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Current comprehensive assessment and management of women at increased risk for breast cancer |
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| Authors: | Hollingsworth Alan B Singletary S Eva Morrow Monica Francescatti Darius S O'Shaughnessy Joyce A Hartman Anne-Renee Haddad Becky Schnabel Freya R Vogel Victor G |
| Institution: | a Department of Surgery, Mercy Health Center, Mercy Women's Center, 4300 McAuley Blvd., Oklahoma City, OK 73120, USA b Department of Surgery, MD Anderson Cancer Center, Houston, TX, USA c Department of Surgery, Northwestern University, Chicago, IL, USA d Department of Surgery, Rush Medical College, Chicago, IL, USA e Baylor-Sammons Cancer Center, US Oncology, Dallas, TX, USA f Department of Medicine, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA g Susan G. Komen Foundation, Dallas, TX, USA h Department of Surgery, Columbia Presbyterian Medical Center, New York, NY, USA i Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA |
| Abstract: | The potential for reducing the risk of breast cancer through selective estrogen receptor modulators, aromatase inhibitors, and surgery has generated interest in the use of quantitative models of risk assessment. With the addition of ductal lavage cytology to traditional epidemiologic risk factors, a discovery of cellular atypia can result in refinement of assigned risk values, while simultaneously optimizing patient selection for selective estrogen receptor modulators utilization. In view of increasing complexity in this arena, a Risk Assessment Working Group was formed to outline management strategies for the patient at an elevated risk for the development of breast cancer. No longer a statistical exercise, quantitative risk assessment is part of basic breast care and comprehensive management includes a discussion of the following: ductal lavage for improved risk stratification, multiple options for risk reduction, and high risk surveillance strategies that might incorporate investigational imaging protocols. |
| Keywords: | Breast cancer Risk assessment Ductal lavage Hormone replacement therapy Risk management strategy Chemoprevention Magnetic resonance imaging |
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