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Breast cancer screening in the Czech Republic: time trends in performance indicators during the first seven years of the organised programme
Ondrej Majek, Jan Danes, Miroslava Skovajsova, Helena Bartonkova, Lucie Buresova, Daniel Klimes, Petr Brabec, Pavel Kozeny, Ladislav Dusek
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-288
Abstract: The CBCSP is monitored using an information system consisting of three principal components: 1) the national cancer registry, 2) a screening registry collecting data on all screening examinations, further assessments and final diagnoses at accredited programme centres, and 3) administrative databases of healthcare payers. Key performance indicators from the European Guidelines have been adopted for continuous monitoring.Breast cancer incidence in the Czech Republic has steadily been increasing, however with a growing proportion of less advanced stages. The mortality rate has recently stabilised. The screening registry includes 2,083,285 records on screening episodes between 2002 and 2008. In 2007-2008, 51% of eligible women aged 45-69 were screened. In 2008, the detection rates were 6.1 and 3.7 per 1,000 women in initial and subsequent screening respectively. Corresponding recall rates are 3.9% and 2.2%, however, it is necessary to pay attention to further assessment performed during the screening visits. Benign to malignant open biopsy ratio was 0.1. Of invasive cases detected in screening, 35.6% was less than 10 mm in diameter. Values of early performance indicators, as measured by both crude and standardized estimates, are generally improving and fulfil desirable targets set by European Guidelines.Mammography screening in the Czech Republic underwent successful transformation from opportunistic prevention to an organised programme. Values of early indicators confirm continuous improvement in different aspects of process quality. Further stimulation of participation through invitation system is necessary to exploit the full potential of screening mammography at the population level.Breast cancer is the most frequent malignant neoplasm in women worldwide [1]. In the past, its incidence and mortality in Central and Eastern European countries were significantly lower than in Western Europe. Yet recent changes in reproductive behaviour of women accompanied by signific
Expression of matrix metalloproteinases (MMPs) in primary human breast cancer and breast cancer cell lines: New findings and review of the literature
Andrea K?hrmann, Ulrike Kammerer, Michaela Kapp, Johannes Dietl, Jelena Anacker
BMC Cancer , 2009, DOI: 10.1186/1471-2407-9-188
Abstract: To fill the gap in our knowledge about MMP expression in breast cancer, we analyzed the expression of all known human MMPs in a panel of twenty-five tissue samples (five normal breast tissues, ten grade 2 (G2) and ten grade 3 (G3) breast cancer tissues). As we found different expression levels for several MMPs in normal breast and breast cancer tissue as well as depending on tumor grade, we additionally analyzed the expression of MMPs in four breast cancer cell lines (MCF-7, MDA-MB-468, BT 20, ZR 75/1) commonly used in research. The results could thus be used as model for further studies on human breast cancer. Expression analysis was performed on mRNA and protein level using semiquantitative RT-PCR, Western blot, immunohistochemistry and immunocytochemistry.In summary, we identified several MMPs (MMP-1, -2, -8, -9, -10, -11, -12, -13, -15, -19, -23, -24, -27 and -28) with a stronger expression in breast cancer tissue compared to normal breast tissue. Of those, expression of MMP-8, -10, -12 and -27 is related to tumor grade since it is higher in analyzed G3 compared to G2 tissue samples. In contrast, MMP-7 and MMP-27 mRNA showed a weaker expression in tumor samples compared to healthy tissue. In addition, we demonstrated that the four breast cancer cell lines examined, are constitutively expressing a wide variety of MMPs. Of those, MDA-MB-468 showed the strongest mRNA and protein expression for most of the MMPs analyzed.MMP-1, -2, -8, -9, -10, -11, -12, -13, -15, -19, -23, -24, -27 and -28 might thus be associated with breast cancer development and tumor progression. Therefore, these MMPs are proper candidates for further functional analysis of their role in breast cancer.Breast cancer is the most common cancer affecting women in the world today. It is the leading cause of cancer related death for women aged between 35 and 55 years worldwide. One in nine women will suffer from breast cancer during her life and in excess 130 thousand women die from breast cancer each
The First Ten Years of Swift Supernovae  [PDF]
Peter J. Brown,Peter W. A. Roming,Peter A. Milne
Physics , 2015,
Abstract: The Swift Gamma Ray Burst Explorer has proven to be an incredible platform for studying the multiwavelength properties of supernova explosions. In its first ten years, Swift has observed over three hundred supernovae. The ultraviolet observations reveal a complex diversity of behavior across supernova types and classes. Even amongst the standard candle type Ia supernovae, ultraviolet observations reveal distinct groups. When the UVOT data is combined with higher redshift optical data, the relative populations of these groups appear to change with redshift. Among core-collapse supernovae, Swift discovered the shock breakout of two supernovae and the Swift data show a diversity in the cooling phase of the shock breakout of supernovae discovered from the ground and promptly followed up with Swift. Swift observations have resulted in an incredible dataset of UV and X-ray data for comparison with high-redshift supernova observations and theoretical models. Swift's supernova program has the potential to dramatically improve our understanding of stellar life and death as well as the history of our universe.
The Prevention of Hereditary Breast and Ovarian Cancer: A Personal View
Steven Narod
Hereditary Cancer in Clinical Practice , 2004, DOI: 10.1186/1897-4287-2-1-5
Abstract: It is nearly ten years since the BRCA1 gene was identified and genetic testing for breast cancer susceptibility is now widespread. During the last ten years we have come to accept that genetic testing can be done outside of research settings, that most women wish to have - and are capable of understanding - personal information about the risks and benefits of genetic testing and that routine pre-test psychological counselling is not mandatory. As a group, women do not suffer unduly from anxiety or depression following the receipt of a positive test result [1] (although we all know of exceptions to this rule). There is still uncertainty about the best estimate to give a carrier for her risks of breast and ovarian cancer. Some argue that different carriers should be given different risks depending on their family history, but this individualized approach to counselling is really too complicated to be practical. But we all agree that the risks are unacceptably high and that something needs to be done to lower them.It was a relatively straightforward task to establish that prophylactic mastectomy is effective. This has been shown in a small prospective study [2], and in historical cohort studies of primary [3] and contralateral [4] breast cancers. Here the data is consistent. Meijers-Heijboer and colleagues observed no case of breast cancer among 76 women who underwent prophylactic mastectomy after a mean follow-up of three years [2]. Metcalfe and colleagues studied 491 women treated for hereditary breast cancer [4]. Only one contralateral breast cancer was observed among 146 women who had undergone a contralateral mastectomy, versus 42 expected (p < 0.0001). Some debate remains about the optimal age of prophylactic mastectomy and about the best techniques for mastectomy and for reconstruction, but there are few who would argue against the effectiveness of the procedure. But our aim is to replace prophylactic mastectomy with something better. This will either come from
Cancer profile in Kolar: A ten years study  [cached]
Kalyani R,Das S,Bindra Singh M,Kumar HML
Indian Journal of Cancer , 2010,
Abstract: Context: Cancer profile varies in different regions and depends on race, lifestyle and diet. The study of a cancer profile helps to know the common cancers in a particular population, its probable risk factors and also helps in cancer control programs. AIM: To study the cancer profile at Kolar, based on Pathology Department records. Settings and Design: Retrospective study from January 1997 to December 2006. Materials and Methods: Cancer cases diagnosed by fine needle aspiration cytology (FNAC) and histopathology in the Department of Pathology were included in the study. The relevant history, clinical findings, and sociodemographic information of each case was retrieved from hospital records. Statistical Analysis Used: Descriptive statistics. Results: Out of a total of 19,615 cases reported at the Department of Pathology, 2,744 (13.98%) were cancer cases. The peak incidence was in the fifth decade in females and the seventh decade in males. Male : Female ratio was 0.7 : 1. Overall there was a steady rise in the number of cases from year 1997 to 2006. The top ten cancers in males were of oral cavity, stomach, esophagus, bone, non-Hodgkin′s lymphoma (NHL), prostate, liver, larynx, penis, and Hodgkin′s disease / bladder and those in females were oral cavity, cervix, breast, stomach, esophagus, thyroid, ovary, bone, rectum, and melanoma. Conclusions: Oral cavity and upper gastrointestinal cancers predominated in both genders. In females, cervical cancer predominated over breast cancer. Thyroid cancers were relatively more common in this region especially in females.
Breast cancer: ten-year follow-up of a cohort of patients admitted in the long-term illness  [PDF]
Vialaret K,Vidal P,Lecadet J,Baris B
Pratiques et Organisation des Soins , 2007,
Abstract: Aim: Describe the main clinical and therapeutic characteristicsfound upon inclusion, assess the overall survivaland per TNM stage, after ten years, of patients admittedfor long-term illnesses (ALD30 scheme) for breast cancer,in 1994, in Auvergne.Methods: Prospective follow-up of a cohort of patients,members of the main health insurance scheme in one offour départements in theAuvergne region and entitled tofull reimbursement of medical expenses on the basis ofanALD30 for breast cancer in 1994.After inclusion in thecohort, regular contact was planned for each patient. Onlydeaths caused by the breast cancer were consideredevents, all other causes of death were not taken intoaccount (censored observations). Analysis of observedsurvival was conducted using the Kaplan-Meier method.Results: This study involved 562 patients. Survival ratesacross all patients was 97% in the first year, 86% in fiveyears and 80% in ten years. Tumours that were smallerthan two centimetres without ganglionic invasion concerned41% of patients, for whom the survival rate at tenyears was 92% ± 4. It was 71% ± 5 for patients sufferingfrom more invasive tumours. At inclusion, treatment bysurgery and radiotherapy concerned 91% of less invasivetumours and 74% of other tumours.Conclusion: As with other studies, the results of our cohortstress the importance of early diagnosis in survival.
User Requirements Notation: The First Ten Years, The Next Ten Years (Invited Paper)  [cached]
Daniel Amyot,Gunter Mussbacher
Journal of Software , 2011, DOI: 10.4304/jsw.6.5.747-768
Abstract: The User Requirements Notation (URN), standardized by the International Telecommunication Union in 2008, is used to model and analyze requirements with goals and scenarios. This paper describes the first ten years of development of URN, and discusses ongoing efforts targeting the next ten years. We did a study inspired by the systematic literature review approach, querying five major search engines and using the existing URN Virtual Library. Based on the 281 scientific publications related to URN we collected and analyzed, we observe a shift from a more conventional use of URN for telecommunications and reactive systems to business process management and aspect-oriented modeling, with relevant extensions to the language being proposed. URN also benefits from a global and active research community, although industrial contributions are still sparse. URN is now a leading language for goal-driven and scenario-oriented modeling with a promising future for many application domains.
Favourable ten-year overall survival in a Caucasian population with high probability of hereditary breast cancer
Laura Cortesi, Cristina Masini, Claudia Cirilli, Veronica Medici, Isabella Marchi, Giovanna Cavazzini, Giuseppe Pasini, Daniela Turchetti, Massimo Federico
BMC Cancer , 2010, DOI: 10.1186/1471-2407-10-90
Abstract: We classified 5923 breast cancer patients registered between 1988 and 2006 at the Department of Oncology and Haematology in Modena, Italy, into one of three different risk categories according to Modena criteria. One thousand eleven patients at H and IS increased risk were tested for BRCA1/2 mutations. The overall survival (OS) and disease free survival (DFS) were the study end-points.Eighty BRCA1 carriers were identified. A statistically significantly better prognosis was observed for patients belonging to the H risk category with respect to women in the IS and sporadic groups (82% vs.75% vs.73%, respectively; p < 0.0001). Comparing only BRCA1 carriers with BRCA-negative and sporadic BC (77% vs.77% vs.73%, respectively; p < 0.001) an advantage in OS was seen.Patients belonging to a population with a high probability of being BRCA1 carriers had a better prognosis than those with sporadic BC. Considering these results, women who previously had BC and had survived ten years could be selected for BRCA1 analysis among family members at high risk of hereditary BC during genetic counselling. Since only 30% of patients with a high probability of having hereditary BC have BRCA1 mutations, selecting women with a long term survival among this population could increase the rate of positive analyses, avoiding the use of expensive tests.The major breast cancer (BC) predisposing genes, BRCA1 and BRCA2 were identified in 1994 and 1995, respectively [1,2]. Unfortunately, the optimal clinical approach to women who develop hereditary breast cancer remains incompletely defined. Studies of the outcomes of women with BRCA1/BRCA2-related cancer have yielded conflicting results. Several reports suggested that women with germline mutations in BRCA1 are more likely to die from their disease than are women with sporadic breast cancer [3-6], whereas BRCA2 mutation carriers and non-mutation carriers seem to share a similar prognosis [7,8]. The poor prognosis in BRCA1 carriers may be consistent
Breast ductal endoscopy: how many procedures qualify?
Flora Zagouri, Theodoros N Sergentanis, Georgia Giannakopoulou, Effrosyni Panopoulou, Dimosthenis Chrysikos, Garifallia Bletsa, John Flessas, George Filippakis, Alexandros Papalabros, Kostas J Bramis, George C Zografos
BMC Research Notes , 2009, DOI: 10.1186/1756-0500-2-115
Abstract: Ten breast fellows received training in our Breast Unit. For the training process, an ex vivo model was adopted. Fellows were trained on 20 surgical specimens derived from modified radical mastectomy for breast cancer. The target of the education program was to acquire proficiency in performing ductoscopy. The achievement of four consecutively successful ductal endoscopies was determined as the point beyond which proficiency had been achieved. The number of procedures needed for the achievement of proficiency as defined above ranged between 9 and 17 procedures. The median value was 13 procedures; i.e. 50% of trainees had achieved proficiency at the 13th procedure or earlier.These pilot findings point to approximately 13 procedures as a point beyond which ductal endoscopy is successfully performed; studies on a larger number of fellows are nevertheless needed. Further research, focusing on the learning curves of different training models of ductal endoscopy, seems desirable.Breast ductal endoscopy is a relatively new diagnostic method which is rapidly gaining ground with the advent of new generation endoscopies. Patients with bloody nipple discharge stand to benefit most from this method, due to its enhanced visualization of previously undetected areas of the breast ductal system [1,2].Indeed, the ability to perform ductal endoscopy is important and useful for breast fellows. Unfortunately, the learning curve in breast ductal endoscopy remains a terra incognita, since no systematic studies have addressed this topic. Various training models have been documented in the literature based on either ex vivo or in vivo specimens, but to date questions still remain [3]; is it an easy-to-learn procedure? The purpose of this study is to determine the point (number of procedures during training) beyond which ductal endoscopy is successfully performed.In this study, 10 breast fellows received training in our Breast Unit. All breast fellows had a minimum of three years experience
Age determines the prognostic role of the cancer stem cell marker aldehyde dehydrogenase-1 in breast cancer
J Sven D Mieog, Esther M de Kruijf, Esther Bastiaannet, Peter JK Kuppen, Anita Sajet, Anton JM de Craen, Vincent THBM Smit, Cornelis JH van de Velde, Gerrit-Jan Liefers
BMC Cancer , 2012, DOI: 10.1186/1471-2407-12-42
Abstract: The study population (N = 574) consisted of all early breast cancer patients primarily treated with surgery in our center between 1985 and 1994. Median follow-up was 17.9 years (range: 0.1 to 23.5). Tissue microarray slides were immunohistochemically stained for ALDH1 expression and quantified by two independent observers who were blinded to clinical outcome. Assessment of the prognostic effect of ALDH1 expression was stratified according to age and systemic treatment.Complete lack of expression of ALDH1 was found in 40% of tumors. With increasing age more tumors showed complete absence of ALDH1 expression (P < .001). In patients aged > 65 years, ALDH1 status was not associated with any clinical outcome. Conversely, in patients aged < 65 years, ALDH1 positivity was an independent risk factor of worse outcome for relapse free period (hazard ratio = 1.71 (95% CI, 1.09 to 2.68); P = .021) and relative survival (relative excess risks of death = 2.36 (95% CI, 1.22 to 3.68); P = .016). Ten-year relative survival risk was 57% in ALDH1-positive patients compared to 83% in ALDH1-negative patients.ALDH1 expression and its prognostic effect are age-dependent. Our results support the hypothesis that breast cancer biology is different in elderly patients compared to their younger counterparts and emphasizes the importance of taking into consideration age-specific interactions in breast cancer research.Age at diagnosis of breast cancer is an important independent prognostic factor. Young age is associated with more aggressive tumors with a relatively high risk of distant metastasis and loco-regional recurrence [1], whereas old age is associated with more indolent tumors [2,3]. Although tumor characteristics differ considerably between age groups (including hormone receptor and human epidermal growth factor receptor 2 (HER2) status), these tumor characteristics can only account for part of the divergence in survival witnessed between age groups [3]. Little is known about the impac
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