.72), ENERGY (AUC = 0.72), ENTROPY (AUC = 0.70) and GLN (gray-level nonuniformity) of the gray-level run-length matrix (AUC = 0.72). Considering the analysis with classifiers and an unbalanced dataset, no significant results were obtained. After the balancing and feature selection procedures, higher values of accuracy, specificity and AUC were reached. The best performance was obtained considering 18 robust features among all metrics derived from CEM and DCE-MRI, using a linear discriminant analysis (accuracy of 0.84 and AUC = 0.88). Conclusions: Classifiers, adjusted with adaptive synthetic sampling and feature selection, allowed for increased diagnostic performance of CEM and DCE-MRI in the differentiation between benign and malignant lesions. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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15 pages, 2795 KiB

Open AccessArticle

Contrast-Enhanced Spectral Mammography Assessment of Patients Treated with Neoadjuvant Chemotherapy for Breast Cancer

by Katarzyna Steinhof-Radwańska, Anna Grażyńska, Andrzej Lorek, Iwona Gisterek, Anna Barczyk-Gutowska, Agnieszka Bobola, Karolina Okas, Zuzanna Lelek, Irmina Morawska, Jakub Potoczny, Paweł Niemiec and Karol Szyluk

Curr. Oncol. 2021, 28(5), 3448-3462; https://doi.org/10.3390/curroncol28050298 - 6 Sep 2021

Cited by 9 | Viewed by 2848

Abstract

Background: Evaluating the tumor response to neoadjuvant chemotherapy is key to planning further therapy of breast cancer. Our study aimed to evaluate the effectiveness of low-energy and subtraction contrast-enhanced spectral mammography (CESM) images in the detection of complete response (CR) for neoadjuvant chemotherapy [...] Read more.

Background: Evaluating the tumor response to neoadjuvant chemotherapy is key to planning further therapy of breast cancer. Our study aimed to evaluate the effectiveness of low-energy and subtraction contrast-enhanced spectral mammography (CESM) images in the detection of complete response (CR) for neoadjuvant chemotherapy (NAC) in breast cancer. Methods: A total of 63 female patients were qualified for our retrospective analysis. Low-energy and subtraction CESM images just before the beginning of NAC and as a follow-up examination 2 weeks before the end of chemotherapy were compared with one another and assessed for compliance with the postoperative histopathological examination (HP). The response to preoperative chemotherapy was evaluated based on the RECIST 1.1 criteria (Response Evaluation Criteria in Solid Tumors). Results: Low-energy images tend to overestimate residual lesions (6.28 mm) and subtraction images tend to underestimate them (2.75 mm). The sensitivity of low-energy images in forecasting CR amounted to 33.33%, while the specificity was 92.86%. In the case of subtraction CESM, the sensitivity amounted to 85.71% and the specificity to 71.42%. Conclusions: CESM is characterized by high sensitivity in the assessment of CR after NAC. The use of only morphological assessment is insufficient. CESM correlates well with the size of residual lesions on histopathological examination but tends to underestimate the dimensions. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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Review

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42 pages, 7475 KiB

Open AccessReview

The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening

by Paula B. Gordon

Curr. Oncol. 2022, 29(5), 3595-3636; https://doi.org/10.3390/curroncol29050291 - 17 May 2022

Cited by 19 | Viewed by 12042

Abstract

The purpose of breast cancer screening is to find cancers early to reduce mortality and to allow successful treatment with less aggressive therapy. Mammography is the gold standard for breast cancer screening. Its efficacy in reducing mortality from breast cancer was proven in [...] Read more.

The purpose of breast cancer screening is to find cancers early to reduce mortality and to allow successful treatment with less aggressive therapy. Mammography is the gold standard for breast cancer screening. Its efficacy in reducing mortality from breast cancer was proven in randomized controlled trials (RCTs) conducted from the early 1960s to the mid 1990s. Panels that recommend breast cancer screening guidelines have traditionally relied on the old RCTs, which did not include considerations of breast density, race/ethnicity, current hormone therapy, and other risk factors. Women do not all benefit equally from mammography. Mortality reduction is significantly lower in women with dense breasts because normal dense tissue can mask cancers on mammograms. Moreover, women with dense breasts are known to be at increased risk. To provide equity, breast cancer screening guidelines should be created with the goal of maximizing mortality reduction and allowing less aggressive therapy, which may include decreasing the interval between screening mammograms and recommending consideration of supplemental screening for women with dense breasts. This review will address the issue of dense breasts and the impact on the stage of breast cancer at the time of diagnosis, and discuss options for supplemental screening. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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Other

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11 pages, 269 KiB

Open AccessCommentary

Misinformation and Facts about Breast Cancer Screening

by Daniel B. Kopans

Curr. Oncol. 2022, 29(8), 5644-5654; https://doi.org/10.3390/curroncol29080445 - 9 Aug 2022

Cited by 7 | Viewed by 2847

Abstract

Quality medical practice is based on science and evidence. For over a half-century, the efficacy of breast cancer screening has been challenged, particularly for women aged 40–49. As each false claim has been raised, it has been addressed and refuted based on science [...] Read more.

Quality medical practice is based on science and evidence. For over a half-century, the efficacy of breast cancer screening has been challenged, particularly for women aged 40–49. As each false claim has been raised, it has been addressed and refuted based on science and evidence. Nevertheless, misinformation continues to be promoted, resulting in confusion for women and their physicians. Early detection has been proven to save lives for women aged 40–74 in randomized controlled trials of mammography screening. Observational studies, failure analyses, and incidence of death studies have provided evidence that there is a major benefit when screening is introduced to the general population. In large part due to screening, there has been an over 40% decline in deaths from breast cancer since 1990. Nevertheless, misinformation about screening continues to be promoted, adding to the confusion. Despite claims to the contrary, a careful reading of the guidelines issued by major groups such as the U.S. Preventive Services Task Force and the American College of Physicians shows that they all agree that most lives are saved by screening starting at the age of 40. There is no scientific support for using the age of 50 as a threshold for screening. All women should be provided with the facts and not false information about breast cancer screening so that they can make “informed decisions” for themselves about whether to participate. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

11 pages, 281 KiB

Open AccessCommentary

How Did CNBSS Influence Guidelines for So Long and What Can That Teach Us?

by Shushiela Appavoo

Curr. Oncol. 2022, 29(6), 3922-3932; https://doi.org/10.3390/curroncol29060313 - 30 May 2022

Cited by 1 | Viewed by 4529

Abstract

The biased randomization and other quality concerns about the Canadian National Breast Screening Studies (CNBSS) were documented and criticized for decades, even by several individuals very close to the research. CNBSS were the outlier studies among several RCTs of the era and yet [...] Read more.

The biased randomization and other quality concerns about the Canadian National Breast Screening Studies (CNBSS) were documented and criticized for decades, even by several individuals very close to the research. CNBSS were the outlier studies among several RCTs of the era and yet were given equal weighting and occasionally higher importance than the remainder of the canon of mammography RCTs. These studies have had an ongoing influence on subsequent evidence review, guideline formation, and, ultimately, patient access to screening. This article explores possible reasons for the ongoing inclusion of CNBSS in the body of mammography screening evidence, discusses the lack of expertise in critical healthcare guideline processes, and, ultimately, suggests several actions and reforms. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

12 pages, 268 KiB

Open AccessCase Report

Marrying Story with Science: The Impact of Outdated and Inconsistent Breast Cancer Screening Practices in Canada

by Jennie Dale, Michelle Di Tomaso and Victoria Gay

Curr. Oncol. 2022, 29(5), 3540-3551; https://doi.org/10.3390/curroncol29050286 - 13 May 2022

Cited by 3 | Viewed by 5087

Abstract

Behind the science of breast cancer in Canada, as well as globally, are the stories of thousands of women, their families, and their communities. These include stories from those who have died or those suffering from the realities of stage III and stage [...] Read more.

Behind the science of breast cancer in Canada, as well as globally, are the stories of thousands of women, their families, and their communities. These include stories from those who have died or those suffering from the realities of stage III and stage IV breast cancer due to late detection, misinformation, and dismissal. The reality for these women is that, whilst grateful for the latest developments in cancer research, much of this knowledge is not reflected in policy and practice. Canadian guidelines do not reflect the recommended screening by experts within the field and inequities in screening practices and practitioner knowledge exist in different areas within Canada. Told through the stories of women with lived experiences of late-stage breast cancer and supported by scientific evidence, this paper explores the impact of outdated breast cancer screening practices on the lives of women. Recent patient advocacy is driving changes, such as notifying women of their breast density in a few jurisdictions in Canada, but we call for the whole medical community to take responsibility and ensure breast screening is optimised to save more lives. Full article

(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)

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