Low-dose radiation from annual mammography screening may increase breast cancer risk in women with genetic or familial predisposition to breast cancer, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
"For women at high risk for breast cancer, screening is very important, but a careful approach should be taken when considering mammography for screening young women, particularly under age 30," said Marijke C. Jansen-van der Weide, Ph.D., epidemiologist in the Department of Epidemiology and Radiology at University Medical Center Groningen in the Netherlands. "Further, repeated exposure to low-dose radiation should be avoided."
Women who are at high risk for breast cancer need to begin screening at a younger age, because they often develop cancer earlier than women at average risk. However, according to Dr. Jansen-van der Weide and colleagues, young women with familial or genetic predisposition to the disease may want to consider alternative screening methods to mammography, because the benefit of early tumor detection in this group of women may be offset by the potential risk of radiation-induced cancer.
According to the American Cancer Society, there is strong evidence supporting the benefits of mammography for women after age 40. However, there are conflicting reports regarding the benefits of mammography for women under 40. Alternative screening methods such as ultrasound and MRI may be made available to younger women, but are generally used as an adjunct to mammography.
The American Cancer Society recommends that some women at high risk (greater than 20 percent lifetime risk) should have MR imaging and mammography every year, typically beginning at age 30.
The researchers conducted an analysis of peer-reviewed, published medical research to determine if low-dose radiation exposure affects breast cancer risk among high-risk women. Out of 47 articles found on the topic, six were selected by the reviewers for inclusion in their analysis. Four studies looked at the effect of exposure to low-dose radiation among breast cancer gene mutation carriers, and two studies researched the effect of radiation on women with a family history of breast cancer. Using data from these studies, the researchers were able to calculate pooled odds ratios to estimate radiation-induced breast cancer risk.
The results showed that among all high-risk women in the study, average increased risk of breast cancer due to low-dose radiation exposure was 1.5 times greater than that of high-risk women not exposed to low-dose radiation. High-risk women exposed before age 20 or with five or more exposures were 2.5 times more likely to develop breast cancer than high-risk women not exposed to low-dose radiation.
"Our findings suggest that low-dose radiation increases breast cancer risk among these young high-risk women, and a careful approach is warranted," Dr. Jansen-van der Weide said.
She noted that this analysis is based on a small study sample and should be interpreted with caution. Dr. Jansen-van der Weide also pointed out that these results apply only to specific high-risk groups of women. Women at average risk were not assessed in this study.
In general, early detection with mammography and prompt treatment can significantly improve a woman's chances of survival. More than 90 percent of women whose breast cancer is found in an early stage will survive. For young, high-risk women and their doctors, it is important to weigh the benefits against any potential risk when making a decision about annual breast cancer screening with mammography.
Coauthors are Geertruida H. de Bock, Ph.D., Marcel J.W. Greuter, Ph.D., Liesbeth Jansen, M.D., Ph.D., Jan C. Oosterwijk, Ph.D., Ruud Pijnappel, M.D., Ph.D., and Matthijs Oudkerk, M.D., Ph.D.
Source
Radiological Society of North America
суббота, 29 октября 2011 г.
суббота, 22 октября 2011 г.
2008 American Society Of Breast Disease Pathfinder Lectures
The 2008 American Society of Breast Disease Pathfinder Lectures will be
delivered by two giants in the field of breast cancer - Mary-Claire King,
PhD, and Bernard Fisher, MD. The Pathfinder Lectures will be part of the
Society's Annual Symposium, April 10-12, 2008, at the Hilton San Diego
Resort, San Diego, California.
In announcing the recipients of the ASBD's only honorary recognition,
Society president Julio A. Ibarra, MD, noted that "through their research
and vision this year's honorees -- Mary-Claire King and Bernard Fisher --
have set the highest of standards and benefited the lives of millions of
women internationally."
Mary-Claire King is Professor of Medicine and Genetics and an American
Cancer Society professor at the University of Washington. She is best known
for discovering that BRCA1 mutations can cause hereditary breast cancer.
Dr. King's work changed historic views by finding a genetic marker for the
existence of BRCA1, which made possible gene location, testing, screening
and prophylactic procedures. Dr. King received her doctorate from the
University of California, Berkeley, where she taught from 1976 until 1995
before moving to the University of Washington.
Bernard Fisher, MD, is a recognized pioneer in the biology and treatment of
breast cancer. He was recently honored by the University of Pittsburgh,
where he serves as distinguished service professor of surgery and scientific
director of the National Surgical Adjuvant Breast and Bowel Project, which
he chaired from 1967 to 1994. Dr. Fisher work has led to an understanding of
breast cancer as a systemic disease that metastasizes unpredictably, and
that can be treated with a combination of conservative local treatment and
systemic therapy.
Established in 2006, the Pathfinder Lectures recognizes the innovators
worldwide who have combined research and clinical practice with an
interdisciplinary understanding to advance the fight against breast disease
and breast cancer. Previous recipients have included Ambassador Nancy
Brinker; Patricia Ganz, MD; Jay Harris, MD; Gabriel Hortobagyi, MD; Daniel
Kopans, MD; David Page, MD; Melvin Silverstein, MD; Laszlo Tabar, MD; and
Umberto Veronesi, MD.
About the American Society of Breast Disease
The American Society of Breast Disease is the leading professional medical
society in the United States to serve all physicians and allied
professionals committed to and advocating an interdisciplinary team approach
to breast cancer and disease management, prevention, early detection,
treatment, and research. The Society provides professional education
programs and advocates for improvements in breast healthcare.
American Society of Breast Disease
delivered by two giants in the field of breast cancer - Mary-Claire King,
PhD, and Bernard Fisher, MD. The Pathfinder Lectures will be part of the
Society's Annual Symposium, April 10-12, 2008, at the Hilton San Diego
Resort, San Diego, California.
In announcing the recipients of the ASBD's only honorary recognition,
Society president Julio A. Ibarra, MD, noted that "through their research
and vision this year's honorees -- Mary-Claire King and Bernard Fisher --
have set the highest of standards and benefited the lives of millions of
women internationally."
Mary-Claire King is Professor of Medicine and Genetics and an American
Cancer Society professor at the University of Washington. She is best known
for discovering that BRCA1 mutations can cause hereditary breast cancer.
Dr. King's work changed historic views by finding a genetic marker for the
existence of BRCA1, which made possible gene location, testing, screening
and prophylactic procedures. Dr. King received her doctorate from the
University of California, Berkeley, where she taught from 1976 until 1995
before moving to the University of Washington.
Bernard Fisher, MD, is a recognized pioneer in the biology and treatment of
breast cancer. He was recently honored by the University of Pittsburgh,
where he serves as distinguished service professor of surgery and scientific
director of the National Surgical Adjuvant Breast and Bowel Project, which
he chaired from 1967 to 1994. Dr. Fisher work has led to an understanding of
breast cancer as a systemic disease that metastasizes unpredictably, and
that can be treated with a combination of conservative local treatment and
systemic therapy.
Established in 2006, the Pathfinder Lectures recognizes the innovators
worldwide who have combined research and clinical practice with an
interdisciplinary understanding to advance the fight against breast disease
and breast cancer. Previous recipients have included Ambassador Nancy
Brinker; Patricia Ganz, MD; Jay Harris, MD; Gabriel Hortobagyi, MD; Daniel
Kopans, MD; David Page, MD; Melvin Silverstein, MD; Laszlo Tabar, MD; and
Umberto Veronesi, MD.
About the American Society of Breast Disease
The American Society of Breast Disease is the leading professional medical
society in the United States to serve all physicians and allied
professionals committed to and advocating an interdisciplinary team approach
to breast cancer and disease management, prevention, early detection,
treatment, and research. The Society provides professional education
programs and advocates for improvements in breast healthcare.
American Society of Breast Disease
суббота, 15 октября 2011 г.
Critical Health Care Does Not Reach Most Women And Children In High Mortality Countries, Despite Gains In Fighting Child Killer Diseases
Leading global health experts, policy-makers and parliamentarians are convening in Cape Town to address the urgent need for accelerated progress to reduce maternal, newborn and child deaths, if internationally-agreed targets are to be met.
According to the 2008 report Tracking Progress in Maternal, Newborn & Child Survival released, few of the 68 developing countries that account for 97% of maternal and child deaths worldwide are making adequate progress to provide critical health care needed to save the lives of women, infants and children. Parliamentarians attending the 118th Assembly of the Inter-Parliamentary Union in Cape Town will join global health experts and policy makers to discuss the role they can play in accelerating action to achieve Millennium Development Goals 4 and 5 on reducing child and maternal mortality.
Over 10 million women and children still die each year from causes which are largely preventable and treatable. The majority of maternal and child deaths occur in Africa and South Asia, with sub-Saharan Africa increasingly bearing the global burden of mortality. One in five children are born in sub-Saharan Africa, yet some 50% of all child deaths globally occur in the region, as do half of maternal deaths worldwide. In Niger, for example, women face a lifetime risk of dying in pregnancy or childbirth which is as high as one in seven.
Tracking Progress in Maternal, Newborn & Child Survival uses existing data to measure coverage of key interventions and approaches proven to reduce maternal and child mortality. The 2008 report highlights the rapid progress that many of the 68 countries are making in providing vaccinations, vitamin A supplementation coverage and insecticide-treated mosquito nets to prevent major killers such as measles and malaria.
Nonetheless, treatment for potentially fatal illnesses and other vital health services still fail to reach the majority of women and children according to the findings. These services are dependent on strong health systems that can provide 24-hour care within the community, at health clinics, and through a functioning referral system when more serious intervention is necessary. Access to these services is most critical at the time of birth and during the first two weeks of life which are riskiest for mother and infant.
Tracking Progress in Maternal, Newborn & Child Survival identifies a series of missed opportunities to save lives:
- Family planning: The unmet need for contraceptives is high. Only one-third of women in the 68 priority countries are using a modern contraceptive method - a proven means of boosting maternal and infant survival;
- Skilled care at birth: Only around half of women and newborns benefit from a skilled birth attendant at the time of birth, and even fewer receive care in the critical days and weeks after childbirth;
- Clinical care for sick children: Only about one-third of children with pneumonia - the biggest single killer of children - receive treatment;
- Nutrition: Undernutrition is the underlying cause of 3.5 million child deaths annually, and as many as 20 per cent of maternal deaths.
Despite these missed opportunities, the report also notes that a number of countries, including China, Haiti, Turkmenistan and several countries in sub-Saharan Africa, have made demonstrable progress in reducing deaths of children under-five in the past three years. Sixteen of the 68 Countdown priority countries are now 'on track' to achieve Millennium Development Goal 4.
To pave the way for a well-functioning 'continuum of care', governments and their partners must address obstacles such as weak health systems, funding shortages, and inequalities in access to care. The report findings show poor families missing out twice, on skilled care at birth and on care for newborns and children when they are ill. Other barriers include armed conflict and a high HIV prevalence, which together have erased any gains in child survival in at least 12 African countries.
Overall funding from donor governments for maternal, newborn and child health has increased in recent years, with Official Development Assistance (ODA) rising from US$2.1 billion to almost US$3.5 billion between 2003-2006, a 64 percent increase. This investment has resulted in significant health gains, notably to boost immunization levels and prevent malaria, Nonetheless, health systems for maternal, newborn and child health remain grossly under-funded in relation to the needs of priority countries. Total donor funding for maternal, newborn and child health still represents just 3% of total donor aid disbursements. Most donor assistance is delivered through specific projects and only 5% has been dedicated to general budget support in recipient countries.
The Countdown findings will be discussed during a three day conference in South Africa, from
17-19 April. The Countdown findings are also the subject of a special issue of the medical journal The Lancet.
Countdown to 2015: Maternal, Newborn and Child Survival is a collaborative effort of United Nations agencies, non-governmental organizations, universities, and other institutions and individuals established to track progress towards Millennium Development Goals 4 and 5, to reduce child and maternal mortality respectively. For more information, visit countdown2015mnch.
Countdown to 2015 partners: Aga Khan University, Australian Agency for International Development (AusAID), The Basic Support for Institutionalizing Child Survival (BASICS) Project, USAID, Bellagio Child Survival Group, Department for International Development, UK (DfID), Family Care International, International Paediatric Association, Johns Hopkins University, London School of Hygiene and Tropical Medicine, The Norwegian Agency for Development Cooperation (Norad), Save the Children, The Bill & Melinda Gates Foundation, The Lancet, The Partnership for Maternal, Newborn & Child Health, The World Bank, University College London Centre for International Health and Development, United Nations Population Fund (UNFPA, United Nations Children's Fund (UNICEF), Universidade Federal de Pelotas, University of Aberdeen, USAID and the World Health Organization.
For video b-roll : Visit thenewsmarket/unicef to access broadcast quality footage from Nepal ("Applying Life-Saving Interventions to Save Nepalese Newborns") and Senegal ("A Rural Healthcare Center Plays Key Role in Reducing Infant and Child Mortality").
Countdown to 2015: Maternal, Newborn and Child Survival
According to the 2008 report Tracking Progress in Maternal, Newborn & Child Survival released, few of the 68 developing countries that account for 97% of maternal and child deaths worldwide are making adequate progress to provide critical health care needed to save the lives of women, infants and children. Parliamentarians attending the 118th Assembly of the Inter-Parliamentary Union in Cape Town will join global health experts and policy makers to discuss the role they can play in accelerating action to achieve Millennium Development Goals 4 and 5 on reducing child and maternal mortality.
Over 10 million women and children still die each year from causes which are largely preventable and treatable. The majority of maternal and child deaths occur in Africa and South Asia, with sub-Saharan Africa increasingly bearing the global burden of mortality. One in five children are born in sub-Saharan Africa, yet some 50% of all child deaths globally occur in the region, as do half of maternal deaths worldwide. In Niger, for example, women face a lifetime risk of dying in pregnancy or childbirth which is as high as one in seven.
Tracking Progress in Maternal, Newborn & Child Survival uses existing data to measure coverage of key interventions and approaches proven to reduce maternal and child mortality. The 2008 report highlights the rapid progress that many of the 68 countries are making in providing vaccinations, vitamin A supplementation coverage and insecticide-treated mosquito nets to prevent major killers such as measles and malaria.
Nonetheless, treatment for potentially fatal illnesses and other vital health services still fail to reach the majority of women and children according to the findings. These services are dependent on strong health systems that can provide 24-hour care within the community, at health clinics, and through a functioning referral system when more serious intervention is necessary. Access to these services is most critical at the time of birth and during the first two weeks of life which are riskiest for mother and infant.
Tracking Progress in Maternal, Newborn & Child Survival identifies a series of missed opportunities to save lives:
- Family planning: The unmet need for contraceptives is high. Only one-third of women in the 68 priority countries are using a modern contraceptive method - a proven means of boosting maternal and infant survival;
- Skilled care at birth: Only around half of women and newborns benefit from a skilled birth attendant at the time of birth, and even fewer receive care in the critical days and weeks after childbirth;
- Clinical care for sick children: Only about one-third of children with pneumonia - the biggest single killer of children - receive treatment;
- Nutrition: Undernutrition is the underlying cause of 3.5 million child deaths annually, and as many as 20 per cent of maternal deaths.
Despite these missed opportunities, the report also notes that a number of countries, including China, Haiti, Turkmenistan and several countries in sub-Saharan Africa, have made demonstrable progress in reducing deaths of children under-five in the past three years. Sixteen of the 68 Countdown priority countries are now 'on track' to achieve Millennium Development Goal 4.
To pave the way for a well-functioning 'continuum of care', governments and their partners must address obstacles such as weak health systems, funding shortages, and inequalities in access to care. The report findings show poor families missing out twice, on skilled care at birth and on care for newborns and children when they are ill. Other barriers include armed conflict and a high HIV prevalence, which together have erased any gains in child survival in at least 12 African countries.
Overall funding from donor governments for maternal, newborn and child health has increased in recent years, with Official Development Assistance (ODA) rising from US$2.1 billion to almost US$3.5 billion between 2003-2006, a 64 percent increase. This investment has resulted in significant health gains, notably to boost immunization levels and prevent malaria, Nonetheless, health systems for maternal, newborn and child health remain grossly under-funded in relation to the needs of priority countries. Total donor funding for maternal, newborn and child health still represents just 3% of total donor aid disbursements. Most donor assistance is delivered through specific projects and only 5% has been dedicated to general budget support in recipient countries.
The Countdown findings will be discussed during a three day conference in South Africa, from
17-19 April. The Countdown findings are also the subject of a special issue of the medical journal The Lancet.
Countdown to 2015: Maternal, Newborn and Child Survival is a collaborative effort of United Nations agencies, non-governmental organizations, universities, and other institutions and individuals established to track progress towards Millennium Development Goals 4 and 5, to reduce child and maternal mortality respectively. For more information, visit countdown2015mnch.
Countdown to 2015 partners: Aga Khan University, Australian Agency for International Development (AusAID), The Basic Support for Institutionalizing Child Survival (BASICS) Project, USAID, Bellagio Child Survival Group, Department for International Development, UK (DfID), Family Care International, International Paediatric Association, Johns Hopkins University, London School of Hygiene and Tropical Medicine, The Norwegian Agency for Development Cooperation (Norad), Save the Children, The Bill & Melinda Gates Foundation, The Lancet, The Partnership for Maternal, Newborn & Child Health, The World Bank, University College London Centre for International Health and Development, United Nations Population Fund (UNFPA, United Nations Children's Fund (UNICEF), Universidade Federal de Pelotas, University of Aberdeen, USAID and the World Health Organization.
For video b-roll : Visit thenewsmarket/unicef to access broadcast quality footage from Nepal ("Applying Life-Saving Interventions to Save Nepalese Newborns") and Senegal ("A Rural Healthcare Center Plays Key Role in Reducing Infant and Child Mortality").
Countdown to 2015: Maternal, Newborn and Child Survival
суббота, 8 октября 2011 г.
Three-Quarters Of Indian Maternal Deaths Preventable, Study Finds
Seventy-five percent of maternal deaths in India are preventable, according to a report released Wednesday by Human Rights Watch, the AP/Google News. The report also indicated that one in every 70 Indian women who reaches reproductive age will die from problems associated with pregnancy, childbirth or unsafe abortion. This maternal mortality rate is 16 times higher than Russia's and 10 times higher than China's, the report said. Lead researcher Aruna Kashyap said that in 2005, this translated into 117,000 deaths in India from maternal-related problems.
The study said that tens of thousands of Indian women die each year because of a weak medical system characterized by caste discrimination, poor planning, little accountability and limited access to emergency care. The report found that a large part of the problem is the lack of accountability for the high maternal mortality rate, with the government, hospitals and health workers all shifting blame. Factors contributing to maternal mortality range from poorly trained obstetrics staff to delivery charges that are out of reach for Indian villagers, many of whom live on less than $2 per day. Delivery, prenatal and postnatal care are supposed to be available at no cost, but clinics sometimes charge $10 for a delivery, plus $1 to cut the umbilical cord and $1 for cleaning the room.
Although India as a whole has seen a decline in maternal deaths in the past few years, some heavily populated areas "actually showed an increase in maternal mortality," the report stated, noting that even in areas where access to care seems to be improving, "significant disparities based on income, caste, place of residence and other arbitrary factors" continue to exist. In 2007, in six northern Indian states, 61% of maternal deaths were among Dalits -- or "untouchables" -- and indigenous people, the communities considered at the lowest rung of the Indian caste system, according to the report.
The report found that a large part of the problem is the lack of accountability for the high maternal mortality rate, with the government, hospitals and health wokers all shifting blame. Factors contributing to maternal mortality range from poorly trained obstetrics staff to delivery charges that are out of reach for Indian villagers, many of whom live on less than $2 per day. Delivery, prenatal and postnatal care are supposed to be avaiable at no cost, but clinics sometimes charge $10 for a delivery, plus $1 to cut the umbilical cord and $1 for cleaning the room.
The report's recommendations include requiring reporting of all pregnancy-related deaths to the government, investigation of those deaths and establishment of an obstetric emergency response system (Sullivan, AP/Google News, 10/7).
WSJ Examines Surrogacy in India
In related news, the Wall Street Journal on Thursday examined the proliferation of Indian surrogacy clinics, which serve both domestic and overseas couples. Since 2005, the number of surrogacy clinics has tripled to about 350 facilities throughout the country, according to Hrishikesh Pai, vice president of the Indian Society for Assisted Reproduction. Pai says that last year about 1,000 surrogate pregnancy attempts were made at the clinics and that this year, the figure is likely to increase to 1,500, with about one-third being made on behalf of international couples. According to the Journal, U.S. couples who use Indian surrogates often are motivated by the lower costs of overseas surrogacy.
The Indian Council of Medical Research, a government body, established surrogacy guidelines in 2005, and there are currently new laws under development that would increase standardization of contract terms, parental identification on birth certificates and compensation. The law also would require clinics to register surrogacy cases and report outcomes, the Journal reports. Critics of India's surrogacy say that new controls are necessary to avoid the exploitation of poor women (Cohen, Wall Street Journal, 10/8).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
суббота, 1 октября 2011 г.
Urethral Diverticulum: A New Complication Associated With Tension-Free Vaginal Tape
UroToday - Urethral diverticulum is an uncommon condition and not always easy to diagnose early. Some of the symptoms of this condition are quite common. The possibility of urethral diverticulum should be included in the evaluation of women with voiding dysfunction and pelvic disorders.
Unfortunately, there is often a delay in the diagnosis of urethral diverticulum. Usually the initial diagnosis is inaccurate as the symptom of post micturition incontinence can be frequently misdiagnosed.
The presented case supports the need for an accurate diagnostic work-up when there are symptoms consistent with urethral diverticulum, including urodynamic studies, cystography, cystoscopy, and intravaginal ultrasonography. Firstly, accurate diagnosis of the urethral diverticulum requires the inclusion of this condition in the differential diagnosis of pelvic dysfunctions. The insertion of a sub-midurethral tape in a patient suffering from stress urinary incontinence because of intrinsic sphincter deficiency probably predisposes the formation of urethral diverticulum.
The high pressure in the proximal urethra - especially when the urethra is obstructed and the bladder neck is open probably is the underlying mechanism for urethral diverticulum formation. This situation can be exacerbated when there are high detrusor pressures. Furthermore, dissection in the peri-urethral area itself can be an additional predisposing factor for urethral diverticulum.
Finally, another possibility leading to the formation of a symptomatic urethral diverticulum could be a pre-existing, small urethral diverticulum. So the need of a meticulous pre-operative evaluation to exclude the existence of this condition preoperatively is recommended.
Anastasios Athanasopoulos, MD as part of Beyond the Abstract on UroToday
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.
To access the latest urology news releases from UroToday, go to:
www.urotoday
Copyright © 2009 - UroToday
Unfortunately, there is often a delay in the diagnosis of urethral diverticulum. Usually the initial diagnosis is inaccurate as the symptom of post micturition incontinence can be frequently misdiagnosed.
The presented case supports the need for an accurate diagnostic work-up when there are symptoms consistent with urethral diverticulum, including urodynamic studies, cystography, cystoscopy, and intravaginal ultrasonography. Firstly, accurate diagnosis of the urethral diverticulum requires the inclusion of this condition in the differential diagnosis of pelvic dysfunctions. The insertion of a sub-midurethral tape in a patient suffering from stress urinary incontinence because of intrinsic sphincter deficiency probably predisposes the formation of urethral diverticulum.
The high pressure in the proximal urethra - especially when the urethra is obstructed and the bladder neck is open probably is the underlying mechanism for urethral diverticulum formation. This situation can be exacerbated when there are high detrusor pressures. Furthermore, dissection in the peri-urethral area itself can be an additional predisposing factor for urethral diverticulum.
Finally, another possibility leading to the formation of a symptomatic urethral diverticulum could be a pre-existing, small urethral diverticulum. So the need of a meticulous pre-operative evaluation to exclude the existence of this condition preoperatively is recommended.
Anastasios Athanasopoulos, MD as part of Beyond the Abstract on UroToday
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.
To access the latest urology news releases from UroToday, go to:
www.urotoday
Copyright © 2009 - UroToday
Подписаться на:
Комментарии (Atom)